Evidence map›Paper›PMID 39627760›Full record

ArticleBMC public health2024

A qualitative assessment of barriers to iron and folic acid supplementation among pregnant women in Botswana.

Poloko Kebaabetswe, Modiegi Diseko, Rebecca Zash, Gloria Mayondi, Judith Mabuta, Mompati Mmalane, Joseph Makhema, Shahin Lockman, Letumile Moeng, Elizabeth Lowenthal and 2 more

Abstract read
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Artificial intelligence for personalized multiple micronutrient supplementation in maternal health.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Poloko KebaabetsweBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Modiegi DisekoBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Rebecca ZashBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Gloria MayondiBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Judith MabutaBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Mompati MmalaneBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Joseph MakhemaBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Shahin LockmanBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Letumile MoengBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Elizabeth LowenthalDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
Roger ShapiroBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Ellen C CanigliaBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana. ellen.caniglia@pennmedicine.upenn.edu.

Funding

Birth Outcomes Surveillance in BotswanaR01HD080471 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2014 to 2018
$2.6M
Expansion of research and mentoring to improve birth outcomes and treatment outcomes among HIV-affected children in BotswanaK24AI131924 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Roger L Shapiro · 2018 to 2026
$1.6M
Decreasing Adverse Birth Outcomes among HIV-infected Women on Antiretroviral TherapyK23HD088230 · NICHD · BETH ISRAEL DEACONESS MEDICAL CENTER · PI ZASH, REBECCA MARIE · 2017 to 2021
$820k
NIAID NIH HHS K24 AI131924NICHD NIH HHS K23 HD088230NICHD NIH HHS R01 HD080471
6 · The paper itself

Abstract

backgroundAntenatal iron and folic acid (IFA) supplementation remains an effective strategy in the prevention of maternal anemia and low birthweight and is universally recommended by WHO. However, uptake of IFA has varied globally due to challenges with acceptability, supply and distribution, counselling and knowledge, and access to health services. In Botswana, nearly one-third of pregnant women engaged in antenatal care do not receive IFA, despite it being standard of care. The objectives of this study were to assess knowledge of and barriers and facilitators to IFA supplementation before and during pregnancy.

methodsWe conducted qualitative interviews with two key stakeholder groups at two different levels-the individual level (pregnant women) and the service delivery level (health care providers). Here, we present results from interviews with pregnant women at two representative antenatal clinic sites in Botswana in 2022.

resultsPregnant women were motivated to be healthy and were knowledgeable about the benefits of supplementation during pregnancy to mothers and their infants; however, women knew more about the benefits of iron than folic acid. Most women were in favor of receiving IFA supplementation prior to pregnancy and receiving fortified foods. Several key barriers were identified: lack of supplement availability in the clinics, poverty, side effects, number of tablets, and adherence. Approaches to overcome these barriers included improving supplement availability, improving health education, increasing supply of nutritious and fortified foods, backyard gardens, and increasing family and monetary support.

conclusionsOur study identified a need to 1) increase the availability of supplementation at antenatal clinics and 2) improve education regarding supplementation to include information about the benefits of folic acid and other micronutrients. Implementation research is needed to ascertain whether increasing supply and improving education could increase utilization of supplementation during pregnancy, with the ultimate goal of improving maternal and infant outcomes.

Indexed as

Dietary SupplementsFolic AcidHealth Knowledge, Attitudes, PracticeIronPrenatal CareQualitative ResearchAdolescentAdultBotswanaFemaleHealth Services AccessibilityHumansInterviews as TopicPregnancyPregnant PeopleYoung AdultFolic AcidIronAntenatal SupplementationBarriers and FacilitatorsFolic AcidIronPregnancy

Identifiers

PMID39627760
PMCPMC11616331

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.