{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:20:07Z","timestamp":1787678407248,"version":"build-2784847793"},"reference-count":21,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,5,21]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Primary care settings in a rural district of Telangana, India, under an anaemia control programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.26.0041","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:23:46Z","timestamp":1787675026000},"page":"229-236","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing parenteral therapy for anaemia among pregnant women in rural India"],"prefix":"10.5588","volume":"16","author":[{"given":"P.","family":"Kotni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Ramaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Cheela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chinnakali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.P.","family":"Tripathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Khandale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Kamban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Konguvel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Manohar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"2026082509234308000_16.3.229.1","unstructured":"World Health Organization . Anaemia. Geneva: WHO, 2025. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/anaemia."},{"key":"2026082509234308000_16.3.229.2","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2015.2.10289"},{"issue":"2","key":"2026082509234308000_16.3.229.3","doi-asserted-by":"crossref","first-page":"e2147046","DOI":"10.1001\/jamanetworkopen.2021.47046","article-title":"Severity of anemia during pregnancy and adverse maternal and fetal outcomes","volume":"5","author":"Shi","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026082509234308000_16.3.229.4","unstructured":"World Health Organization . Anaemia. Geneva: WHO, 2024. https:\/\/www.who.int\/data\/nutrition\/nlis\/info\/anaemia."},{"key":"2026082509234308000_16.3.229.5","unstructured":"World Health Organization . Global nutrition targets 2025: policy brief series. Geneva: WHO, 2025."},{"key":"2026082509234308000_16.3.229.6","unstructured":"International Institute for Population Sciences, ICF . India National Family Health Survey NFHS-4 2015-16. Mumbai, India: IIPS and ICF, 2017."},{"key":"2026082509234308000_16.3.229.7","unstructured":"International Institute for Population Sciences, ICF . India National Family Health Survey NFHS-5 2019-21. Mumbai, India: IIPS and ICF, 2022."},{"key":"2026082509234308000_16.3.229.8","unstructured":"Guidelines - AMB . National Health Mission. New Delhi, India: Mohfw and GOI, 2018. https:\/\/nhm.gov.in\/index1.php?lang=1&level=4&sublinkid=1455&lid=804."},{"issue":"1","key":"2026082509234308000_16.3.229.9","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4103\/ijmr.ijmr_246_23","article-title":"Clinical effectiveness of ferric carboxymaltose (iv) versus iron sucrose (iv) in treatment of iron deficiency anaemia in pregnancy: a systematic review and meta-analysis","volume":"159","author":"Srimathi","year":"2024","journal-title":"Indian J Med Res"},{"key":"2026082509234308000_16.3.229.10","doi-asserted-by":"crossref","first-page":"763576","DOI":"10.1155\/2015\/763576","article-title":"Intravenous iron therapy in patients with iron deficiency anemia: dosing considerations","volume":"2015","author":"Koch","year":"2015","journal-title":"Anemia"},{"key":"2026082509234308000_16.3.229.11","doi-asserted-by":"publisher","DOI":"10.4103\/ijpvm.IJPVM_321_19"},{"issue":"1","key":"2026082509234308000_16.3.229.12","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":"Akinajo","year":"2024","journal-title":"Reprod Health"},{"issue":"2","key":"2026082509234308000_16.3.229.13","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":"Mayson","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2026082509234308000_16.3.229.14","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2026082509234308000_16.3.229.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2025-019886"},{"issue":"2","key":"2026082509234308000_16.3.229.16","doi-asserted-by":"crossref","first-page":"e0324578","DOI":"10.1371\/journal.pone.0324578","article-title":"Patients\u2019 perceptions of care in a type 1 hybrid effectiveness-implementation trial on intravenous iron for anaemia in pregnancy in Nigeria","volume":"21","author":"Balogun","year":"2026","journal-title":"PLoS One"},{"issue":"1","key":"2026082509234308000_16.3.229.17","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1186\/s12889-023-16195-5","article-title":"Contextual factors affecting the implementation of an anemia focused virtual counseling intervention for pregnant women in plains Nepal: a mixed methods process evaluation","volume":"23","author":"Bhattarai","year":"2023","journal-title":"BMC Public Health"},{"key":"2026082509234308000_16.3.229.18","doi-asserted-by":"crossref","first-page":"1464967","DOI":"10.3389\/fnut.2024.1464967","article-title":"Impact of a virtual antenatal intervention for improved diet and iron intake in Kapilvastu district, Nepal - the VALID randomized controlled trial","volume":"11","author":"Saville","year":"2024","journal-title":"Front Nutr"},{"issue":"2","key":"2026082509234308000_16.3.229.19","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/rfc2.25","article-title":"Factors and strategies influencing implementation of an intravenous iron intervention for antenatal anaemia: a mixed-methods systematic review","volume":"2","author":"Verbunt","year":"2023","journal-title":"Reprod Female Child Health"},{"issue":"1","key":"2026082509234308000_16.3.229.20","doi-asserted-by":"crossref","first-page":"e0004858","DOI":"10.1371\/journal.pgph.0004858","article-title":"Implementation strategies and outcomes of intravenous iron use for treatment of anaemia during and after pregnancy in low- and middle-income countries: a scoping review","volume":"6","author":"Balogun","year":"2026","journal-title":"PLoS Glob Public Health"},{"key":"2026082509234308000_16.3.229.21","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":"Manda-Taylor","year":"2022","journal-title":"Gates Open Res"}],"container-title":["Public Health Action"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/pha.26.0041","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:23:49Z","timestamp":1787675029000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/pha.26.0041"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8,1]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.5588\/pha.26.0041"],"URL":"https:\/\/doi.org\/10.5588\/pha.26.0041","relation":{},"ISSN":["2220-8372"],"issn-type":[{"value":"2220-8372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}