{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:35:29Z","timestamp":1789875329851,"version":"4.0.1"},"reference-count":113,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Anaemia during pregnancy is a serious public health problem, inequitably burdening women in low-and middle-income countries. Despite numerous strategies and programs, anaemia prevalence rates have stagnated. We aimed to explore women\u2019s, health workers\u2019, and other key stakeholders\u2019 perceptions of anaemia in pregnant women, or their experiences with its prevention, testing, or treatment. We conducted a qualitative evidence synthesis. We searched MEDLINE (Ovid), Scopus, and CINAHL from inception to 12 November 2024, with no language or geographical restrictions. Data were analysed using thematic synthesis, and confidence in each review finding was assessed using the GRADE-CERQual approach. We included 61 papers from 23 countries. We grouped 25 review findings under four themes: (a) socio-cultural context of anaemia in pregnant women; (b) prevention and\/or treatment of anaemia in pregnant women through diet, supplementation, or clinical intervention; (c) testing pregnant women for anaemia; and (d) factors affecting health workers\u2019 engagement in the management of anaemia in pregnant women. Women\u2019s management of anaemia in pregnancy was affected by the socio-cultural context, particularly their limited decision-making power and social position. Many women perceived a nutritious diet as integral to managing anaemia; however, high cost was often a barrier. Reasons women did not adhere to supplements included side-effects and difficulty remembering to take them, with family support improving adherence. Blood transfusion was perceived as treatment for severe anaemia, while intravenous iron was considered for women with iron-deficiency anaemia who were unable to take supplements, attended antenatal care late, or could not receive a transfusion. Health workers described difficulties testing pregnant women for anaemia and structural health-system deficiencies that affected their engagement. Findings may inform future WHO recommendations for managing anaemia in pregnant women. Future research could use review findings alongside implementation science frameworks to develop strategies for improving prevention, testing, and\/or treatment of anaemia in pregnant women.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005158","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T17:23:45Z","timestamp":1759339425000},"page":"e0005158","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perceptions and experiences of the prevention, testing, and treatment of anaemia in pregnant women: A qualitative evidence synthesis"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5711-6715","authenticated-orcid":true,"given":"Ebony","family":"Verbunt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Vazquez","family":"Corona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zge","family":"Tun\u00e7alp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3516-5812","authenticated-orcid":true,"given":"Lisa M.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9194-6472","authenticated-orcid":true,"given":"Khic-Houy","family":"Prang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Vaughan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4179-4682","authenticated-orcid":true,"given":"Meghan A.","family":"Bohren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"1","key":"pgph.0005158.ref001","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s13045-021-01202-2","article-title":"Burden of anemia and its underlying causes in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019","volume":"14","author":"S Safiri","year":"2021","journal-title":"J Hematol Oncol"},{"issue":"1","key":"pgph.0005158.ref002","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/nyas.14092","article-title":"Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries","volume":"1450","author":"CM Chaparro","year":"2019","journal-title":"Ann N Y Acad Sci"},{"issue":"8","key":"pgph.0005158.ref003","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.3390\/nu13082745","article-title":"Anemia among Women of Reproductive Age: An Overview of Global Burden, Trends, Determinants, and Drivers of Progress in Low- and Middle-Income Countries","volume":"13","author":"A Owais","year":"2021","journal-title":"Nutrients"},{"key":"pgph.0005158.ref004","volume-title":"Prevalence of anaemia in women of reproductive age (aged 15-49) (%), by pregnancy status","author":"World Health Organization","year":"2025"},{"key":"pgph.0005158.ref005","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience","author":"World Health Organization","year":"2016"},{"issue":"2","key":"pgph.0005158.ref006","doi-asserted-by":"crossref","first-page":"278","DOI":"10.3390\/biomedicines12020278","article-title":"Is It Time to Alter the Standard of Care for Iron Deficiency\/Iron Deficiency Anemia in Reproductive-Age Women?","volume":"12","author":"MB Bellad","year":"2024","journal-title":"Biomedicines"},{"issue":"2","key":"pgph.0005158.ref007","article-title":"Anemia in Pregnancy: ACOG Practice Bulletin, Number 233","volume":"138","author":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins \u2013 Obstetrics","year":"2021","journal-title":"Obstet Gynecol"},{"key":"pgph.0005158.ref008","volume-title":"Patient Blood Management Guidelines: Module 5 - Obstetrics and Maternity","author":"National Blood Authority NBA","year":"2015"},{"issue":"6","key":"pgph.0005158.ref009","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/bjh.16221","article-title":"UK guidelines on the management of iron deficiency in pregnancy","volume":"188","author":"S Pavord","year":"2019","journal-title":"Br J Haematol"},{"key":"pgph.0005158.ref010","volume-title":"Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors","author":"M Ezzati","year":"2004"},{"key":"pgph.0005158.ref011","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/978-3-030-75385-6_29","article-title":"Anaemia in Pregnancy.","volume-title":"Contemporary Obstetrics and Gynecology for Developing Countries","author":"O Ogunbode","year":"2021"},{"issue":"1","key":"pgph.0005158.ref012","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12884-023-05489-6","article-title":"Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes: an updated global systematic review and meta-analysis","volume":"23","author":"MF Young","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"issue":"9516","key":"pgph.0005158.ref013","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0140-6736(06)68397-9","article-title":"WHO analysis of causes of maternal death: a systematic review","volume":"367","author":"KS Khan","year":"2006","journal-title":"Lancet"},{"issue":"5","key":"pgph.0005158.ref014","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(18)30078-0","article-title":"Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis","volume":"6","author":"J Daru","year":"2018","journal-title":"Lancet Glob Health"},{"issue":"23","key":"pgph.0005158.ref015","first-page":"2199","article-title":"Benefits and Risks of Iron Interventions in Infants in Bangladesh. Reply","volume":"385","author":"S-R Pasricha","year":"2021","journal-title":"N Engl J Med"},{"key":"pgph.0005158.ref016","volume-title":"Accelerating anaemia reduction: a comprehensive framework for action","author":"World Health Organization","year":"2023"},{"key":"pgph.0005158.ref017","volume-title":"Global nutrition targets 2025: anaemia policy brief","author":"World Health Organization","year":"2014"},{"issue":"12","key":"pgph.0005158.ref018","article-title":"Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study","volume":"3","author":"DM Ba","year":"2019","journal-title":"Curr Dev Nutr"},{"key":"pgph.0005158.ref019","article-title":"Barriers and enablers for iron folic acid (IFA) supplementation in pregnant women","author":"K Siekmans","year":"2018","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pgph.0005158.ref020","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s12961-019-0467-5","article-title":"Qualitative Evidence Synthesis (QES) for Guidelines: Paper 1 - Using qualitative evidence synthesis to inform guideline scope and develop qualitative findings statements","volume":"17","author":"S Downe","year":"2019","journal-title":"Health Res Policy Syst"},{"key":"pgph.0005158.ref021","volume-title":"Cochrane qualitative evidence synthesis: Protocol and review template","author":"C Glenton","year":"2023"},{"issue":"7","key":"pgph.0005158.ref022","article-title":"Daily oral iron supplementation during pregnancy","volume":"2015","author":"JP Pe\u00f1a-Rosas","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"pgph.0005158.ref023","article-title":"Intermittent oral iron supplementation during pregnancy","volume":"2015","author":"JP Pe\u00f1a-Rosas","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"pgph.0005158.ref024","author":"Covidence","year":"n.d"},{"key":"pgph.0005158.ref025","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/1471-2288-8-45","article-title":"Methods for the thematic synthesis of qualitative research in systematic reviews","volume":"8","author":"J Thomas","year":"2008","journal-title":"BMC Med Res Methodol"},{"key":"pgph.0005158.ref026","volume-title":"NVivo 14","author":"QSR International","year":"2023","edition":"14"},{"key":"pgph.0005158.ref027","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13012-017-0688-3","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series","volume":"13","author":"S Lewin","year":"2018","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref028","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13012-017-0689-2","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table","volume":"13","author":"S Lewin","year":"2018","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref029","volume-title":"Cochrane qualitative evidence synthesis: Protocol and review template","author":"C Glenton","year":"2023"},{"key":"pgph.0005158.ref030","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13012-017-0690-9","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations","volume":"13","author":"H Munthe-Kaas","year":"2018","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref031","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13012-017-0691-8","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence","volume":"13","author":"CJ Colvin","year":"2018","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref032","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13012-017-0692-7","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data","volume":"13","author":"C Glenton","year":"2018","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref033","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13012-017-0693-6","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data","volume":"13","author":"J Noyes","year":"2018","journal-title":"Implement Sci"},{"issue":"8","key":"pgph.0005158.ref034","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003610","article-title":"Prevention and management of anaemia in pregnancy: Community perceptions and facility readiness in Ghana and Uganda","volume":"4","author":"T Tancred","year":"2024","journal-title":"PLOS Glob Public Health"},{"issue":"1","key":"pgph.0005158.ref035","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000534708","article-title":"Anemia in Pregnancy: Study Phenomenology","volume":"42","author":"RD Pasaribu","year":"2024","journal-title":"Port J Public Health"},{"key":"pgph.0005158.ref036","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ejogrb.2024.03.005","article-title":"The Experience of Anaemia and Ingesting Oral Iron Supplementation in Pregnancy: A Qualitative Study","volume":"297","author":"FE O\u2019Toole","year":"2024","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"2","key":"pgph.0005158.ref037","doi-asserted-by":"crossref","first-page":"77","DOI":"10.12968\/bjom.2024.32.2.77","article-title":"Pregnant women\u2019s perceptions of daily iron supplementation in rural Ghana","volume":"32","author":"L Ferka","year":"2024","journal-title":"British Journal of Midwifery"},{"issue":"2","key":"pgph.0005158.ref038","doi-asserted-by":"crossref","first-page":"46","DOI":"10.30597\/mkmi.v20i2.32569","article-title":"Supports and Barriers Regarding The Iron-Folic Acid Supplementation Adherence Level in Anemic Pregnant Women: Indonesian\u2019s Perspective","volume":"20","author":"RN Atmadani","year":"2024","journal-title":"MKMI"},{"issue":"1","key":"pgph.0005158.ref039","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12978-024-01743-y","article-title":"Acceptability of IV iron treatment for iron deficiency anaemia in pregnancy in Nigeria: a qualitative study with pregnant women, domestic decision-makers, and health care providers","volume":"21","author":"OR Akinajo","year":"2024","journal-title":"Reprod Health"},{"issue":"1","key":"pgph.0005158.ref040","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s43058-024-00609-5","article-title":"Implementation fidelity of intravenous ferric carboxymaltose administration for iron deficiency anaemia in pregnancy: a mixed-methods study nested in a clinical trial in Nigeria","volume":"5","author":"OR Akinajo","year":"2024","journal-title":"Implement Sci Commun"},{"issue":"1","key":"pgph.0005158.ref041","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0000825","article-title":"Adherence to iron and folate supplementation and associated factors among women attending antenatal care in public health facilities at Covid-19 pandemic in Ethiopia","volume":"3","author":"AA Tefera","year":"2023","journal-title":"PLOS Glob Public Health"},{"issue":"11","key":"pgph.0005158.ref042","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.4103\/jfmpc.jfmpc_1089_23","article-title":"Predictors of maternal and fetal outcome in severely anemic pregnant mothers: A sequential mixed methods study","volume":"12","author":"V Saraswathy","year":"2023","journal-title":"J Family Med Prim Care"},{"key":"pgph.0005158.ref043","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/jehp.jehp_1008_22","article-title":"Sociocultural and drug-related factors associated with adherence to iron-folic acid supplementation among pregnant women - A mixed-methods study","volume":"12","author":"LP Muthuraj","year":"2023","journal-title":"J Educ Health Promot"},{"issue":"2","key":"pgph.0005158.ref044","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1017\/S0007114522003208","article-title":"Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study","volume":"130","author":"J Morrison","year":"2023","journal-title":"Br J Nutr"},{"key":"pgph.0005158.ref045","doi-asserted-by":"crossref","first-page":"288","DOI":"10.12688\/f1000research.130980.1","article-title":"Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision","volume":"12","author":"A Kuliya-Gwarzo","year":"2023","journal-title":"F1000Res"},{"issue":"4","key":"pgph.0005158.ref046","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0283631","article-title":"Attention for and awareness of anemia in adolescents in Karnataka, India: A qualitative study","volume":"18","author":"B Gillespie","year":"2023","journal-title":"PLoS One"},{"issue":"11","key":"pgph.0005158.ref047","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001310","article-title":"Barriers and facilitators of micronutrient supplementation among non-pregnant women of reproductive age in Johannesburg, South Africa","volume":"2","author":"TM Silubonde","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"pgph.0005158.ref048","doi-asserted-by":"crossref","first-page":"66","DOI":"10.12688\/gatesopenres.13631.2","article-title":"Perceptions and experiences of intravenous iron treatment for anaemia in pregnancy in Malawi: a formative qualitative study","volume":"6","author":"L Manda-Taylor","year":"2022","journal-title":"Gates Open Res"},{"issue":"6","key":"pgph.0005158.ref049","doi-asserted-by":"crossref","DOI":"10.9745\/GHSP-D-21-00426","article-title":"Improving Iron and Folic Acid Supplementation Among Pregnant Women: An Implementation Science Approach in East-Central Uganda","volume":"10","author":"AK Luwangula","year":"2022","journal-title":"Glob Health Sci Pract"},{"key":"pgph.0005158.ref050","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3889\/oamjms.2022.7617","article-title":"Husband\u2019s Perception on Anemia among Pregnant Women based on Cultural Perspective: A Qualitative Study","volume":"10","author":"D Darmawati","year":"2022","journal-title":"Open Access Maced J Med Sci"},{"key":"pgph.0005158.ref051","article-title":"Exploring Indonesian mothers\u2019 perspectives on anemia during pregnancy: A qualitative approach","author":"D Darmawati","year":"2022","journal-title":"Enferm Clin (Engl Ed)"},{"key":"pgph.0005158.ref052","article-title":"Addressing anaemia in pregnancy in rural plains Nepal: A qualitative, formative study","author":"J Morrison","year":"2021","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pgph.0005158.ref053","doi-asserted-by":"crossref","DOI":"10.25159\/2520-5293\/6948","article-title":"Barriers to Optimal Iron Supplementation by Pregnant Women Attending the Mutare City Clinic, Manicaland, Zimbabwe","volume":"23","author":"P Mahundi","year":"2021","journal-title":"AJNM"},{"issue":"2","key":"pgph.0005158.ref054","doi-asserted-by":"crossref","first-page":"119","DOI":"10.20473\/jn.v16i2.27418","article-title":"Perspectives of Pregnant Women Regarding Iron Deficiency Anemia","volume":"16","author":"S Klankhajhon","year":"2021","journal-title":"J Ners"},{"key":"pgph.0005158.ref055","doi-asserted-by":"crossref","first-page":"80","DOI":"10.12688\/wellcomeopenres.16699.2","article-title":"Adherence to iron and folic acid supplementation during pregnancy among postnatal mothers seeking maternal and child healthcare at Kakamega level 5 hospital in Kenya: a cross-sectional study","volume":"6","author":"F Bahati","year":"2021","journal-title":"Wellcome Open Res"},{"issue":"4","key":"pgph.0005158.ref056","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0249360","article-title":"Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study","volume":"16","author":"S Aziz Ali","year":"2021","journal-title":"PLoS One"},{"issue":"5","key":"pgph.0005158.ref057","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1017\/S1368980019003938","article-title":"Strategies to address anaemia among pregnant and lactating women in India: a formative research study","volume":"23","author":"PA Williams","year":"2020","journal-title":"Public Health Nutr"},{"issue":"1","key":"pgph.0005158.ref058","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1186\/s12884-020-02883-2","article-title":"Predictors of prenatal iron folic acid supplement utilization in Wolaita, South Ethiopia: a community based cross-sectional study (quantitative and qualitative approach)","volume":"20","author":"EW Wana","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pgph.0005158.ref059","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1186\/s12889-020-08574-z","article-title":"Moving beyond individual barriers and identifying multi-level strategies to reduce anemia in Odisha India","volume":"20","author":"E Sedlander","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"pgph.0005158.ref060","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s40795-020-00403-1","article-title":"Implementation fidelity of nutritional counselling, iron and folic acid supplementation guidelines and associated challenges in rural Uasin Gishu County Kenya","volume":"6","author":"RM Riang\u2019a","year":"2020","journal-title":"BMC Nutr"},{"issue":"1","key":"pgph.0005158.ref061","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1186\/s12913-020-05274-7","article-title":"Improving the effectiveness of point of care tests for malaria and anaemia: a qualitative study across three Ghanaian antenatal clinics","volume":"20","author":"T Palmer","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"pgph.0005158.ref062","doi-asserted-by":"crossref","first-page":"3127245","DOI":"10.1155\/2020\/3127245","article-title":"Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania","volume":"2020","author":"WB Lyoba","year":"2020","journal-title":"Int J Reprod Med"},{"issue":"10","key":"pgph.0005158.ref063","doi-asserted-by":"crossref","first-page":"5205","DOI":"10.4103\/jfmpc.jfmpc_721_20","article-title":"Adherence to iron and folic acid supplementation among antenatal mothers attending a tertiary care center, Puducherry: A mixed-methods study","volume":"9","author":"P Lavanya","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"1","key":"pgph.0005158.ref064","article-title":"Time for change is now: Experiences of participants in a community-based approach for iron and folic acid supplementation in a rural county in Kenya, a qualitative study","volume":"15","author":"MW Kamau","year":"2020","journal-title":"PLoS One"},{"key":"pgph.0005158.ref065","doi-asserted-by":"crossref","first-page":"8597174","DOI":"10.1155\/2020\/8597174","article-title":"Barriers to Health Workers in Iron Deficiency Anemia Prevention among Indonesian Pregnant Women","volume":"2020","author":"D Darmawati","year":"2020","journal-title":"Anemia"},{"key":"pgph.0005158.ref066","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/8710254","article-title":"Acehnese Cultural Leaders\u2019 Perspective on Anemia in Pregnant Women: A Qualitative Study","volume":"2020","author":"D Darmawati","year":"2020","journal-title":"Advances in Public Health"},{"issue":"1","key":"pgph.0005158.ref067","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1186\/s12884-020-02993-x","article-title":"Antenatal testing for anaemia, HIV and syphilis in Indonesia - a health systems analysis of low coverage","volume":"20","author":"C Baker","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pgph.0005158.ref068","doi-asserted-by":"crossref","first-page":"20","DOI":"10.11591\/ijphs.v9i1.20385","article-title":"Adherence to iron and folic acid supplementation and associated factors among antenatal care attendants in Northwest Ethiopia","volume":"9","author":"BA Mekonnen","year":"2020","journal-title":"IJPHS"},{"issue":"1","key":"pgph.0005158.ref069","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12913-018-3844-9","article-title":"Integrated point-of-care testing (POCT) for HIV, syphilis, malaria and anaemia at antenatal facilities in western Kenya: a qualitative study exploring end-users\u2019 perspectives of appropriateness, acceptability and feasibility","volume":"19","author":"N Young","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"pgph.0005158.ref070","first-page":"491","article-title":"Micronutrient intake and perceived barriers among anaemic pregnant women in Aceh, Indonesia","volume":"31","author":"P Nahrisah","year":"2019","journal-title":"J Ayub Med Coll Abbottabad"},{"issue":"1","key":"pgph.0005158.ref071","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s12913-018-3017-x","article-title":"Identifying bottlenecks in the iron and folic acid supply chain in Bihar, India: a mixed-methods study","volume":"18","author":"AS Wendt","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"pgph.0005158.ref072","doi-asserted-by":"crossref","first-page":"118","DOI":"10.5993\/AJHB.42.4.11","article-title":"Perceptions of Alternative Tobacco Products, Anti-tobacco Media, and Tobacco Regulation among Young Adults: A Qualitative Study","volume":"42","author":"B Getachew","year":"2018","journal-title":"Am J Health Behav"},{"key":"pgph.0005158.ref073","article-title":"Ethiopian women\u2019s perspectives on antenatal care and iron-folic acid supplementation: Insights for translating global antenatal calcium guidelines into practice","author":"Z Birhanu","year":"2018","journal-title":"Matern Child Nutr"},{"issue":"3","key":"pgph.0005158.ref074","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.12350","article-title":"Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe","volume":"13","author":"CB Tinago","year":"2017","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pgph.0005158.ref075","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.12233","article-title":"Translating formative research findings into a behaviour change strategy to promote antenatal calcium and iron and folic acid supplementation in western Kenya","volume":"13","author":"SL Martin","year":"2017","journal-title":"Matern Child Nutr"},{"issue":"3","key":"pgph.0005158.ref076","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.12331","article-title":"Adherence partners are an acceptable behaviour change strategy to support calcium and iron-folic acid supplementation among pregnant women in Ethiopia and Kenya","volume":"13","author":"SL Martin","year":"2017","journal-title":"Matern Child Nutr"},{"issue":"3","key":"pgph.0005158.ref077","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1891\/2156-5287.6.3.183","article-title":"Perceived Barriers and Facilitators of a New Model in Managing Pregnant Women With Iron Deficiency Anemia: A Qualitative Study","volume":"6","author":"W Widyawati","year":"2016","journal-title":"Int J Childbirth"},{"issue":"1","key":"pgph.0005158.ref078","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s41043-016-0066-9","article-title":"Anaemia is typical of pregnancies: capturing community perception and management of anaemia in pregnancy in Anambra State, Nigeria","volume":"35","author":"NG Onyeneho","year":"2016","journal-title":"J Health Popul Nutr"},{"issue":"1","key":"pgph.0005158.ref079","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s41043-016-0068-7","article-title":"Factors associated with compliance to recommended micronutrients uptake for prevention of anemia during pregnancy in urban, peri-urban, and rural communities in Southeast Nigeria","volume":"35","author":"NG Onyeneho","year":"2016","journal-title":"J Health Popul Nutr"},{"issue":"2","key":"pgph.0005158.ref080","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/ajo.12417","article-title":"Intravenous iron: barriers and facilitators to its use at nine maternity hospitals in New South Wales, Australia","volume":"56","author":"E Mayson","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"2","key":"pgph.0005158.ref081","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1177\/0379572116637721","article-title":"Determinants of Persistent Anemia in Poor, Urban Pregnant Women of Chandigarh City, North India: A Mixed Method Approach","volume":"37","author":"NG Diamond-Smith","year":"2016","journal-title":"Food Nutr Bull"},{"key":"pgph.0005158.ref082","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12884-015-0478-3","article-title":"A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives","volume":"15","author":"W Widyawati","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"pgph.0005158.ref083","article-title":"Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda","author":"U Baker","year":"2015","journal-title":"Int J Gynaecol Obstet"},{"key":"pgph.0005158.ref084","doi-asserted-by":"crossref","first-page":"781973","DOI":"10.1155\/2015\/781973","article-title":"Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study","volume":"2015","author":"A Arega Sadore","year":"2015","journal-title":"J Environ Public Health"},{"key":"pgph.0005158.ref085","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s12889-015-1697-2","article-title":"How can formative research inform the design of an iron-folic acid supplementation intervention starting in first trimester of pregnancy in Bangladesh?","volume":"15","author":"A Alam","year":"2015","journal-title":"BMC Public Health"},{"key":"pgph.0005158.ref086","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1186\/1471-2393-14-344","article-title":"Perceptions of antenatal iron-folic acid supplements in urban and rural Pakistan: a qualitative study","volume":"14","author":"YB Nisar","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"issue":"8","key":"pgph.0005158.ref087","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1007\/s10995-014-1443-x","article-title":"\u201cThere is iron and iron\u2026\u201d Burkinab\u00e8 women\u2019s perceptions of iron supplementation: a qualitative study","volume":"18","author":"A Compaore","year":"2014","journal-title":"Matern Child Health J"},{"issue":"3","key":"pgph.0005158.ref088","doi-asserted-by":"crossref","DOI":"10.1016\/j.midw.2013.10.012","article-title":"\u201cThis is normal during pregnancy\u201d: a qualitative study of anaemia-related perceptions and practices among pregnant women in Mumbai, India","volume":"30","author":"N Chatterjee","year":"2014","journal-title":"Midwifery"},{"issue":"3","key":"pgph.0005158.ref089","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1177\/1010539511403133","article-title":"Determinants of adherence to iron\/folate supplementation during pregnancy in two provinces in Cambodia","volume":"23","author":"P Lacerte","year":"2011","journal-title":"Asia Pac J Public Health"},{"issue":"5","key":"pgph.0005158.ref090","first-page":"401","article-title":"Cultural representations about anaemia and supplement with iron","volume":"108","author":"G Sammartino","year":"2010","journal-title":"Arch Argent Pediatr"},{"issue":"1","key":"pgph.0005158.ref091","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1740-8709.2004.00002.x","article-title":"Linking traditional treatments of maternal anaemia to iron supplement use: an ethnographic case study from Pemba Island, Zanzibar","volume":"1","author":"SL Young","year":"2005","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pgph.0005158.ref092","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/156482650202300109","article-title":"Toward better compliance with iron-folic acid supplements: understanding the behavior of poor urban pregnant women through ethnographic decision models in Vadodara, India","volume":"23","author":"J Ghanekar","year":"2002","journal-title":"Food Nutr Bull"},{"issue":"4","key":"pgph.0005158.ref093","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0277-9536(01)00185-X","article-title":"Women\u2019s perceptions of iron deficiency and anemia prevention and control in eight developing countries","volume":"55","author":"R Galloway","year":"2002","journal-title":"Soc Sci Med"},{"issue":"2","key":"pgph.0005158.ref094","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1054\/midw.1999.0196","article-title":"Community attitudes to pregnancy, anaemia, iron and folate supplementation in urban and rural Lagos, south-western Nigeria","volume":"16","author":"OO Ejidokun","year":"2000","journal-title":"Midwifery"},{"issue":"6","key":"pgph.0005158.ref095","article-title":"Provision and uptake of routine antenatal services: a qualitative evidence synthesis","volume":"6","author":"S Downe","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"pgph.0005158.ref096","doi-asserted-by":"crossref","first-page":"100865","DOI":"10.1016\/j.mam.2020.100865","article-title":"Oral iron supplementation in iron-deficient women: How much and how often?","volume":"75","author":"NU Stoffel","year":"2020","journal-title":"Mol Aspects Med"},{"issue":"2","key":"pgph.0005158.ref097","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(23)00468-0","article-title":"A global analysis of the determinants of maternal health and transitions in maternal mortality","volume":"12","author":"JP Souza","year":"2024","journal-title":"Lancet Glob Health"},{"issue":"12","key":"pgph.0005158.ref098","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-070677","article-title":"Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review","volume":"13","author":"G Cormick","year":"2023","journal-title":"BMJ Open"},{"issue":"1","key":"pgph.0005158.ref099","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1182\/asheducation-2016.1.57","article-title":"Single-dose intravenous iron for iron deficiency: a new paradigm","volume":"2016","author":"M Auerbach","year":"2016","journal-title":"Hematology Am Soc Hematol Educ Program"},{"issue":"2","key":"pgph.0005158.ref100","doi-asserted-by":"crossref","first-page":"491","DOI":"10.3390\/microbiolres12020033","article-title":"Oral Iron Supplementation\u2014Gastrointestinal Side Effects and the Impact on the Gut Microbiota","volume":"12","author":"SR Bloor","year":"2021","journal-title":"Microbiology Research"},{"issue":"2","key":"pgph.0005158.ref101","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0117383","article-title":"Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis","volume":"10","author":"Z Tolkien","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pgph.0005158.ref102","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1186\/s13063-022-06690-2","article-title":"Intravenous versus oral iron for iron deficiency anaemia in pregnant Nigerian women (IVON): study protocol for a randomised hybrid effectiveness-implementation trial","volume":"23","author":"BB Afolabi","year":"2022","journal-title":"Trials"},{"key":"pgph.0005158.ref103","unstructured":"Australian New Zealand Clinical Trials Registry. Randomized controlled trial of the effect of intraVenous iron on anaemia in Malawian pregnant women. 2018 [cited 2021 November 23]. https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=375587"},{"key":"pgph.0005158.ref104","unstructured":"Australian New Zealand Clinical Trials Registry. Efficacy and demonstration of intravenous iron for anaemia in pregnancy (EDIVA). 2021 [cited 2021 November 30]https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=382186&isReview=true"},{"issue":"1","key":"pgph.0005158.ref105","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1186\/s13063-021-05549-2","article-title":"RAPIDIRON: Reducing Anaemia in Pregnancy in India-a 3-arm, randomized-controlled trial comparing the effectiveness of oral iron with single-dose intravenous iron in the treatment of iron deficiency anaemia in pregnant women and reducing low birth weight deliveries","volume":"22","author":"RJ Derman","year":"2021","journal-title":"Trials"},{"issue":"11","key":"pgph.0005158.ref106","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-053288","article-title":"Protocol for a multicentre, parallel-group, open-label randomised controlled trial comparing ferric carboxymaltose with the standard of care in anaemic Malawian pregnant women: the REVAMP trial","volume":"11","author":"MN Mwangi","year":"2021","journal-title":"BMJ Open"},{"issue":"1","key":"pgph.0005158.ref107","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s43058-022-00299-x","article-title":"An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol","volume":"3","author":"K-H Prang","year":"2022","journal-title":"Implement Sci Commun"},{"issue":"10388","key":"pgph.0005158.ref108","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1016\/S0140-6736(23)00278-7","article-title":"Ferric carboxymaltose versus standard-of-care oral iron to treat second-trimester anaemia in Malawian pregnant women: a randomised controlled trial","volume":"401","author":"S-R Pasricha","year":"2023","journal-title":"Lancet"},{"issue":"1","key":"pgph.0005158.ref109","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/s41591-024-03385-w","article-title":"Ferric carboxymaltose for anemia in late pregnancy: a randomized controlled trial","volume":"31","author":"S-R Pasricha","year":"2025","journal-title":"Nat Med"},{"issue":"11","key":"pgph.0005158.ref110","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-021223","article-title":"Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings","volume":"8","author":"J Sumankuuro","year":"2018","journal-title":"BMJ Open"},{"issue":"10056","key":"pgph.0005158.ref111","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1016\/S0140-6736(16)31472-6","article-title":"Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide","volume":"388","author":"S Miller","year":"2016","journal-title":"Lancet"},{"issue":"1","key":"pgph.0005158.ref112","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems","volume":"12","author":"L Atkins","year":"2017","journal-title":"Implement Sci"},{"key":"pgph.0005158.ref113","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"S Michie","year":"2011","journal-title":"Implement Sci"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0005158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T17:24:03Z","timestamp":1759339443000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0005158"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":113,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0005158","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}