Barriers to Health Workers in Iron Deficiency Anemia Prevention among Indonesian Pregnant Women

Abstract

Background. Anemia is a global maternal health problem that commonly occurs in developing countries. During pregnancy, a woman will receive antenatal services to check her condition and prevent complications. This study aimed to explore barriers towards achieving eradication of iron deficiency anemia among pregnant women in Aceh Besar District, Indonesia. Methods. This qualitative study was conducted on 18 health workers who were recruited through a purposive sampling method. Data were collected through in-depth interviews using open-ended questions to gain insight about participants’ experiences in managing iron deficiency anemia among pregnant women. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview’s result. Result. Three main themes emerged: (1) facilities, infrastructures, and supplement support; (2) sociocultural factors; and (3) health provider competency deficits and no developing guidelines. Conclusion. Our findings provide understanding that there are many obstacles and barriers encountered by health workers in iron deficiency anemia prevention management. Thus, the management of anemia must be supported by a skilled health worker and quality facilities. Health workers and pregnant women must work together to achieve optimal management of anemia prevention.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study

“…Health facilities are an important factor in handling IDA in adolescents. These data are supported by research conducted by Darmawati in Aceh Besar, suggesting that health care facilities are an important factor that must be considered in the management of iron deficiency anemia prevention [ 33 ]. Hemoglobin examination facilities for adolescents are still lacking, so hemoglobin examination does not accompany the provision of iron supplements.…”

“…In this study, commitment is related to the accessibility of counseling for adolescents and the availability of health service rooms, as well as the availability of facilities, funding, and the attitudes of health workers and paramedical personnel in IDA programs. In line with the research of Darmawati et al, the management of iron deficiency anemia must be supported by facilities and financial support [ 33 ].…”

“…Limited facilities and infrastructure are also obstacles for health workers in conveying health information [ 33 ]. Health facilities are an important factor in handling IDA in adolescents.…”

“…This problem is related to the competence of health workers, which needs improvement. Training is needed to improve the competence of health workers when providing health services for the prevention of IDA [ 33 ]. However, some aspects are satisfactory, such as the accuracy of the officers.…”

Nutritional Education to the Nutritional Maternal Knowledge and Iron Intake among Toddlers with Anemia

“…Mother's knowledge about child feeding can be increased through outreach programs at integrated health post services (in Indonesian is Pos Pelayanan Terpadu, abbreviated as Posyandu). However, nutrition counseling at the Posyandu, especially in the Aceh Besar District, has not been carried out properly, besides the low quality of cadres due to the lack of training and their low education level [13]. One of the implementations of the Information Communication and Education program at the posyandu is nutrition education interventions given to cadres and mothers of toddlers to improve knowledge, attitudes, and skills.…”