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Pregnant women's perceptions of daily iron supplementation in rural Ghana

02 February 2024
Volume 32 · Issue 2



In Ghana, compliance with daily iron supplementation during pregnancy is low, particularly in the Tain district. This may be related to pregnant women's perceptions of iron supplements. The aim of this study was to explore pregnant women's perceptions of daily iron supplements in the Tain district.


This descriptive qualitative study used an interpretative approach. Data were gathered from a purposive sample of 20 pregnant mothers, through semi-structured interviews and face-to-face in-depth discussions. Data were analysed thematically.


Women were unwilling to take iron supplements because of their belief that daily iron supplements make a baby too big for vaginal birth, leading to cervical tears, episiotomy or caesarean section. They were also concerned that supplements could cause nausea and vomiting during pregnancy, and excessive bleeding during labour and birth.


It is important to educate pregnant women on the benefits of iron supplementation during pregnancy and encourage them to acquire information from verified sources.

Iron is a vital requirement for the synthesis of haemoglobin. Iron deficiency anaemia is a major public health issue worldwide (Kamau et al, 2018; Musyoki et al, 2019). The risk of iron deficiency anaemia is higher in pregnant women, as the demand for physiological iron requirements increases during pregnancy to account for the needs of both the mother and the fetus. The World Health Organization (WHO, 2014) advocates for universal iron supplementation for pregnant women, recommending that they should receive a standard dose of 30–40mg of iron and 400µg of folic acid during pregnancy.

Globally, almost half of all pregnant women are anaemic and the majority of these women live in low- and middle-income countries (Goonewardene et al, 2012; United Nations Children's Fund et al, 2015; Musyoki et al, 2019). In Ghana, the prevalence of iron deficiency anaemia among pregnant women is estimated at 45% (Appiah et al, 2020). To maximise haemoglobin concentration and prevent anaemia during pregnancy, interventions typically include the provision of iron and folic acid supplements to pregnant women (Ghana Statistical Service et al, 2015). The approved dosage in Ghana is 60mg/day of ferrous sulphate and 400μg of folic acid, administered orally once daily for 180 days or more from preconception to birth. This is typically provided in a single combined iron and folic acid tablet (WHO, 2014).

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