Community attitudes to pregnancy, anaemia, iron and folate supplementation in urban and rural Lagos, south-western Nigeria

Objective: to identify community perspectives and attitudes to pregnancy, anaemia, iron and folate supplements during pregnancy in Lagos, south-western Nigeria. Design: qualitative using focus group discussions, observational data and in-depth interviews. Setting: Amukoko, a peri-urban slum area and Ibese a rural coastal area in Lagos, south-western Nigeria. Participants: 23 pregnant women and two health-care providers. Findings: maternal anaemia is not perceived as a priority health problem by pregnant women. Knowledge of the signs and symptoms of anaemia is limited among rural pregnant women,The recognition of maternal complications associated with anaemia is low among pregnant women and some health-care providers. Severe blood loss at or after delivery is sometimes attributed to the excessive use of iron and folate supplements. Sustaining the motivation to continue taking iron tablets and communicating the benefits of iron supplementation which could encourage compliance was also lacking. Implications for practice: an understanding of the local beliefs, attitudes and practices regarding pregnancy is needed to design more effective methods of health education for pregnant women and to provide maternal services which are 'culturally acceptable'. (C) 2000 Harcourt Publishers Ltd.