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<p>Anaemia affects over one-third of pregnant women in Bangladesh, leading to serious consequences including maternal death and stillbirth. Yet, only about half of pregnant women are tested for anaemia, and few receive intravenous iron – an effective treatment option. It remains unclear whether health facilities have the resources, and whether health workers are willing and able, to deliver these services. Embedded within a demonstration project, our study aimed to evaluate the organisational readiness of Bangladesh’s primary health care system to provide point-of-care anaemia testing and intravenous iron treatment for pregnant women. We employed a multi-phase, mixed-methods, parallel convergent design. Formative research included a baseline health facility readiness assessment (n=20). In the parallel process evaluation, health workers completed the Organisational Readiness for Implementing Change questionnaire (n=35), and a sample participated in qualitative interviews (n=21). Quantitative data were analysed descriptively, while qualitative data were analysed using inductive thematic analysis and mapped to the Capability, Opportunity, and Motivation model of Behaviour Change. Findings were integrated across data sources for a comprehensive evaluation. We found high psychological readiness for implementing anaemia testing and intravenous iron treatment, with health workers demonstrating strong commitment and confidence in providing these services to pregnant women. However, structural readiness was incomplete, with sustaining both interventions beyond the demonstration project requiring addressing resource constraints, including shortages of equipment, guidelines, nurses, and doctors. Government support for implementation and resource provision will be essential to ensure the continued delivery of anaemia testing and intravenous iron treatment in Bangladesh’s primary health care system.</p>

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From Testing to Treatment: A Mixed-Methods Study of Organisational Readiness for Intravenous Iron for Pregnant Women with Anaemia in Bangladesh

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Ebony Verbunt,
  • ABM Rasheduzzaman,
  • Bidhan Krishna Sarker,
  • AM Quaiyum Rahman,
  • Jena Derakhshani Hamadani,
  • Sant-Rayn Pasricha,
  • Meghan A Bohren,
  • Cathy Vaughan,
  • Khic-Houy Prang

摘要

Anaemia affects over one-third of pregnant women in Bangladesh, leading to serious consequences including maternal death and stillbirth. Yet, only about half of pregnant women are tested for anaemia, and few receive intravenous iron – an effective treatment option. It remains unclear whether health facilities have the resources, and whether health workers are willing and able, to deliver these services. Embedded within a demonstration project, our study aimed to evaluate the organisational readiness of Bangladesh’s primary health care system to provide point-of-care anaemia testing and intravenous iron treatment for pregnant women. We employed a multi-phase, mixed-methods, parallel convergent design. Formative research included a baseline health facility readiness assessment (n=20). In the parallel process evaluation, health workers completed the Organisational Readiness for Implementing Change questionnaire (n=35), and a sample participated in qualitative interviews (n=21). Quantitative data were analysed descriptively, while qualitative data were analysed using inductive thematic analysis and mapped to the Capability, Opportunity, and Motivation model of Behaviour Change. Findings were integrated across data sources for a comprehensive evaluation. We found high psychological readiness for implementing anaemia testing and intravenous iron treatment, with health workers demonstrating strong commitment and confidence in providing these services to pregnant women. However, structural readiness was incomplete, with sustaining both interventions beyond the demonstration project requiring addressing resource constraints, including shortages of equipment, guidelines, nurses, and doctors. Government support for implementation and resource provision will be essential to ensure the continued delivery of anaemia testing and intravenous iron treatment in Bangladesh’s primary health care system.