Factors Affecting Intravenous Iron Access for Pregnancy Anaemia in Malawi

A qualitative study conducted in Zomba, Malawi, investigates the barriers and facilitators influencing access to and utilization of intravenous iron for treating anaemia in pregnancy. While oral iron is the standard treatment, it often suffers from low adherence due to poor tolerance. This research, embedded within a clinical trial, utilized in-depth interviews and focus group discussions with pregnant women, their husbands, and caregivers. The findings reveal that obstacles exist on both supply and demand sides. Supply-side challenges include limited service awareness, logistical constraints, and unclear communication from healthcare providers. Demand-side factors involve women’s knowledge levels, cultural norms, personal beliefs, and social support systems. Conversely, facilitators such as patient-centred service delivery, clear provider communication, and family involvement significantly enhance trust and uptake. The study concludes that addressing these dual-domain barriers through patient-centred approaches and strengthening health systems are essential for optimizing intravenous iron interventions. These measures aim to improve health literacy, ensure equitable access to antenatal care, and ultimately reduce maternal and neonatal complications associated with anaemia in low-resource settings.