TABLE 2.
Illustrative quotes from antenatal care providers about calcium supplementation
| Themes | Illustrative quotes |
|---|---|
| Training was sufficient, but more depth was desired | We never went so deep into it. But, we got the essence, we got that this is calcium, it is there to do this and this for the mother… but if there was time, we could have gone deeper… but the training we got, we are using it and we are performing. —Health center nurse, #03-06 |
| Perceived improvements in women's health as a result of calcium supplements | I know it is essential to give women the supplements because… before this program was introduced these women had difficulties during pregnancy… When we started giving out this calcium, those problems with pregnancy reduced… women are taking it positively because they find someone to encourage them at home and remind them to take these supplements. The way that we counsel them, they usually find it essential for them to take these pills because they know the benefits. —Dispensary nurse, #11-31 |
| Observed increased attendance at antenatal care | I have liked [calcium] because initially when you give pregnant women health education, it really spreads and everybody is eager. Whenever they come, they will even remind you, “What about the calcium and IFA?” Compared to places where they are not giving calcium, they prefer coming here because they say they understand there is a new pill. —Health center nurse, #17-48 |
| Experienced increased workload | [The addition of calcium] has led to more work on our side. You see, I have to do the counseling and the dispensing… but there is nothing you can do about the workload because we [providers] are few. —Health center nurse, #15-43 |
| Comorbidities made adherence challenging | We are giving them anti-malaria medicine, IFA, and now calcium… for some, it is like you are overloading them. Even some will tell you, “Doctor, there are so many medicines.” Others say they don't like swallowing tablets. After counseling, they come to see the benefits and will take them, but she will tell you she doesn't like taking all these medicines. —Health center nurse, #03-06 |
| Suggestions to improve supplementation programs | What I have heard from almost all my clients, in fact all of them, is that these tablets are too many to take. At least, if it could have been 1, it would be OK. If there was a way they could make 1 tablet taken once, however big or small, at least it will be a combination. There wouldn't be a lot tablets being carried all over. —Dispensary nurse, #04-13 |
| Opinions about adherence partner strategy | It is also good when you have somebody who is encouraging you to take it; at least you feel you have somebody who is caring for you, who is concerned. —Health center nurse, #17-46 |