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Review Article
Iron supplementation in children to prevent deficiency and anaemia: A qualitative synthesis
Submitted: 05 November 2024 | Published: 14 May 2025
About the author(s)
Denny Mabetha, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Health Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaIdriss I. Kallon, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Marianne Visser, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Celeste Naude, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Willem Odendaal, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; and Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Amanda S. Brand, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Sara Cooper, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Abstract
Background: Iron deficiency anaemia in young children is a major problem globally, particularly in low- and middle-income countries (LMICs). The World Health Organization (WHO) recommends preventive oral iron supplements to reduce the prevalence of iron deficiency and anaemia in high-prevalence settings.
Aim: To conduct a qualitative evidence synthesis exploring the factors influencing the acceptability, feasibility and equity of preventive oral iron supplementation in young children for the Global Evidence, Local Adaptation (GELA) project, which supports the development of evidence-informed, locally relevant guideline recommendations in three sub-Saharan countries.
Method: We searched MEDLINE, Epistemonikos, CINAHL and PsycInfo from inception to 07 July 2023 for eligible studies. We synthesised the data using thematic analysis and assessed the methodological quality of the studies (using an adaptation of the Critical Appraisal Skills Programme tool) and confidence in the review findings (using GRADE-CERQual).
Results: We included six studies, five from LMICs. Findings indicated knowledge and perceptions about iron supplementation, as well as relationships with intervention providers, can have a beneficial or detrimental influence on caregiver acceptance (moderate to high confidence); caregiver acceptance may be negatively affected by a lack of reliable information but can potentially be enhanced through community-based education (moderate confidence); healthcare workers’ knowledge, resources and support may improve the feasibility of intervention provision (moderate confidence) and socio-economic challenges around access to the intervention may adversely affect equity (low confidence).
Conclusion: A complex interplay of contextual factors may impact the provision and uptake of preventive oral iron supplementation in young children.
Contribution: This work provides insights into how preventative oral iron supplementation might be contextually tailored.
Keywords
Sustainable Development Goal
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