![]() ![]() Our findings revealed good attitudes to iron drip. We interviewed pregnant women, family support and health care providers in 10 health facilities in Lagos and Kano States, Nigeria. Therefore, this study was conducted to understand the factors that will make this treatment widely accepted. ![]() ![]() Moreover, being effective is different from being utilised. However, it is not routinely used in countries like Nigeria. Fortunately, an alternative therapy in the form of a drip has been shown to overcome these challenges. The use of oral iron has been the primary treatment however, it is associated with significant side effects, which have led to poor compliance. Without treatment, this condition could affect the baby, possibly leading to its sudden demise in the womb, immediately after birth, or even the woman’s death. It could lead to fatigue, decreased work capacity, and dizziness if not detected. This low blood level is usually caused by poor intake of an iron-rich diet. Low blood level in pregnancy is of public health importance and with common occurrence worldwide, but with a higher rate in low resource settings where its burden greatly affects both the mother and her baby. Trial registration ISRCTN registry ISRCT N6348 4804. HCP training, optimisation of information and clinical care delivery during antenatal visits, uninterrupted supply of IV iron, and subsidies to offset higher costs need to be considered to improve its acceptability. IV iron has a potential to become the preferred treatment for iron-deficiency anaemia in pregnancy in Nigeria if proven effective. Finally, even though high out-of-pocket costs might make IV iron out of reach for poor women, the HCPs felt it can potentially prevent higher treatment fees from complications of IDA. To all stakeholder groups, leveraging the existing infrastructure to facilitate IV iron treatment will stimulate coherence and self-efficacy while strengthening the existing trust between pregnant women and HCPs can avert misconceptions. However, to pregnant women and the HCPs, IV iron could present a higher opportunity cost than oral iron for the users and providers as it necessitates additional time to receive and administer it. It was perceived as a suitable alternative to blood transfusion for specific individuals based on ethicality. The HCPs noted the effectiveness of IV iron in its ability to evoke an immediate response and capacity to reduce anaemia-related complications. Generally, all stakeholders had a positive affective attitude towards IV iron based on its comparative advantages to oral iron. We identified three main themes and eight sub-themes that reflected the prospective acceptability of IV iron therapy. We used the theoretical framework of acceptability to conduct qualitative content analysis. ![]() Semi-structured topic guides guided 12 focus group discussions (140 participants) and 29 key informant interviews. We purposively sampled various stakeholders, including pregnant women, domestic decision-makers, and healthcare providers (HCPs) during the pre-intervention phase of a hybrid clinical trial (IVON trial) in 10 healthcare facilities across three levels of the health system. This qualitative study explored the acceptability of IV iron in the states of Kano and Lagos in Nigeria. Among pregnant women with iron deficiency, which is a leading cause of anaemia (IDA), intravenous (IV) iron is an alternative treatment in moderate or severe cases. The main treatment, daily oral iron, is associated with suboptimal adherence and effectiveness. Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. ![]()
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