Anaemia prevention among pregnant women: Views and experiences of pregnant women and antenatal care providers in Accra, Ghana

Abstract

Background and ObjectiveAnaemia among pregnant women is a public health challenge in Ghana. Although there isa national programme of routine iron-folic acid (IFA) supplementation, coverage issuboptimal. The current study explored experiences and perceptions of anaemiaprevention, and IFA use among pregnant women and antenatal care providers at twohospitals in Accra, Ghana, for enhancing the supplementation programme.MethodsUtilizing a qualitative approach, 6 focus group discussions with 48 purposively selectedpregnant women, and 10 in-depth interviews with care providers in two hospitals wereconducted. Interviews were transcribed verbatim. Using both deductive and inductiveapproaches, priori themes that informed the design of the interview guides, and emergingcodes from transcripts were used in data analysis.ResultsIn both hospitals, pregnant women reported awareness of anaemia and identified poorquality diets and failure to take IFA as the predominant causes. Regular IFAsupplementation, and consumption of fruits, vegetables, and animal-source foods wereindicated as the main anaemia remedies by the pregnant women. Turkey berry, beetroot,and hibiscus flower were also reported as therapeutic remedies for anaemia. IFA use waslinked with improved appetite, haemoglobin, and health status of mothers and their fetus.Both providers and pregnant women indicated that IFA is freely accessible throughgovernment facilities but may also be purchased. IFA supplements are recommended to betaken daily but three times for treatment; however, non-adherence to the recommendedfrequency was reported. This was attributed to adverse reactions including nausea andvomiting, unanticipated cost of increased appetite, forgetfulness to take IFA,misperceptions about adverse effects of IFA, transportation cost to access IFA, and longwaiting time at hospitals. Community-level focused antenatal care, follow-up visits, andphone calls were reported by providers as strategies to improve IFA uptake. Communitysensitization, enhanced access to IFA, and participatory approach to ANC services weresuggested by pregnant women as strategies for improving IFA uptake.ConclusionsFood insecurity and misperceptions about IFA should be addressed as part of efforts toaddress low IFA adherence and high maternal and child anaemia rates in Ghana.