New intervention for improving Iron and Folic Acid Supplementation during pregnancy

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Created On: 13/02/2023

The Anemia Implementation Science Initiative incorporated enhanced quality improvement (QI) activities into an integrated health project that used QI methodologies to discuss maternal iron-deficiency anaemia and reduced uptake of iron and folic acid supplementation (IFAS) among women in antenatal care (ANC) treatment centres in East-Central Uganda.

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Key take away

The use of an enhanced quality improvement + Implementation science technique can result in a considerable increase in the likelihood of pregnant women receiving iron and folic acid supplementation and health education about this supplementation in antenatal care.

Background

Method

An enhanced QI intervention was carried out from July 2019 to September 2020 to resolve the 2 constraints of stock-outs and inadequate medical awareness for pregnant women during ANC. This mixed-methods effectiveness study was based on a quasi-experimental design to evaluate whether the intervention augmented the availability of IFAS in the intervention districts.

The researchers used longitudinal facility-level data from two treatment districts and one comparison district for the quantitative outcomes. The effect of the intervention on IFAS health education and IFA availability at the health facility was studied with the help of difference-in-difference estimation.

Logistic regression modelling helped to investigate the factors linked with IFAS uptake and possible differences in the baseline values. For better understanding, exit conversations were performed with ANC clients and detailed conversations with providers and district managers.

Result

The probability of pregnant women both, receiving IFAS and health education on IFAS during ANC statistically increased meaningfully due to the intervention. Engagement of stakeholders and buy-in was also improved, which caused alteration at all levels of the health system, as per the examinees.

Conclusion

The two key constraints to the accessibility of IFAS for pregnant women attending ANC—poor provision of IFAS education and a weak drug quantification process were effectively taken care of with the help of the intervention. This method improved the district’s ability to support and control the IFAS commodities even without extra funds for the acquisition of commodities. In general, the ANC quality can also be reinforced.