BACKGROUND Iron and Folic Acid are two of the micronutrients recommended for pregnant women to support optimal maternal outcomes with regard to preventing anaemia and foetal birth defects. It is difficult to establish if women provided with iron and folic acid supplementation in Zambia benefit from it and how well it is implemented. The overall objective of this study was to determine the levels of uptake and compliance to iron and folic acid in pregnancy among women of child-bearing age in Zambia, with a focus on both supply and demand factors. METHODS A cross sectional, mixed method study was done. Data was collected in August and September 2015 from six of the 14 districts in which Scaling Up Nutrition interventions were being undertaken as well as Lusaka district. A household survey covering 402 males and females of child-bearing age, 27 key informant interviews amongst key stakeholders and 12 focus group discussions at community level were conducted. RESULTS Antenatal clinic attendance was almost universal (98.7%); the majority of both men (92.1%) and women (97.4%) had heard messages about iron and folic acid supplementation; the majority (96.5%) of women reported having taken iron and folic acid tablets during their last pregnancy, with 61.3% starting in the second trimester, 27.2% during the first trimester, and 7.7% in their third trimester. Eighty-five per cent (80.5%) of the women reported that they had taken all the tablets they were given with about 13.4% not taking all the tablets received. CONCLUSIONS Root cause analysis, using both qualitative and quantitative findings, showed that the main challenges faced were long distances to health facilities and high transport costs; some women not being reached with supplementation messaging; lack of formalised and uniform training around delivery of antenatal messages across health care workers; women not attending antenatal monthly to replenish supplements; and forgetfulness to take the drugs daily. While male involvement may be a supportive factor, it sometimes hinders women from accessing antenatal services. Results showed that both uptake and compliance to iron and folic acid supplementation in pregnancy in Zambia were sub-optimal.

中文翻译：

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对赞比亚 7 个地区妊娠期铁和叶酸补充摄入和依从性不佳的根本原因分析。


背景铁和叶酸是推荐给孕妇的两种微量营养素，以支持预防贫血和胎儿出生缺陷的最佳母体结局。很难确定赞比亚补充铁和叶酸的妇女是否从中受益以及实施情况如何。本研究的总体目标是确定赞比亚育龄妇女怀孕期间铁和叶酸的摄取水平和依从性，重点关注供应和需求因素。方法 进行了横断面、混合方法研究。 2015 年 8 月和 9 月从正在开展“加强营养”干预措施的 14 个地区中的 6 个地区以及卢萨卡地区收集了数据。我们对 402 名育龄男性和女性进行了家庭调查，对主要利益相关者进行了 27 次关键信息访谈，并在社区层面进行了 12 次焦点小组讨论。结果 产前门诊就诊率几乎达到了 98.7%；大多数男性（92.1%）和女性（97.4%）都听说过有关补充铁和叶酸的信息；大多数 (96.5%) 的女性表示在上次怀孕期间服用了铁片和叶酸片，其中 61.3% 的女性在妊娠中期开始服用，27.2% 的女性在妊娠早期服用，7.7% 在妊娠晚期服用。 85% (80.5%) 的女性表示她们已经服用了收到的所有药片，大约 13.4% 的女性没有服用收到的所有药片。 结论 使用定性和定量研究结果进行的根本原因分析表明，面临的主要挑战是距卫生设施较远以及运输成本较高；一些女性没有收到补充信息；缺乏针对卫生保健工作者传递产前信息的正式和统一的培训；没有每月进行产前补充补充剂的女性；以及忘记每天服药。虽然男性的参与可能是一个支持因素，但有时会阻碍女性获得产前服务。结果显示，赞比亚孕期补充铁和叶酸的吸收率和依从性均不理想。