Iron-Folic Acid Distribution and Consumption Through Antenatal Care: Identifying Barriers Across Countries

For this study, SPRING examined the distribution and consumption of iron-folic acid (IFA) tablets within antenatal care (ANC) programs in twenty-two countries with high burdens of undernutrition. Using design data from Demographic and Health Surveys, the study seeks to identify where pregnant women falter in obtaining and consuming an ideal minimum of 180 IFA tablets. From these data, SPRING developed a schematic that identifies four sequential “falter points” to consuming 180 IFA tablets: 1) ANC attendance, 2) IFA receipt or purchase, 3) IFA consumption, and 4) the number of tablets consumed. While most women receive and take some IFA tablets, few receive or take enough. The analysis identifies where ANC-based distribution of IFA falters in each country, enabling policy makers to design and prioritize follow-up activities to more precisely identify barriers, an essential next step to improving IFA distribution through ANC.