Utilisation of iron and folic acid among pregnant women in a rural community of West Bengal: A mixed-methods study

Abstract Background: Iron-deficiency anaemia in pregnancy poses significant risks to maternal and foetal health. Methods: The present mixed-methods study was designed to estimate the prevalence of anaemia, to elicit adherence patterns of iron and folic acid (IFA) tablets intake among 158 pregnant mothers in the second and third trimester of pregnancy in a rural setting of West Bengal and also to explore the enabling and challenging factors regarding IFA tablets intake. Results: Prevalence of anaemia among the pregnant women was 52.5%, and overall adherence to IFA tablets was 67.7%. Adherence was higher among pregnant women with higher education levels and those from nuclear families. Forgetfulness followed by side effects due to IFA tablets were common causes for non-adherence to IFA. In qualitative analysis, health education by service providers, peer group and social support and free and regular supply of IFA tablets were identified as enabling factors, whereas unpalatability, side effects, competing priorities in the family and misconceptions were identified as challenging factors. Conclusions: Anaemia in pregnancy is still widely prevalent with missed opportunity to utilise the benefit of IFA supplementation. Addressing various challenges for adherence to IFA tablet intake is the need of an hour for reducing anaemia, thereby improving maternal and foetal health outcomes.