Iron Deficiency in Indigenous Pregnant Women

Table of Contents
Part A...................................................................................................................................2
Public Health Issue: Iron Deficiency...............................................................................2
Prevalence........................................................................................................................2
Determinants....................................................................................................................3
Consequences..................................................................................................................3
Part B...................................................................................................................................4
Description of Approach..................................................................................................4
Strength of Evidence........................................................................................................5
Equity...............................................................................................................................6
Acceptability....................................................................................................................6
Feasibility........................................................................................................................7
Part C...................................................................................................................................7
Evidence 1.......................................................................................................................7
Aims and Relevance....................................................................................................7
Study Design and Methods..........................................................................................8
Results and Discussion................................................................................................8
Strengths and Limitations............................................................................................8
Implications.................................................................................................................8
Conflicts of Interest.....................................................................................................9

Relevant References....................................................................................................9
Evidence 2.......................................................................................................................9
Aims and Relevance....................................................................................................9
Study Design and Methods..........................................................................................9
Results and Discussion..............................................................................................10
Strengths and Limitations..........................................................................................10
Implications...............................................................................................................10
Conflicts of Interest...................................................................................................10
Relevant References..................................................................................................10
Conclusion.........................................................................................................................11
References..........................................................................................................................12

Part A
Public Health Issue: Iron Deficiency
The following paper will shed light on the public health issue of micronutrient deficiency
associated with iron, within the country of Australia in general and the target population of
indigenous and aboriginal pregnant women in particular. Iron deficiency (ID) implies a
physiological condition in which an individual is consuming reduced quantities of iron, as
compared to the Recommended Dietary Intakes (RDI). This results in Iron Deficiency Anemia
(IDA) a physiological condition characterized by inadequate hemoglobin in the blood, due to low
levels of iron in the body [2]. The of Aboriginals and Torres Strait Islander people in Australia,
are prevalently deprived of nutritious food accessibility and availability of required healthcare
service and treatment resources [3]. Hence, the essential role of iron during pregnancy, harmful
consequences of deficiency and deficient iron status in socially disadvantaged groups like
Indigenous pregnant women residing in rural and remote areas form the rationale behind
selection of this target population.
Prevalence
According to the collaborative statistical report by the Food Standards Australia New
Zealand (FSANZ) and Australia Bureau of Statistics (ABS), it has been estimated that only one
among a group of four females are meeting the RDI of iron (18mg/day as per the Nutrient
Reference Values for Australia and New Zealand [4]. The Australian Journal of General Practice
(AJGP) highlights high prevalence of iron deficiency anemia (IDA) during pregnancy among
non-Indigenous Australian women at rates of 18% in Tasmania and 19.6% in New South Wales
[5]. In contrast, as reported by the Australian Government’s Department of Health, the

prevalence of iron deficiency anemia has been estimated to be significantly high among
aboriginal Australian women during pregnancy, at rates of 50% in remote areas across
communities of the Northern Territories, 10% in Brisbane and 12% across nationwide
community health organizations attending to this target population. Such statistics highlight the
alarming state of iron deficiency among Australian indigenous females during pregnancy, hence
necessitating immediate public health based mitigation [6].
Determinants
The strong association between socioeconomic disadvantage and indigenous
communities is the key factor determining high prevalence of iron deficiency among indigenous
pregnant women in Australia. The target population of Indigenous pregnant women residing in
rural and remote areas of Australia encounter reduced accessibility to healthcare services which
may provide required preventive treatment, maternal care and nutritional education [7]. In
addition to accessibility, pharmaceutical organizations, maternal and child healthcare
organizations and community services may find it difficult to establish their care centers or
transport pharmaceutical products, hence contributing to health inequities and poor health
outcomes among rural Indigenous pregnant women [8]. Healthcare services may also not be
compliant to the diverse linguistic needs of such communities hence resulting in disparities and
negative health outcomes due to cultural incompetence [9]. Further, due to prolonged history of
oppression, Indigenous groups possess compromised financial resources and are often unable to
afford and find accessibility to nutritious food (such as iron rich foods for example, red meat,
green leafy vegetables, nuts, seeds and fortified cereal products) and healthcare resources,
resulting in increased risk of micronutrient deficiencies [10]. Further, Indigenous communities of
Australia possess a rich, diverse and unique cultural heritage consisting of traditional dietary and