Rethinking maternal IFA supplementation: A qualitative approach to understanding barriers and facilitators in Ayacucho, Peru

Abstract

The prevalence of anemia among women of reproductive age in Peru has increased recently despite government efforts to provide free iron and folic acid (IFA) supplements to pregnant women. Numerous quantitative studies have identified reasons for high discontinuation rates; however, this study provides qualitative insight into the nuances influencing Peruvian women's adherence to the supplementation regime. Twenty‐two in‐depth interviews were conducted with women 16 weeks gestation to two months post‐partum in urban, semi‐urban, and rural communities. Additionally, nine key participant interviews took place with obstetricians and directors of maternal health programs at the hospital and district levels. Results indicate that women do not take the generic form of the prescribed IFA tablets because they have a strong odor and taste, which make women feel nauseous. In order to overcome barriers to supplementation, providers should gain the trust of a patient during her first visit and particularly during her first pregnancy through successful counseling strategies. Providers would like a more reliable way to monitor women's adherence to the regimen, accomplished by conducting monthly visits to patients’ homes to provide more directed counseling. IFA programming efforts should consider alternative physical forms of the supplement that have a more appealing taste and are easier to ingest.Grant Funding Source : CARE Internatioal