Anemia Implementation Science Initiative


The Uganda Anemia Implementation Science Initiative (ISI) seeks to address the challenge of weak implementation and impact of anemia control programs for women and children in Uganda. Anemia ISI activities will be nested within the URC USAID Regional Health Integration to Enhance Services in East Central Uganda Activity (RHITES-EC) Project.

Anemia ISI focuses specifically on the anemia prevention intervention of iron folic acid supplementation (IFAS) in antenatal care (ANC). As part of its work across multiple technical areas, RHITES-EC supports facilities to provide nutrition services, including anemia control and prevention in ANC. The ISI has engaged a group of key stakeholders, referred to as the “core team” to ensure that its work is relevant to the priorities of anemia prevention in Uganda. This core team includes representatives from the Ministry of Health, the Office of the Prime Minister, Uganda National Medical Stores (government-owned drug procurement, storage and distribution organization), USAID, UNICEF, and other implementing organizations such as the Infectious Diseases Institute.


Project Objectives

  • Assess national- and district-level bottlenecks to effective IFAS. Stakeholders in the IFAS service delivery and supply chain systems came together at a national-level bottleneck analysis workshop in October 2018 to prioritize bottlenecks in each system. Priority bottlenecks in the service delivery system included poor health education in antenatal care and low rates of male involvement in ANC. In the supply chain systems, bottlenecks revolve around recurrent stock-outs of IFAS due to poor quantification procedures. The priority bottlenecks were validated at district-level meetings in December 2018 with results entered into a bottleneck inventory which will be revisited periodically by the core team.
  • Conduct two implementation research studies based on the priority bottlenecks. Research questions will focus on the current implementation of antenatal health education and quantification and assessing how the use of quality improvement approaches changes health education and stock-outs, and hopefully uptake and utilization of iron and folic acid. Implementation research studies commence in mid-2019.
  • Integrate the evidence from the implementation research studies into anemia prevention programs and policy. Evidence uptake activities will occur throughout the project with key members of the core team communicating important findings to policymakers and program managers. At the end of the project, an evidence-sharing meeting will be held to ensure that all information from the two implementation research studies, as well as the bottleneck assessments, are widely shared and utilized.


Mothers and their children wait outside a clinic in Uganda. © 2017 Cynthia Ayeza Mutabaazi, Courtesy of Photoshare
Mothers and their children wait outside a clinic in Uganda. © 2017 Cynthia Ayeza Mutabaazi, Courtesy of Photoshare
2018 to 2020
Regions/ Countries