Alternative approaches to decreasing maternal anemia: identifying the need for social marketing strategies to promote iron-folic acid supplementation in the Peruvian highlands

Anemia is the most common health condition affecting women during pregnancy, and leads to adverse health outcomes of both the mother and infant. Despite national fortification and supplementation programs in Peru, 21% of women of reproductive age are anemic. Adherence to iron-folic acid (IFA) supplements in this vulnerable population is low and influenced by side effects of the tablets, such as nausea and vomiting, caused by the generic formula of the tablets. The trust within a patient–provider relationship and the provider's competency at effective counseling increases women's adherence, whereas late entry into prenatal care and government regulations limit early initiation of IFA supplementation. It is important for partners to support women during supplementation and participate in their prenatal care. Social marketing strategies targeting the product, price, place, promotion, and policy of IFA supplements should decrease barriers to women's ability to obtain IFA tablets and adhere to the supplementation regimen and reduce iron deficiency maternal anemia. Public health practitioners implementing supplementation programs should consider different behavioral influences at the intrapersonal, interpersonal, and community levels that affect adherence. Copyright © 2012 John Wiley & Sons, Ltd.