{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:21:42Z","timestamp":1790263302450,"version":"4.1.0"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014450","name":"Anschutz Medical Campus, University of Colorado","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014450","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>In Pakistan, there is a dearth of literature on the perceptions of anemia among women of reproductive age (WRA). This study was undertaken to explore the perceptions of women, their husbands, and healthcare providers about anemia, its possible causes, and how anemia impacts maternal and child health in Thatta, Pakistan.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A qualitative study was conducted in Thatta, Pakistan from September to December 2018. Using a pre-tested semi-structured interview (SSI), we collected data to understand their definitions of anemia through ten focus group discussions (FGDs) with women and their partners and ten primary informant interviews (KIIs) with healthcare providers. We identified six major themes: (I) Knowledge and awareness of anemia, (II) Causes and consequences of Anemia, (III) Dietary practices, (IV) Knowledge and practices regarding the use of iron-folic acid supplements, (V) Factors influencing prevention and control of anemia and (VI) Women\u2019s health behavior. We analyzed the data through thematic analysis using NVivo 10 software.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Most community members were not aware of the term anemia but described anemia as a condition characterized by \u2018blood deficiency\u2019 in the body. All study participants perceived anemia as an important health problem tending to cause adverse outcomes among WRA and their children. Study participants perceived gutka (chewable tobacco) consumption as an important cause of anemia. Healthcare providers identified short inter-pregnancy intervals, lack of family planning, poor health-seeking behavior, and consumption of unhealthy food as causes of anemia in the district. Consumption of unhealthy food might not be related to related to a poorer knowledge of iron-deficient foods, but economic constraints. This was further endorsed by the healthcare providers who mentioned that most women were too poor to afford iron-rich foods. All men and women were generally well versed with the sources of good nutrition to be consumed by WRA to prevent anemia.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>The findings suggest that the government should plan to develop strategies for poverty-stricken and vulnerable rural women and plan health awareness programs to improve dietary practices, compliance with supplements, and health-seeking behavior among women of reproductive age. There is a need to develop effective counseling strategies and context-specific health education sessions to improve the health-seeking behavior of women and men in the Thatta district of Pakistan. Besides, there is need to address social determinants of health such as poverty that pushes women of poorer socioeconomic strata to eat less nutritious foods and have more anaemia. Therefore, a comprehensive and robust strategic plan need to be adopted by government that focuses not only on the awareness programs, but also aim to reduce inequities that lead to pregnant women eat iron-poor foods, which, in turn, forces them to become anemic.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0249360","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T19:33:52Z","timestamp":1619552032000},"page":"e0249360","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8996-7995","authenticated-orcid":true,"given":"Sumera","family":"Aziz Ali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Feroz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid","family":"Abbasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savera","family":"Aziz Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahreen","family":"Allana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Michael","family":"Hambidge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy F.","family":"Krebs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie E.","family":"Westcott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Goldenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"issue":"4","key":"pone.0249360.ref001","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00277-010-1144-5","article-title":"Anemia\u2014still a major health problem in many parts of the world","volume":"90","author":"N Milman","year":"2011","journal-title":"Annals of hematology"},{"issue":"5","key":"pone.0249360.ref002","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1182\/blood-2005-07-3046","article-title":"The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration?","volume":"107","author":"E Beutler","year":"2006","journal-title":"Blood"},{"issue":"19","key":"pone.0249360.ref003","doi-asserted-by":"crossref","first-page":"2594","DOI":"10.1080\/14767058.2017.1349746","article-title":"Anemia and pregnancy outcomes: a longitudinal study.","volume":"31","author":"K Tunkyi","year":"2018","journal-title":"The Journal of Maternal-Fetal & Neonatal Medicine"},{"issue":"07","key":"pone.0249360.ref004","doi-asserted-by":"crossref","first-page":"676","DOI":"10.4236\/ojog.2018.87072","article-title":"Prevalence of Maternal Anemia in Pregnancy: The Effect of Maternal Hemoglobin Level on Pregnancy and Neonatal Outcome.","volume":"8","author":"MA Youssry","year":"2018","journal-title":"Open Journal of Obstetrics and Gynecology"},{"issue":"9","key":"pone.0249360.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004922","article-title":"The global economic and health burden of human hookworm infection","volume":"10","author":"SM Bartsch","year":"2016","journal-title":"PLoS neglected tropical diseases"},{"key":"pone.0249360.ref006","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression","author":"DW Hosmer","year":"2013"},{"issue":"1","key":"pone.0249360.ref007","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/sj.ejcn.1601504","article-title":"The burden of anemia among women in India","volume":"57","author":"M Bentley","year":"2003","journal-title":"European journal of clinical nutrition"},{"key":"pone.0249360.ref008","unstructured":"Ministry of National Services Regulation and Coordination (MoNHSR&C) GoP. National Nutrition Survey. 2018."},{"issue":"2","key":"pone.0249360.ref009","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1177\/156482650802900207","article-title":"Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan","volume":"29","author":"N Baig-Ansari","year":"2008","journal-title":"Food and nutrition bulletin"},{"key":"pone.0249360.ref010","article-title":"Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan.","author":"S Parks","year":"2018","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"issue":"5","key":"pone.0249360.ref011","doi-asserted-by":"crossref","first-page":"1280S","DOI":"10.1093\/ajcn\/71.5.1280s","article-title":"Anemia and iron deficiency: effects on pregnancy outcome","volume":"71","author":"LH Allen","year":"2000","journal-title":"The American journal of clinical nutrition"},{"issue":"5","key":"pone.0249360.ref012","first-page":"627","article-title":"Prevalence & consequences of anaemia in pregnancy","volume":"130","author":"K Kalaivani","year":"2009","journal-title":"Indian J Med Res"},{"issue":"2","key":"pone.0249360.ref013","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3945\/jn.111.149237","article-title":"Child Health Epidemiology Reference G. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes","volume":"142","author":"N Kozuki","year":"2012","journal-title":"J Nutr"},{"key":"pone.0249360.ref014","article-title":"Maternal anemia and pregnancy outcomes: a population-based study","volume":"1","author":"RH Beckert","year":"2019","journal-title":"Journal of Perinatology"},{"issue":"2","key":"pone.0249360.ref015","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1007\/s12630-012-9861-y","article-title":"risks of anemia and related management strategies: can perioperative blood management improve patient safety?","volume":"60","author":"GM Hare","year":"2013","journal-title":"Canadian Journal of Anesthesia\/Journal canadien d\u2019anesth\u00e9sie"},{"issue":"2","key":"pone.0249360.ref016","first-page":"232","article-title":"Association between anaemia during pregnancy and blood loss at and after delivery among women with vaginal births in Pemba Island, Zanzibar, Tanzania","volume":"26","author":"JA Kavle","year":"2008","journal-title":"Journal of health, population, and nutrition"},{"issue":"9890","key":"pone.0249360.ref017","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries","volume":"382","author":"RE Black","year":"2013","journal-title":"The lancet"},{"issue":"2","key":"pone.0249360.ref018","doi-asserted-by":"crossref","first-page":"495","DOI":"10.3945\/ajcn.115.107896","article-title":"Maternal anemia and risk of adverse birth and health outcomes in low-and middle-income countries: systematic review and meta-analysis, 2","volume":"103","author":"MM Rahman","year":"2016","journal-title":"The American journal of clinical nutrition"},{"issue":"03","key":"pone.0249360.ref019","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1055\/s-2000-9508","article-title":"Anemia during pregnancy and birth outcome: a meta-analysis.","volume":"17","author":"X Xiong","year":"2000","journal-title":"American journal of perinatology"},{"issue":"5","key":"pone.0249360.ref020","doi-asserted-by":"crossref","first-page":"e548","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":"The Lancet Global Health"},{"issue":"10","key":"pone.0249360.ref021","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.3390\/nu11102534","article-title":"Maternal Characteristics Affect Fetal Growth Response in the Women First Preconception Nutrition Trial","volume":"11","author":"KM Hambidge","year":"2019","journal-title":"Nutrients"},{"key":"pone.0249360.ref022","article-title":"Iron Deficiency Anaemia Assessment, Prevention, and Control A guide for programme managers","author":"World Health Organization","year":"2001"},{"issue":"1","key":"pone.0249360.ref023","first-page":"195","article-title":"Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan.","volume":"27","author":"MA Habib","year":"2018","journal-title":"Asia Pac J Clin Nutr"},{"issue":"Suppl 4","key":"pone.0249360.ref024","doi-asserted-by":"crossref","first-page":"e12478","DOI":"10.1111\/mcn.12478","article-title":"Determinants of anemia among women and children in Nepal and Pakistan: An analysis of recent national survey data","volume":"14","author":"KL Harding","year":"2018","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pone.0249360.ref025","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4236\/ojepi.2016.61010","article-title":"Geographic access to working family planning centers and unintended pregnancies among married women: a community based nested case control study","volume":"6","author":"SA Ali","year":"2016","journal-title":"Open Journal of Epidemiology"},{"key":"pone.0249360.ref026","article-title":"Health care access and barriers for the physically disabled in rural Punjab, Pakistan.","author":"M Ahmad","year":"2013","journal-title":"International Journal of Sociology and Social Policy"},{"key":"pone.0249360.ref027","unstructured":"National Institute of Population Studies. Pakistan Demographic and Health Survey 2012\u201313. Isamabad 2013 2017. Available from: http:\/\/www.nips.org.pk\/abstract_files\/Priliminary%20Report%20Final.pdf."},{"issue":"1","key":"pone.0249360.ref028","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12978-019-0688-7","article-title":"Factors associated with anemia among women of the reproductive age group in Thatta district: study protocol","volume":"16","author":"SA Ali","year":"2019","journal-title":"Reproductive health"},{"issue":"2","key":"pone.0249360.ref029","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1093\/heapol\/14.2.191","article-title":"Does use of a government service depend on distance from the health facility?","volume":"14","author":"R NoorAli","year":"1999","journal-title":"Health policy and planning."},{"key":"pone.0249360.ref030","article-title":"Sixth Population and Housing Census-2017","author":"Governtment of Pakistan Ministry of Statistics PBoS","year":"2017"},{"issue":"8","key":"pone.0249360.ref031","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":"Maternal and child health journal"},{"issue":"2","key":"pone.0249360.ref032","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/1742-4755-12-S2-S1","article-title":"The Global Network Maternal Newborn Health Registry: a multi-national, community-based registry of pregnancy outcomes.","volume":"12","author":"CL Bose","year":"2015","journal-title":"Reproductive Health"},{"issue":"1","key":"pone.0249360.ref033","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1471-2393-14-111","article-title":"Preconception maternal nutrition: a multi-site randomized controlled trial.","volume":"14","author":"KM Hambidge","year":"2014","journal-title":"BMC pregnancy and childbirth"},{"issue":"2","key":"pone.0249360.ref034","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/ajcn\/nqy228","article-title":"A multicountry randomized controlled trial of comprehensive maternal nutrition supplementation initiated before conception: the Women First trial","volume":"109","author":"KM Hambidge","year":"2019","journal-title":"The American journal of clinical nutrition"},{"issue":"4","key":"pone.0249360.ref035","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":"Social science medicine Today"},{"issue":"3","key":"pone.0249360.ref036","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1016\/j.midw.2013.10.012","article-title":"\u2018This is normal during pregnancy\u2019: 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"},{"key":"pone.0249360.ref037","article-title":"Perceptions of anemia and health seeking behavior among women in four Indian states","author":"P Bentley","year":"1998","journal-title":"Mothercare\/john snow, inc"},{"issue":"2","key":"pone.0249360.ref038","first-page":"425","article-title":"Knowledge, attitude and practices of pregnant women regarding anemia, iron rich diet and iron supplements and its impact on their hemoglobin levels","volume":"5","author":"K Nivedita","year":"2016","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"issue":"3","key":"pone.0249360.ref039","first-page":"210","article-title":"Lady health workers programme in Pakistan: challenges, achievements and the way forward","volume":"61","author":"A Hafeez","year":"2011","journal-title":"Journal of the Pakistan Medical Association"},{"issue":"1","key":"pone.0249360.ref040","first-page":"52","article-title":"Genotoxic and Carcinogenic Effect of Gutkha: A Fast-growing Smokeless Tobacco.","volume":"10","author":"B Sankhla","year":"2018","journal-title":"Addiction & health"},{"issue":"8","key":"pone.0249360.ref041","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0009-9120(01)00271-5","article-title":"Effects of tobacco smoking on plasma selenium, zinc, copper and iron concentrations and related antioxidative enzyme activities","volume":"34","author":"A Kocyigit","year":"2001","journal-title":"Clinical biochemistry"},{"issue":"1\u20132","key":"pone.0249360.ref042","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.cca.2006.08.028","article-title":"Monitoring micronutrients in cigarette smokers","volume":"377","author":"CA Northrop-Clewes","year":"2007","journal-title":"Clinica Chimica Acta"},{"issue":"1","key":"pone.0249360.ref043","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s12011-016-0621-7","article-title":"Hepcidin and iron metabolism in pregnancy: correlation with smoking and birth weight and length","volume":"173","author":"M Che\u0142chowska","year":"2016","journal-title":"Biological trace element research"},{"key":"pone.0249360.ref044","first-page":"167","article-title":"Systemic nicotine administration suppresses food intake via reduced meal sizes in both male and female rats","volume":"41","author":"V Blaha","year":"1998","journal-title":"ACTA MEDICA-HRADEC KRALOVE"},{"issue":"2","key":"pone.0249360.ref045","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S0039-6060(99)70163-7","article-title":"Nicotine\u2019s effect on hypothalamic neurotransmitters and appetite regulation","volume":"126","author":"G Miyata","year":"1999","journal-title":"Surgery"},{"issue":"1","key":"pone.0249360.ref046","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12978-018-0516-5","article-title":"Antenatal tobacco use and iron deficiency anemia: integrating tobacco control into antenatal care in urban India.","volume":"15","author":"R Mistry","year":"2018","journal-title":"Reproductive health"},{"issue":"3","key":"pone.0249360.ref047","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4103\/0019-557X.89948","article-title":"Smokeless tobacco: a major public health problem in the SEA region: a review.","volume":"55","author":"PC Gupta","year":"2011","journal-title":"Indian journal of public health"},{"issue":"5","key":"pone.0249360.ref048","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.18203\/2394-6040.ijcmph20181667","article-title":"Predictors of smokeless tobacco consumption among women: a community based study in a slum of Kolkata","volume":"5","author":"A Dasgupta","year":"2018","journal-title":"International Journal Of Community Medicine And Public Health"},{"issue":"3","key":"pone.0249360.ref049","doi-asserted-by":"crossref","first-page":"245","DOI":"10.14260\/jemds\/250","article-title":"Gutka-a malignant entity seeks benign exit in India.","volume":"2","author":"P Kharat","year":"2013","journal-title":"J Evol Med Dent Sci"},{"key":"pone.0249360.ref050","first-page":"2014","article-title":"Determinant factors of anemia among nonpregnant women of childbearing age in southwest Ethiopia: a community based study.","author":"Y Asres","year":"2014","journal-title":"International scholarly research notices"},{"issue":"9","key":"pone.0249360.ref051","doi-asserted-by":"crossref","first-page":"e291","DOI":"10.1371\/journal.pntd.0000291","article-title":"Hookworm-related anaemia among pregnant women: a systematic review","volume":"2","author":"S Brooker","year":"2008","journal-title":"PLoS neglected tropical diseases."},{"issue":"3","key":"pone.0249360.ref052","first-page":"211","article-title":"Risk factors for anemia among pregnant women attending antenatal clinic at Jimma University Hospital, southwest Ethiopia","volume":"44","author":"T Belachew","year":"2006","journal-title":"Ethiopian Medical Journal"},{"issue":"3","key":"pone.0249360.ref053","doi-asserted-by":"crossref","first-page":"e91252","DOI":"10.1371\/journal.pone.0091252","article-title":"Demographic and spatial predictors of anemia in women of reproductive age in Timor-Leste: implications for health program prioritization","volume":"9","author":"AA Lover","year":"2014","journal-title":"PloS one"},{"issue":"1","key":"pone.0249360.ref054","first-page":"195","article-title":"Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan","volume":"27","author":"MA Habib","year":"2018","journal-title":"Asia Pacific journal of clinical nutrition"},{"issue":"7","key":"pone.0249360.ref055","doi-asserted-by":"crossref","first-page":"6828","DOI":"10.1166\/asl.2017.9408","article-title":"Short Interpregnancy Interval as a Risk Factor for Anemia in Pregnancy: A Retrospective Cohort Study in Duren Sawit, Jakarta, 2014\u20132016","volume":"23","author":"D Riyanto","year":"2017","journal-title":"Advanced Science Letters"},{"issue":"2","key":"pone.0249360.ref056","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1728-4465.2012.00308.x","article-title":"Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms","volume":"43","author":"A Conde\u2010Agudelo","year":"2012","journal-title":"Studies in family planning"},{"issue":"4","key":"pone.0249360.ref057","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3347\/kjp.2017.55.4.391","article-title":"Hookworm infection: a neglected cause of overt obscure gastrointestinal bleeding","volume":"55","author":"K-Y Wei","year":"2017","journal-title":"The Korean journal of parasitology"},{"issue":"2","key":"pone.0249360.ref058","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.wombi.2014.11.004","article-title":"Survey of women\u2019s perceptions of information provided in the prevention or treatment of iron deficiency anaemia in an Australian tertiary obstetric hospital","volume":"28","author":"E Vosnacos","year":"2015","journal-title":"Women and Birth"},{"issue":"1","key":"pone.0249360.ref059","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 and childbirth"},{"key":"pone.0249360.ref060","article-title":"Global anaemia reduction efforts among women of reproductive age: impact, achievement of targets and the way forward for optimizing efforts","author":"World Health Organization","year":"2020"},{"key":"pone.0249360.ref061","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2147\/JBM.S17194","article-title":"The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood.","volume":"2","author":"E Osaro","year":"2011","journal-title":"Journal of blood medicine"},{"key":"pone.0249360.ref062","author":"World Health Organization","year":"2015"},{"key":"pone.0249360.ref063","author":"JC Harris","year":"2020","journal-title":"Blood Product Safety. StatPearls"},{"issue":"3","key":"pone.0249360.ref064","doi-asserted-by":"crossref","first-page":"e0229916","DOI":"10.1371\/journal.pone.0229916","article-title":"Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: A qualitative study","volume":"15","author":"AA Gele","year":"2020","journal-title":"PloS one."},{"issue":"4","key":"pone.0249360.ref065","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1080\/01443610310001209342","article-title":"The acceptability and use of contraception: a prospective study of Somalian women\u2019s attitude","volume":"23","author":"H Comerasamy","year":"2003","journal-title":"Journal of Obstetrics Gynaecology"},{"key":"pone.0249360.ref066","doi-asserted-by":"crossref","first-page":"110","DOI":"10.2307\/2648299","article-title":"Islamic precepts and family planning: The perceptions of Jordanian religious leaders and their constituents","author":"C Underwood","year":"2000","journal-title":"International Family Planning Perspectives"},{"issue":"3","key":"pone.0249360.ref067","first-page":"500","article-title":"Role of religious leaders in promoting contraceptive use in Nigeria: evidence from the Nigerian urban reproductive health initiative. Global Health","volume":"6","author":"SA Adedini","year":"2018","journal-title":"Science Practice"},{"key":"pone.0249360.ref068","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2147\/IJWH.S27577","article-title":"Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study.","volume":"4","author":"AA Gele","year":"2012","journal-title":"International Journal of women\u2019s Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T21:08:18Z","timestamp":1698959298000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249360"}},"subtitle":[],"editor":[{"given":"Frank T.","family":"Spradley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,27]]},"references-count":68,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0249360","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,27]]}}}