Identifying bottlenecks in the iron and folic acid supply chain in Bihar, India: a mixed-methods study

Table 3 ANM reported iron and folic acid supplement supply status and procurement protocols by district

	IFA Out of Stock (%)	Cannot Request IFA from PHC (%)^a	Uses Buffer Stock (%)^b	Average Buffer Stock (mean (95% CI))^c	Only obtains IFA from the PHC (%)^d
District A	90.5	17.3	59.1	447 (265, 628)	81.9
District B	28.1	7.0	87.4	911 (355, 1467)	63.2
District C	63.3	5.3	81.4	544 (219, 867)	64.1
District D	0.0	7.3	92.6	1112 (520, 1704)	81.7
District E	26.0	17.5	69.6	1196 (425, 1967)	82.8
District F	47.8	14.3	60.2	1182 (246, 2118)	78.1
District G	16.2	3.5	82.1	303 (121, 485)	41.0
District H	13.8	19.8	42.6	1177 (613, 1743)	82.7
Total	44.1	9.5	74.4	751 (554, 949)	67.8

ANM Auxiliary Nurse Midwife, IFA iron and folic acid supplements (100 mg elemental iron and 500 mcg folic acid), PHC Primary Health Centre, CI Confidence Interval
^aANMs responded to a multiple choice question asking how they receive IFA from the PHC with 3 possible responses: through fixed deliveries (cannot request), through fixed deliveries (can request), or can only receive IFA through request
^bAlternate responses were: request IFA when completely out of stock or cannot request IFA
^cAverage buffer stock was calculated only among those ANMs reporting buffer stock use
^dAlternate responses were: can take IFA from ASHA kits, can borrow IFA from other health sub-centres, or can purchase IFA using health sub-centre funds; On average, 6.9% of survey data was missing from the above table

ISSN: 1472-6963