An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol

Abstract Background Antenatal iron supplementation is critical to maternal and child health; however, access and adherence to oral iron are inconsistent in many low- and middle-income countries (LMICs). Modern intravenous (IV) iron products have become available in high-income clinical settings and...

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Main Authors: Khic-Houy Prang, Elisabeth Mamani-Mategula, Ebony Verbunt, Effie Chipeta, Ricardo Ataide, Martin Mwangi, Kamija Phiri, Sant-Rayn Pasricha, Margaret Kelaher, Lucinda Manda-Taylor
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Implementation Science Communications
Subjects:
Online Access:https://doi.org/10.1186/s43058-022-00299-x
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author Khic-Houy Prang
Elisabeth Mamani-Mategula
Ebony Verbunt
Effie Chipeta
Ricardo Ataide
Martin Mwangi
Kamija Phiri
Sant-Rayn Pasricha
Margaret Kelaher
Lucinda Manda-Taylor
author_facet Khic-Houy Prang
Elisabeth Mamani-Mategula
Ebony Verbunt
Effie Chipeta
Ricardo Ataide
Martin Mwangi
Kamija Phiri
Sant-Rayn Pasricha
Margaret Kelaher
Lucinda Manda-Taylor
author_sort Khic-Houy Prang
collection DOAJ
description Abstract Background Antenatal iron supplementation is critical to maternal and child health; however, access and adherence to oral iron are inconsistent in many low- and middle-income countries (LMICs). Modern intravenous (IV) iron products have become available in high-income clinical settings and provide an opportunity to deliver high doses of iron in a single-short infusion during pregnancy. However, there is limited knowledge of the drivers and barriers for such an intervention to be effectively delivered and upscaled in LMICs. In this study protocol, we describe the implementation research programme to support an IV iron intervention in Malawi for pregnant women with moderate and severe anaemia. Methods The implementation research programme has three phases, each guided by implementation science conceptual frameworks. In Phase 1, we will conduct formative research (context assessment of the health system with key informant interviews) to determine how IV iron can be effectively introduced into routine antenatal care. We will use the findings to co-develop potential strategies with end-users and healthcare providers to improve intervention implementation. In Phase 2, we will disseminate the implementation strategies to support the uptake and delivery of the intervention in the study settings. In Phase 3, the intervention will be implemented, and we will conduct formative evaluation (interviews with end-users, healthcare providers, and analysis of health services data) to investigate the feasibility and acceptability of the intervention and strategies. We will also identify processes and contextual factors that facilitate or impede the delivery and uptake of IV iron. Discussion In LMICs, modern IV iron products present a novel opportunity to rapidly cure moderate and severe anaemia in pregnancy, thereby improving maternal and child health outcomes. This implementation research programme will provide guidance and recommendations on how best an IV iron intervention for pregnant women with anaemia can be implemented in an LMIC setting like Malawi. We will develop locally relevant and culturally appropriate implementation strategies by engaging with key stakeholders (pregnant women, healthcare providers, and policymakers) and identifying factors likely to facilitate successful implementation. The findings of this research can guide the implementation of an IV iron intervention in Malawi and other LMICs.
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spelling doaj.art-b46a3f338cc54186a869f3797679404a2022-12-22T02:38:15ZengBMCImplementation Science Communications2662-22112022-06-013111710.1186/s43058-022-00299-xAn implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocolKhic-Houy Prang0Elisabeth Mamani-Mategula1Ebony Verbunt2Effie Chipeta3Ricardo Ataide4Martin Mwangi5Kamija Phiri6Sant-Rayn Pasricha7Margaret Kelaher8Lucinda Manda-Taylor9Centre for Health Policy, Melbourne School of Population and Global Health, The University of MelbourneKamuzu University of Health SciencesCentre for Health Policy, Melbourne School of Population and Global Health, The University of MelbourneKamuzu University of Health SciencesPopulation Health and Immunity division, Walter and Eliza Hall Institute of Medical ResearchKamuzu University of Health SciencesKamuzu University of Health SciencesPopulation Health and Immunity division, Walter and Eliza Hall Institute of Medical ResearchCentre for Health Policy, Melbourne School of Population and Global Health, The University of MelbourneKamuzu University of Health SciencesAbstract Background Antenatal iron supplementation is critical to maternal and child health; however, access and adherence to oral iron are inconsistent in many low- and middle-income countries (LMICs). Modern intravenous (IV) iron products have become available in high-income clinical settings and provide an opportunity to deliver high doses of iron in a single-short infusion during pregnancy. However, there is limited knowledge of the drivers and barriers for such an intervention to be effectively delivered and upscaled in LMICs. In this study protocol, we describe the implementation research programme to support an IV iron intervention in Malawi for pregnant women with moderate and severe anaemia. Methods The implementation research programme has three phases, each guided by implementation science conceptual frameworks. In Phase 1, we will conduct formative research (context assessment of the health system with key informant interviews) to determine how IV iron can be effectively introduced into routine antenatal care. We will use the findings to co-develop potential strategies with end-users and healthcare providers to improve intervention implementation. In Phase 2, we will disseminate the implementation strategies to support the uptake and delivery of the intervention in the study settings. In Phase 3, the intervention will be implemented, and we will conduct formative evaluation (interviews with end-users, healthcare providers, and analysis of health services data) to investigate the feasibility and acceptability of the intervention and strategies. We will also identify processes and contextual factors that facilitate or impede the delivery and uptake of IV iron. Discussion In LMICs, modern IV iron products present a novel opportunity to rapidly cure moderate and severe anaemia in pregnancy, thereby improving maternal and child health outcomes. This implementation research programme will provide guidance and recommendations on how best an IV iron intervention for pregnant women with anaemia can be implemented in an LMIC setting like Malawi. We will develop locally relevant and culturally appropriate implementation strategies by engaging with key stakeholders (pregnant women, healthcare providers, and policymakers) and identifying factors likely to facilitate successful implementation. The findings of this research can guide the implementation of an IV iron intervention in Malawi and other LMICs.https://doi.org/10.1186/s43058-022-00299-xIntravenous ironMaternal healthAnaemiaMalawiLow- and middle-income countriesImplementation research
spellingShingle Khic-Houy Prang
Elisabeth Mamani-Mategula
Ebony Verbunt
Effie Chipeta
Ricardo Ataide
Martin Mwangi
Kamija Phiri
Sant-Rayn Pasricha
Margaret Kelaher
Lucinda Manda-Taylor
An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
Implementation Science Communications
Intravenous iron
Maternal health
Anaemia
Malawi
Low- and middle-income countries
Implementation research
title An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
title_full An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
title_fullStr An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
title_full_unstemmed An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
title_short An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol
title_sort implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in malawi study protocol
topic Intravenous iron
Maternal health
Anaemia
Malawi
Low- and middle-income countries
Implementation research
url https://doi.org/10.1186/s43058-022-00299-x
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