Challenges, motivators and coping strategies of iron-folic acid tablets intake in the girls iron-folic acid tablet supplementation program in Wa municipality of Ghana

Abstract Background The World Health Organization has recommended intermittent weekly iron-folic acid (IFA) supplementation as the most cost-effective intervention to reduce the burden of anemia among adolescents and women in child bearing age. Given the documented benefits of iron-folic acid supplementation, it goes with jurisdictional hurdles and motivators for uptake yet little is known in this regard in our study’s settings. This study aimed to assess the challenges, motivators, and coping strategies for IFA tablets intake among beneficiaries in the Girls Iron-Folic Acid Tablet Supplementation (GIFTS) program of the Upper West region-Ghana. Materials and methods A convergent parallel mixed-methods design (n = 355; three focus group discussions) was used in this study. Semi-structured questionnaire was used to gather data on socio-demographic characteristics, motivators for IFA tablets intake, while focus group discussion was used to collect data on challenges, motivators and coping strategies for IFA tablets intake. Results Challenges to IFA tablets intake were reported under personal level (pharmacophobia, inadequate knowledge, experienced side effects, and forgetfulness), product level (negative sensory attributes), and school/distribution level (distribution failures and shortages). IFA tablets intake was motivated by perceived personal level benefits (nutritional and health benefits, appetite enhancement, menstrual benefits) derived from the IFA up-take. Participants adopted various coping strategies for personal and product level challenges, (Water therapy, massage therapy, medication, rest/reduced mobility, changed dressing style, avoiding tablets intake, and masking of tablets). The study also showed that participants had no specific coping mechanism for school/distribution level challenges (distribution failures and shortages). Conclusion Varied challenges, motivators, and coping strategies for IFA intake were identified. Beneficiaries experienced shortages of IFA tablets distribution. It is thus recommended that implementers of the GIFTS program make the tablets readily available to schools to avoid shortages.