Operational problems of an iron supplementation programme for pregnant women: an assessment of UNRWA experience
Pappagallo, S.; Bull, D.L.
Bulletin of the World Health Organization 74(1): 25-33
1996
ISSN/ISBN: 0042-9686 PMID: 8653813 Document Number: 297494
The authors identified the following operational problems in their assessment of an iron supplementation program for the 70,000 pregnant refugee women cared for by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA): late entry to antenatal care, high drop-out rate from antenatal care, low compliance in follow-up hemoglobin examinations, and misdirected continued testing of women who were not anemic at registration. These findings are based upon data obtained through the retrospective survey of 1267 antenatal records in health centers located in the West Bank, Gaza, Syrian Arab Republic, Jordan, and Lebanon. The authors stress that routine iron supplementation of all pregnant women should be considered only in countries where severe anemia is prevalent and should always be coupled with additional interventions which are effective at improving iron deficiency anemia in a given population. In most countries, attention should be directed toward changing dietary habits to enhance the availability of local foodstuffs which are rich in iron. An initial hemoglobin test may help to identify the relatively few initially anemic subjects who need further attention. Repeated testing during pregnancy is not warranted.