Document Type



Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to alack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Careestablished a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant womenreceiving daily iron and folic acid (IFA) at theirfirst antenatal care visit and throughout pregnancy. Despite theseefforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand theexperiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare,Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured in-depthinterviews were conducted in Shona and English, with pregnant women (n= 24) and healthcare workers (n=14)providing direct antenatal care services to pregnant women in two high-density community clinics. Data wereanalysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmentallevels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconcep-tions about IFA, limited access to nutrition information, delayed entry or non-uptake of antenatal care and socialnorms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefitsof supplementation, fear of negative health complications with non-utilization, family support and healthcareworker recommendation for supplementation. Studyfindings can inform approaches to strengthen micronutrientsupplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortalityand improve overall maternal and child health in Zimbabwe.

Digital Object Identifier (DOI)


© 2016 John Wiley & Sons Ltd

APA Citation

Tinago, C., Annang Ingram, L., Blake, C., & Frongillo, E. (2016). Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe. Maternal & Child Nutrition, 13(3), e12350. doi: 10.1111/mcn.12350