References

Al-Qazaz HK, Hassali MA, Shafie AA, Syed Sulaiman SA, Sundram S Perception and knowledge of patients with type 2 diabetes in Malaysia about their disease and medication: a qualitative study. Res Social Adm Pharm. 2011; 7:(2)180-191 https://doi.org/10.1016/j.sapharm.2010.04.005

Appiah PK, Nkuah D, Bonchel DA Knowledge of and adherence to anaemia prevention strategies among pregnant women attending antenatal care facilities in Juaboso District in Western-North Region, Ghana. J Pregnancy. 2020; 2020:1-8 https://doi.org/10.1155/2020/2139892

Barnes L, Moss-Morris R, Kaufusi M Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients. N Z Med J. 2004; 117:(1188)

Beressa G, Lencha B, Bosha T, Egata G Utilization and compliance with iron supplementation and predictors among pregnant women in Southeast Ethiopia. Sci Rep. 2022; 12:(1) https://doi.org/10.1038/s41598-022-20614-9

Campbell S, Greenwood M, Prior S Purposive sampling: complex or simple? Research case examples. J Res Nurs. 2020; 25:(8)652-661 https://doi.org/10.1177/1744987120927206

Dwivedi S, Chopra D Adverse effects of herbal medicine. Clin Med. 2013; 13:(4)417-418 https://doi.org/10.7861/clinmedicine.13-4-417a

Fawzi W, Abdel Mohsen MY, Hashem AH, Moussa S, Coker E, Wilson KCM Beliefs about medications predict adherence to antidepressants in older adults. Int Psychogeriatr. 2012; 24:(1)159-169 https://doi.org/10.1017/S1041610211001049

Fiedler J, D'Agostino A, Sununtnasuk C Nutrition technical brief: a rapid initial assessment of the distribution and consumption of iron-folic acid tablets through antenatal care in Ghana.Arlington, VA: USAID; 2014

Funk F, Ryle P, Canclini C, Neiser S, Geisser P The new generation of intravenous iron: chemistry, pharmacology, and toxicology of ferric carboxymaltose. Arzneimittelforschung. 2010; 60:(6a)345-353

Goonewardene M, Shehata M, Hamad A Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012; 26:(1)3-24 https://doi.org/10.1016/j.bpobgyn.2011.10.010

Ghana demographic and health survey 2014.Rockville, Maryland, USA: ICF International; 2015

Holmgren C, Aagaard-Tillery KM, Silver RM, Porter TF, Varner M Hyperemesis in pregnancy: an evaluation of treatment strategies with maternal and neonatal outcomes. Am J Obstet Gynecol. 2008; 198:(1)56.e1-56.e4 https://doi.org/10.1016/j.ajog.2007.06.004

Jahani S, Elahi N, Shahinzade A, Hakim A, Latifi SM Relation of knowledge and attitude with control of medication in tuberculosis patients in Ahvaz Iran. Majallah-i Danishgah-i Ulum-i Pizishki-i Gurgan. 2011; 12:80-84

Kalimbira AA, Mtimuni BM, Chilima DM Maternal knowledge and practices related to anaemia and iron supplementation in rural Malawi: a cross-sectional study. Afr J Food Agric Nutr Dev. 2009; 9:(1)550-564 https://doi.org/10.4314/ajfand.v9i1.19212

Kangalgil M, Sahinler A, Kırkbir IB, Ozcelik AO Associations of maternal characteristics and dietary factors with anemia and iron-deficiency in pregnancy. J Gynecol Obstet Hum Reprod. 2021; 50:(8) https://doi.org/10.1016/j.jogoh.2021.102137

Kamau MW, Mirie W, Kimani S Compliance with iron and folic acid supplementation (IFAS) and associated factors among pregnant women: results from a cross-sectional study in Kiambu County, Kenya. BMC Public Health. 2018; 18:(1) https://doi.org/10.1186/s12889-018-5437-2

Kassa ZY, Awraris T, Daba AK, Tenaw Z Compliance with iron folic acid and associated factors among pregnant women through pill count in Hawassa city, South Ethiopia: a community based cross-sectional study. Reprod Health. 2019; 16:(1) https://doi.org/10.1186/s12978-019-0679-8

Lee NM, Saha S Nausea and vomiting of pregnancy. Gastroenterology clinics of North America. 2011; 40:(2)309-vii https://doi.org/10.1016/j.gtc.2011.03.009

Leila MD Relation between health beliefs and adherence in patients with hyperlipidemia. J Pharm Care. 2013; 1:(3)95-99

Mayes' midwifery. In: Macdonald S, Magill-Cuerden J (eds). London: Elsevier; 2011

Mithra P, Unnikrishnan B, Rekha T Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India. Afr Health Sci. 2014; 13:(4)880-885 https://doi.org/10.4314/ahs.v13i4.3

Mulder B, Bijlsma M, Schuiling-Veninga C Risks versus benefits of medication use during pregnancy: what do women perceive?. Patient Prefer Adherence. 2017; 12:1-8 https://doi.org/10.2147/PPA.S146091

Murray-Kolb LE, Beard JL Iron treatment normalizes cognitive functioning in young women. Am J Clin Nutr. 2007; 85:(3)778-787 https://doi.org/10.1093/ajcn/85.3.778

Murphy JF, O'Riordan J, Newcombe RG, Coles EC, Pearson JF Relation of haemoglobin levels in first and second trimesters to outcome of pregnancy. Lancet. 1986; 327:992-995 https://doi.org/10.1016/s0140-6736(86)91269-9

Musyoki MS, Thigiti J, Munyoki G Maternal related factors associated with compliance to iron and folic supplementation among pregnant mothers in Machakos County. Womens Health Sci J. 2019; 3:(2) https://doi.org/10.23880/whsj-16000136

Mwangi MN, Prentice MA, Verhoef H Safety and benefits of antenatal oral iron supplementation in low-income countries: a review. B J Haem. 2017; 177:(6)884-895

Nugraheni G, Sulistyarini A, Zairina E Beliefs about medicines in pregnancy: a survey using the beliefs about medicines questionnaire in Indonesia. Int J Clin Pharm. 2020; 42:(1)57-64 https://doi.org/10.1007/s11096-019-00937-w

Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C UK guidelines on the management of iron deficiency in pregnancy.London, UK: British Committee for Standards in Haematology; 2011

Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015; (7) https://doi.org/10.1002/14651858.CD004736.pub5

Posadzki P, Watson LK, Ernst E Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med. 2013; 13:(1)7-12 https://doi.org/10.7861/clinmedicine.13-1-7

Raghavan R, Ferlic-Stark L, Clarke C, Rungta M, Goodgame R The role of patient religiosity in the evaluation and treatment outcomes for chronic HCV infection. J Relig Health. 2013; 52:(1)79-90 https://doi.org/10.1007/s10943-011-9455-y

Ramsey JE, Greer I, Sattar N Obesity and reproduction. BMJ. 2006; 333:(7579)1159-1162 https://doi.org/10.1136/bmj.39049.439444.DE1

Said AS, Manji KP Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study. BMC Pregnancy Childbirth. 2016; 16:(1) https://doi.org/10.1186/s12884-016-1044-3

Sweileh WM, Zyoud SH, Abu Nab'a RJ Influence of patients' disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health. 2014; 14:(1) https://doi.org/10.1186/1471-2458-14-94

Taye B, Abeje G, Mekonen A Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study. Pan Afr Med J. 2015; 20 https://doi.org/10.11604/pamj.2015.20.43.4894

Tefera YG, Gebresillassie BM, Getnet Mersha A, Belachew SA Beliefs and risk awareness on medications among pregnant women attending the antenatal care unit in Ethiopia University Hospital. Front Public Health. 2020; 8

Tierson FD, Olsen CL, Hook EG Nausea and vomiting of pregnancy and association with pregnancy outcome. Am J Obstet Gynecol. 1986; 155

Twigg MJ, Lupattelli A, Nordeng H Women's beliefs about medication use during their pregnancy: a UK perspective. Int J Clin Pharm. 2016; 38:968-976

Levels and trends in child mortality: report 2014: estimates developed by the UN Inter Agency Group for Child Mortality Estimation.New York: United Nations Children's Fund; 2015

Vincze G, Barner JC, Lopez D Factors associated with adherence to self-monitoring of blood glucose among persons with diabetes. Diabetes Educ. 2004; 30:(1)112-125 https://doi.org/10.1177/014572170403000119

Weigel RM, Weigel MM Nausea and vomiting of early pregnancy and pregnancy outcome. A meta-analytical review. Br J Obstet Gynecol. 1989; 96:1312-1318

Guideline: daily iron and folic acid supplementation in pregnant women.Geneva, Switzerland: World Health Organization; 2014

Vitamin and mineral requirements in human nutrition.Geneva: World Health Organization; 2004

Understanding Cultural Health Beliefs and Practices in Ghana, Africa. 2016. http//ideaexchange.uakron.edu/honors_research_projects/276 (accessed 10 January 2024)

Pregnant women's perceptions of daily iron supplementation in rural Ghana

02 February 2024
Research
02 February 2024
Volume 32 · Issue 2

Abstract

Background/Aims

In Ghana, compliance with daily iron supplementation during pregnancy is low, particularly in the Tain district. This may be related to pregnant women's perceptions of iron supplements. The aim of this study was to explore pregnant women's perceptions of daily iron supplements in the Tain district.

Methods

This descriptive qualitative study used an interpretative approach. Data were gathered from a purposive sample of 20 pregnant mothers, through semi-structured interviews and face-to-face in-depth discussions. Data were analysed thematically.

Results

Women were unwilling to take iron supplements because of their belief that daily iron supplements make a baby too big for vaginal birth, leading to cervical tears, episiotomy or caesarean section. They were also concerned that supplements could cause nausea and vomiting during pregnancy, and excessive bleeding during labour and birth.

Conclusions

It is important to educate pregnant women on the benefits of iron supplementation during pregnancy and encourage them to acquire information from verified sources.

Iron is a vital requirement for the synthesis of haemoglobin. Iron deficiency anaemia is a major public health issue worldwide (Kamau et al, 2018; Musyoki et al, 2019). The risk of iron deficiency anaemia is higher in pregnant women, as the demand for physiological iron requirements increases during pregnancy to account for the needs of both the mother and the fetus. The World Health Organization (WHO, 2014) advocates for universal iron supplementation for pregnant women, recommending that they should receive a standard dose of 30–40mg of iron and 400µg of folic acid during pregnancy.

Globally, almost half of all pregnant women are anaemic and the majority of these women live in low- and middle-income countries (Goonewardene et al, 2012; United Nations Children's Fund et al, 2015; Musyoki et al, 2019). In Ghana, the prevalence of iron deficiency anaemia among pregnant women is estimated at 45% (Appiah et al, 2020). To maximise haemoglobin concentration and prevent anaemia during pregnancy, interventions typically include the provision of iron and folic acid supplements to pregnant women (Ghana Statistical Service et al, 2015). The approved dosage in Ghana is 60mg/day of ferrous sulphate and 400μg of folic acid, administered orally once daily for 180 days or more from preconception to birth. This is typically provided in a single combined iron and folic acid tablet (WHO, 2014).

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Daily uptake
Iron supplement
Medication
Pregnant women