Unveiling the experiences of women of reproductive age with access to iron-rich food and the use of gutka: an exploratory study from a coastal slum of Karachi, Pakistan

Abstract

BackgroundAnemia among married women of reproductive age (MWRA) is an emerging public health issue. With the growing prevalence in coastal slums, understanding of community perceptions, practices and attitudes towards consuming iron-rich food items is very crucial. An in-depth understanding of why community women are consuming gutka is also important in these slums. The aim of this paper is to present the findings of this qualitative study to better understand community perceptions and experiences regarding access to iron-rich food and use of gutka. MethodA simple exploratory design using focus group discussions with nonpregnant MWRA and community health workers as well as thorough interviews with different shopkeepers were performed at Rehri Goth, a coastal slum at Karachi, Pakistan. Further, observational visits were also conducted to perform a market survey and to explore the situation regarding the availability of iron-rich food items in the community. ResultsCommunity-level knowledge and understanding on consuming iron-rich food items was poor, and many participants shared concerns regarding accessibility in terms of purchasing power as well as poor availability of these food items in the community as the key issues. These issues are rooted in the sociocultural beliefs that lead to adopting behaviors that result in the use of monotonous diet. These findings were consistent with the fact that observational visits revealed that the community has very low availability of four iron-rich items. Meat shops are only available in 21.4% of the area, and beef availability was only 41.7% during observational visits. Additionally, gutka consumption is considered by locals as a solution to poor accessibility of food. ConclusionStudy findings suggest that strategies should be developed at the policy-forming and implementation level to increase awareness about consuming iron-rich food items as well as initiatives to improve the accessibility to these items.