Prevent Anemia During Pregnancy

Ensure Women Receive Important Supplements During Pregnancy

This intervention is one of the interventions identified in the nutritional deficiency execution group included in the highest priority package which defines those health interventions most essential and readily implementable, even for countries with few resources.  Read more about the interventions in our Health Program. 

Anemia is a major public health concern, mainly affecting young children, pregnant and postpartum women. It is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. While we have not seen many cases in our local service area, we also do not want to see a problem.

Pregnant women require additional iron and folic acid to meet their own nutritional needs as well as those of the developing fetus. Deficiencies in iron and folic acid during pregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development.

Pregnant women in rural Tanzania are supposed to start coming monthly to the clinic the moment they know they are pregnant. During such visits they are tested, provided supplements, and other important information to ensure a healthy pregnancy.

Karimu discussed pregnancies with each clinic in Ayalagya and Arri wards. Several issues were identified:

• Clinics run out of supplements sometimes causing some pregnant women not to receive them.

• The importance of eating food rich in iron is not yet included in the training materials that the clinics use.

• Food / caloric supplements are not provided to food insecure households. While this can be a concern, this issue is not viable to address at this time and is not a normal practice in Tanzania, so will be excluded from this intervention.

Our objectives with this intervention are that: 

1. At every visit, pregnant women are provided with folic acid and ferrous sulfate supplements sufficient to last until their next visit.

2. Pregnant women are educated on the importance of foods that are rich in iron.

Towards this end Karimu will enhance the maternal educational training and will be tracking how well clinics deliver supplements to pregnant women: the number and type given, whether supply is adequate for all pregnant women coming to the clinics,  the government's ability to fulfill the needed supply and how much Karimu has to supplement. 

This intervention will terminate when 

• At least 80% of pregnant women routinely receive education on the importance of taking supplements during pregnancy. 

• The government provides 95% of needed supplements to the dispensaries.

• The clinics are recording supplement metrics accurately and routinely

• 95% of women are receiving supplements regularly

• The project will conclude after 36 months, provided all criteria above are successfully met.

• At Least 80% of pregnant women have received the importance of taking supplements during pregnancy. 

Update Dec 2024: At the beginning of the year, we initiated this project to address anemia in pregnancy, which remains a significant challenge in rural areas. The implementation focused on ensuring the consistent availability of supplements, such as folic acid and ferrous sulfate (FeFo), at dispensaries and health centers. This was complemented by providing education to pregnant women through medical staff and educational videos broadcast on televisions in the dispensaries.

Based on data collected throughout the year, a 2 month gap in supplement distribution to pregnant women was observed at Tsaayo Dispensary. This shortage occurred at the beginning of the year due to delays in the supply of supplements. However, once the government was able to supply the dispensary with the necessary supplements, distribution resumed and continued uninterrupted for the rest of the year. The government typically provides all medications to dispensaries. While shortages can be addressed by requesting special funds to buy them through private pharmacies, this is  both a time consuming and long process so is generally not used. 

Benefits:

• Continued focus on healthy pregnancies

Cost: 

• Karimu cost: $1000