A qualitative study of primary care physicians’ perceptions and experiences on iron-folic acid consumption

Authors

  • Ankur Joshi Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh
  • Surya Bali Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh
  • Saket Kale Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh
  • Sharad Tiwari Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh
  • Viswanath Arutagi Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20171328

Keywords:

Anemia, IFA, Qualitative research, Physician perception, Experiences

Abstract

Background: A primary health centre (PHC) physician, because of his physician-provider interaction at community level and legitimate capacity to deliver and monitor health services, serves as an ideal candidate to understand the specific health/ health program related issues.

Methods: This community based qualitative study was conducted in selected clusters of state of Madhya Pradesh (central India) identified through multileveled stratification. The physicians serving in primary health centres from the selected clusters were in depth interviewed through topic guides based upon conceptual construct. The data obtained through in-depth interviews was utilized for thematic framework and linkage association.

Results: Two major interrelated themes emerged from the convergence of the user related and system related subthemes. The first major theme is “distorted perceptions reinforced by unpleasant encounters” which is constructed from the convergence of user concerns. The theme “system resistance and resource constraints” is assembled from convergence of system issues.

Conclusions: On a policy perspective, all the attempts should be made to break the misconception around IFA supplementation and to augment the feeling of ownership in the community. 

Author Biographies

Ankur Joshi, Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh

Assistant Professor, Department of Community and Family Medicine,
All India Institute of Medical Sciences, Rishikesh(Uttrakhand), India

Surya Bali, Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh

Associate Professor
Department of Community and Family Medicine
All India Institute of Medical Sciences(AIIMS)
Bhopal, MP- 462024

Sharad Tiwari, Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh

Resident,

Department of Community Medicine, Gandhi Medical College, Bhopal(Madhya Pradesh), India

 

Viswanath Arutagi, Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh

Resident

Department of Community Medicine, Gandhi Medical College, Bhopal(Madhya Pradesh), India

References

WHO. Number of countries categorized by public health significance of anaemia. Available at http://www.who.int/vmnis/anaemia/prevalence/anaemia_data_status_t4/en/. Accessed on 21 September 2016.

Benoist BD. World Health Organization, Centers for Disease Control and Prevention (U.S.). Worldwide prevalence of anaemia 1993-2005 of: WHO Global Database of anaemia. Geneva: World Health Organization; 2008. Available at http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf. Accessed 21 September 2016.

Benoist BD, McLean E, Egli I, Cogswell M, editors. Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Geneva: WHO press; 2008.

Kapil U, Bhadoria AS. National Iron-plus Initiative guidelines for control of iron deficiencyanaemia in India, 2013. The National Medical Journal of India. 2014;27(1):27-9.

Government of India. Ministry of Health and Family Welfare. Adolescent Division. Guidelines for Control of Iron Deficiency Anaemia: National Iron Plus Initiative; 2013.

Deb S. Implementation of national iron plus initiative for child health: Challenges ahead. Indian Journal of Public Health. 2015;59(1):1.

Allen L. World Health Organization, Food and Agriculture Organization of the United Nations. Guidelines on food fortification with micronutrients. Geneva; Rome: World Health Organization ; Food and Agriculture Organization of the United Nations; 2006.

Iron absorption and its implications on strategies to control Iron deficiency anaemia: ICMR Bulletin. 2000;30(2):1-7.

Stoltzfus RJ, Dreyfuss ML. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. Washington, DC: ILSI Pr.; 1999.

Organization WH, others. Iron deficiency anaemia: assessment, prevention and control: a guide for programme managers. 2001. Available at http://apps.who.int/iris/handle/10665/66914. Accessed on 14 January 2016.

Pal PP, Sharma S, Sarkar TK, Mitra P. Iron and Folic Acid Consumption by the Ante-natal Mothers in a Rural Area of India in 2010. Int J Prev Med. 2013;4(10):1213–6.

Wendt A, Stephenson R, Young M, Webb-Girard A, Hogue C, Ramakrishnan U, et al. Individual and Facility-Level Determinants of Iron and Folic Acid Receipt and Adequate Consumption among Pregnant Women in Rural Bihar, India. PLoS One. 2015;10(3).

Kumar R. Empowering Primary Care Physicians in India. J Family Med Prim Care. 2012;1(1):1–2.

Vlassoff C, Tanner M, Weiss M, Rao S. Putting People First: A Primary Health Care Success in Rural India. Indian J Community Med. 2010;35(2):326–30.

Majumder A, Upadhyay V. An analysis of the primary health care system in India with focus on reproductive health care services. ArthaBeekshan. 2004;12(4):29–38.

Mash R, Almeida M, Wong WCW, Kumar R, von Pressentin KB. The roles and training of primary care doctors: China, India, Brazil and South Africa. Hum Resour Health. 2015;13:93.

17. Dicker RC. A brief review of the basic principles of epidemiology. In: Gregg MB eds. Field Epidemiology. 3rd edition. Newyork, NY: Oxford University Press, Inc. 2008: 16-37.

Dutta AJ, Patel PB, Bansal RK. Compliance to Iron Supplementa-tion Among Pregnant Women: a Cross Sectional Study in Urban Slum. Natl J Community Med. 2014:5(4);457-62.

Priya SH, Datta SS, Bahurupi YA, Narayan KA, Anbarasan N, Ramya MR. Factors Influencing Weekly IFA Supplementation Programme (WIFS) among School Children: Where to Focus Our Attention? Int J Contemporary Med Res. 2016;3(4):1075-9.

Ogundipe et al.: Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: A cross-sectional hospital-based study. BMC Public Health. 2012;12:481.

Niquini RP, de AzevedoBittencourt SD, de Aquino Lacerda EM, Saunders C, Carmo Leal MD. Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro. Rev. Bras. Saúde Matern. Infant. Recife. 2016;16 (2):189-99.

Park K. Park Text book of Preventive and Social Medicine 23rd ed.; Jabalpur : Bhanot Publication; 2015.

Tripathi KD. Essentials of Medical Pharmacology. 6th edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2008.

Mithra P, Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India. African Health Sci. 2013;13(4):880-5.

Sadore AA, Gebretsadik LA, Hussen MA. Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study. J Environmental Public Health. 2015;1:1-7.

Nisar YB, Alam A, Aurangzeb B, Dibley MJ. Perceptions of antenatal iron-folic acid supplements in urban and rural Pakistan: a qualitative study.BMC Pregnancy and Childbirth. 2014;14:344.

Orme J, Powell J, Taylor P, Grey M eds. Public Health for the 21st century, new perspectives on policy, Participation and practice. 2nd edition. New York, NY: McGraw-Hill; 2007

Steyn PS, Cordero JP, Gichangi P, Smit JA, Nkole T, Kiarie J, Temmerman M. Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: a scoping review. Reproductive Health. 2016;13:88.

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Published

2017-03-28

How to Cite

Joshi, A., Bali, S., Kale, S., Tiwari, S., & Arutagi, V. (2017). A qualitative study of primary care physicians’ perceptions and experiences on iron-folic acid consumption. International Journal Of Community Medicine And Public Health, 4(4), 1081–1086. https://doi.org/10.18203/2394-6040.ijcmph20171328

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Original Research Articles