Implementation of intravenous iron for anaemic women during pregnancy in Malawi
Loading...
Date
2021-11-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Type of study: This research program will employ a mixed-methods research design, involving three
studies.
Problem statement: Antenatal iron supplementation has been shown to be critical to maternal and
newborn health; however, in many low-income countries, access and adherence to oral iron is
limited. Randomised controlled trials of the Effect of intraVenous iron on Anaemia in Malawian
Pregnant women in second-trimester (REVAMP) and third-trimester (REVAMP-TT) will determine
whether intravenous (IV) iron is better than oral iron in improving anaemia and benefiting critical
maternal and child outcomes. Very little is known about the acceptability and feasibility of
implementing IV iron for anaemic women during pregnancy to improve maternal and child health
outcomes in low-middle income countries (LMICs) like Malawi. This study aims to address this gap
in research and published literature.
Objectives of the study: The overall objective will be to inform the acceptability and feasibility of the
implementation of IV iron for anaemic women during pregnancy in the Malawian healthcare system.
Specifically, the study will a) identify health system barriers and facilitators to implementing IV iron
in the healthcare system of Malawi; b) identify touchpoints and co-develop strategies for the
successful implementation of REVAMP-TT; and c) identify barriers and facilitators to delivering and
upscaling of REVAMP-TT.
Methodology: The research program will be implemented in eight health centres in the Zomba
district, namely Likangala, Bimbi, Lambulira, Domasi, Naisi, Matawale, City clinic and Sadzi Health
Centre. Interviews and focus groups will be conducted with policy makers, health system managers,
health centre staff, community members and pregnant women enrolled in REVAMP-TT. Health
services data and clinical audits data will be collected across the health centres. The research
program will involve three studies:
1) Health system analysis. The aim is to understand the health system barriers and facilitators to
implementing IV iron in the Malawian healthcare system.
2) Co-design of implementation interventions. This will help us understand the ‘touchpoints’ and
strategies for the successful implementation of REVAMP-TT.
3) Development evaluation of implementation interventions. The purpose is to understand the
barriers and facilitators to delivering and upscaling of REVAMP-TT at the individual, health centre
and health system level.
Ethics: This research will adhere to local and international guidelines for ethical and scientific conduct
of research that involves human participants. Written informed consent will be obtained from all
participants before the conduct of each interview and focus group discussion.
Expected findings: We aim to understand the barriers and facilitators (i.e., health systems/health
services supply-side and health-users demand-side) to implementing and accessing IV iron for
anaemic women during pregnancy to improve maternal and child health outcomes. The research
findings will lead to the development of intervention strategies by identifying key modifiable factors
along the healthcare continuum.
Dissemination of findings: Results from this research program will be disseminated at the CoM
Research Dissemination Conference and to specific interest groups, both in meetings / workshops
and through conferences, nationally and internationally; and through journal article[s]. Final
publications will be shared with COMREC.