Enhancing parenteral therapy for anaemia among pregnant women in rural India.

Abstract

Setting: Primary care settings in a rural district of Telangana, India, under an anaemia control programme.

Objective: To explore the facilitators and barriers to parenteral iron therapy for moderate and severe anaemia, and possible solutions from the perspective of health care providers and pregnant women.

Design: A qualitative descriptive study. Twenty in-depth interviews and four focus group discussions were conducted with health care providers (primary care and district hospital) and postnatal mothers who had moderate or severe anaemia. Manual content analysis with inductive coding was done to identify themes and sub-themes.

Results: Facilitators included availability of IV iron at higher-level facilities, support from ASHAs (community health volunteers), community nutrition schemes, and growing access to digital health information. Barriers clustered around medicine stock-outs at lower-level facilities, transport difficulties, out-of-pocket costs, wage loss, need for escorts to hospitals, and strong fears and misconceptions about injections. Suggested solutions focused on uninterrupted IV iron supply, decentralised service delivery, capacity-building of frontline workers, digital and community-led communication strategies, and social support mechanisms.

Conclusion: Strengthening supply chains, decentralising parenteral iron therapy, and enhancing culturally sensitive counselling and community support are essential to improve uptake and completion of parenteral therapy in primary care settings.