Maternal Iron/ Folic Acid Supplement Coverage

The indicator assesses the proportion of mothers who during their last pregnancy consumed the number of iron/ folic acid supplements recommended by the local Ministry of Health and its local health facilities. Their consumption is essential for preventing the risks associated with anemia, such as premature birth, low birth weight and maternal mortality.

Determine the indicator's value by using the following methodology:

1) Review the national policy and local health facilities’ practices to identify the number of iron/ folic acid supplements they recommend women to use during pregnancy. In most countries, a combined iron-folic acid supplement is given to pregnant women, and therefore you do not have to ask separately about iron and folic acid.  

2) Conduct individual interviews with a representative sample of mothers of children aged 0-11 months, asking them:

Q1: During the last pregnancy, were you given or did you buy any iron tablets or iron syrup?

A1: yes / no / does not know

(ask the following question only if the previous answer is YES)

Q2: During the whole pregnancy, for how many days did you take the tablets or syrup?

A2:

1) ………… (enter the number of days)

2) does not know

Since some women may not know that they were given iron tablets, instruct the interviewers to show the woman the sample tablets as they ask this question.  It is good to check for blister packages and to know about standard number of tablets per package, so that you can ask for the number of blister packages finished.

3) To calculate the indicator’s value, divide the number of respondents who consumed the recommended number of iron/folic acid supplements by the total number of respondents (exclude those with “does not know” as an answer).  Multiply the result by 100 to convert it to a percentage.

Disaggregate the data by location (near/ far from the nearest health facility; rural/ urban areas), source of supplement (purchased in a shop/ received in a health facility), mother’s age, number of children, and socio-economic status (wealth quintile, level of education).

1) A coverage of less than 80% generally indicates that supplementation requires some more priority. At the same time, however high, medium and low designations should be discussed within the context.

2) The most common recommendation is to interview mothers of children aged 0-23 months. However, this assumes that the mothers will remember the information your survey asks about for up to two and half years. Since this is not very likely, IndiKit recommends using a shorter recall period for this indicator by interviewing mothers of children aged 0-11 months. Use it only if the data is supposed to be used purely for the purpose of your intervention (i.e. making programming decisions, measuring its results, etc.) and does not need to be comparable with the statistics of other stakeholders which use longer recall period. 

3) This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or another document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use.