From Policy to Pastoralists: Rethinking Iron–Folate Supplementation Strategies in Ghana

Abstract

Background: Iron deficiency anaemia remains a pressing global health challenge, disproportionately affecting low- and middle-income countries where poverty, dietary insufficiencies, and health inequities intersect. Iron–folate supplementation (IFAS) is critical for reducing maternal anaemia and improving pregnancy outcomes. Yet adherence remains a persistent challenge in many low-resource and marginalised populations. Recent evidence from Ghana among Fulani pregnant women highlights both progress and persisting barriers: while nearly half accessed supplements, only one-third adhered to the regimen. This commentary situates these findings within broader evidence from Sub-Saharan Africa, identifying cultural, socioeconomic, and logistical determinants of adherence. Aims: This commentary article aims to rethink iron–folate supplementation strategies in Ghana. Methodology:  The published paper was among Fulani pregnant women in Ghana in 2022. We isolated the results from a published article and compared it with similar articles to draw policy directions and inform context-sensitive interventions. Results: We argue that without tailored, community-centred approaches including spousal engagement, culturally sensitive education, reminder systems, and strengthened supply chains, current strategies risk excluding pastoral and nomadic women from essential maternal health interventions. Conclusion: Addressing these inequities is central to achieving the Sustainable Development Goal (SDG) commitment of “leaving no one behind. ”The Fulani study provides a critical lens on maternal health inequities in Ghana. It reveals that adherence to IFAS is not merely a question of individual compliance but a reflection of systemic, cultural, and socioeconomic barriers.