Abstract
High prevalence of anemia and low iron and folic acid (IFA) consumption among pregnant women in Bihar has been identified as an important public health issue. Surveys have shown only 30% of Bihari women indicate receiving IFA and 23% report IFA counseling during their last pregnancy. To address this, we conducted twenty in‐depth interviews and focus group discussions in two districts of Bihar with three key types of frontline healthcare workers (FLWs) to explore their knowledge and awareness of anemia and IFA counseling techniques.FLWs attributed anemia to factors including poor diet, close child spacing, high parity, and lack of rest, which they perceived to stem from poverty, lack of awareness, low priority of women's status, and family tension. Many felt anemia was not a significant issue, estimating its prevalence as 0–20% (compared to survey estimates of 60%). FLWs tended to restrict IFA consumption to the 4th–8th month, and many reported that excess IFA intake can cause harm. In conclusion, Bihari FLWs had high knowledge of anemia causes but did not view it as a common issue in their communities. Further, their views of proper consumption windows may prevent added health benefits of IFA consumption during the 9th month and lactation from being realized. Efforts to allow IFA intake over a longer timeframe may increase the opportunity for women to receive IFA tablets and be a key step to increasing IFA consumption.Grant Funding Source: Funding support provided by a BMGF grant through a subcontract with CARE‐India
Published Version
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