Using Data to Improve Iron Folic Acid (IFA) Tablet Intake Among Pregnant Women (PW) in Boucle Du Mouhoun (BdM) and Hauts Hassins (HB) Regions of Burkina Faso

Abstract Objectives To improve IFA tablet intake among PW in BdM and HB regions through evidence-based design and management of a facility-based antenatal care (ANC) intervention. Methods Mixed methods were used to design and collect data on the ANC intervention aiming to improve IFA tablet intakes among PW. Formative research from May 2019 to understand barriers of optimal IFA tablet intake as well as baseline results from December 2019 were used to design the intervention. In intervention areas, health system managers took corrective actions using data from weekly IFA stock surveillance, routine information system (PW attending the 1st ANC visit within the 1st trimester, adequate number of IFA tablets provided), exit interviews (percentage of PW who heard about IFA importance and how to manage side effects) during regular review meetings, . The endline survey was conducted in February 2021. Results Formative research data showed PW started the first ANC visits late due to misperceptions and ANC provider practices. Stock-outs occurred, and numbers of IFA tablets received were insufficient to meet daily intake needs until the next ANC visit. IFA counseling did not address personal barriers. The intervention was designed to strengthen the health system to address those barriers. Using routine data, decisions were taken to allow prevent stock-out (reallocate stock between facilities, directly supply those in pre-stock-out without waiting monthly period, mutualize logistics to supply several facilities simultaneously), provide ANC before the 4th month, provide 10-day dose margin between two ANC visits, reinforce counseling on importance of IFA and tips to manage side effects. These decisions were followed up during supervision. Endline data showed IFA service improvement and impact in uptake. In intervention areas, PW who took 180 + IFA tablets increased (9.2% to 23.7%). Conclusions Strategic use of data to design and manage nutrition programs helps effectively address the main barriers, take timely corrective actions during implementation. Funding Sources Bill & Melinda Gates Foundation through Alive & Thrive, managed by FHI Solutions.