{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:10:32Z","timestamp":1784308232845,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T00:00:00Z","timestamp":1470700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"SPARC Graduate Research Grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health\u2010service and social environments on utilization. Semi\u2010structured in\u2010depth interviews were conducted in Shona and English, with pregnant women (<jats:italic>n<\/jats:italic>\u2009=\u200924) and healthcare workers (<jats:italic>n<\/jats:italic>\u2009=\u200914) providing direct antenatal care services to pregnant women in two high\u2010density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non\u2010uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non\u2010utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. \u00a9 2016 John Wiley &amp; Sons Ltd<\/jats:p>","DOI":"10.1111\/mcn.12350","type":"journal-article","created":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T05:26:38Z","timestamp":1470720398000},"source":"Crossref","is-referenced-by-count":25,"title":["Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe"],"prefix":"10.1111","volume":"13","author":[{"given":"Chiwoneso B.","family":"Tinago","sequence":"first","affiliation":[{"name":"Department of Health, College of Health Sciences West Chester University  West Chester Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Annang Ingram","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine E.","family":"Blake","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Frongillo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/71.5.1280s"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980007000924"},{"key":"e_1_2_10_5_1","unstructured":"City of Harare. (2014)City Health Department 2013 Annual Report Harare Zimbabwe."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1999.0609"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","unstructured":"Darnton\u2010HillI.(2012)Global burden and significance of multiple micronutrient deficiencies in pregnancy. Available at:http:\/\/www.karger.com\/Article\/Abstract\/337421[Accessed July 15 2013].","DOI":"10.1159\/000337421"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1054\/midw.1999.0196"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2010.00261.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4314\/ajfand.v9i1.19209"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00185-X"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90135-X"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01312.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.02.015"},{"key":"e_1_2_10_15_1","volume-title":"Qualitative research design: an interactive approach","author":"Maxwell J.","year":"2013"},{"key":"e_1_2_10_16_1","unstructured":"Ministry of Health and Child Care. (2015)The focused antenatal care protocol. Ministry of Health and Child Care."},{"issue":"1","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1891\/1058-1243.12.1.42","article-title":"Nutrition and HIV\u2010positive pregnancy","volume":"12","author":"Montgomery K.S.","year":"2003","journal-title":"The Journal of Perinatal Education"},{"key":"e_1_2_10_18_1","unstructured":"MoraJ.O.(2007)Integrated anemia control strategy has significantly reduced anemia in women and children in Nicaragua.Ottawa Canada: Micronutrient Initiative. Available at:http:\/\/www.micronutrient.org\/CMFiles\/PubLib\/Nicaragua_Anemiacontrolprog_finalrpt1RXF\u201011272008\u20107660.pdf [Accessed September 16 2014]."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2011.00338.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12156"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.206565"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8020067"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-344"},{"issue":"12","key":"e_1_2_10_24_1","article-title":"Daily oral iron supplementation during pregnancy","author":"Pe\u00f1a\u2010Rosas J.P.","year":"2012","journal-title":"The Cochrane database of systematic reviews"},{"key":"e_1_2_10_25_1","volume-title":"The Coding Manual for Qualitative Researchers: Second Edition","author":"Salda\u00f1a J.","year":"2013"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265100312S202"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/83.5.993"},{"issue":"4","key":"e_1_2_10_28_1","first-page":"CD007536","article-title":"Routine pre\u2010pregnancy health promotion for improving pregnancy outcomes","author":"Whitworth M.","year":"2009","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_29_1","unstructured":"WHO. 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