Study Objectives: 

1. To assess barriers and facilitators to prenatal supplementation and preconception fortification through interviews with pregnant women, including the role of side effects, access, knowledge, and beliefs.
2. To assess barriers and facilitators to prenatal supplementation and preconception fortification through interviews with nurses and midwives, including the role of knowledge, availability of medication, side effects, and adherence.
3. To assess barriers and facilitators to prenatal supplementation and preconception fortification through interviews with pharmacists, including the role of knowledge, supply chain, and availability of medications.
4. To assess barriers and facilitators to prenatal supplementation through interviews with Ministry of Health officials, including the role of availability of medications, supply chain, health systems, and policy. 

Study Design: This study will employ a non-randomized purposive method involving qualitative design to enable the researchers to describe and explain the social context of the barriers and facilitators to prenatal supplementation and preconception fortification in Botswana.

Study Population and Size: Pregnant women aged 18 years and above; nurses/midwives; pharmacists involved in acquisition, distribution and dispatchment of drugs and involved with supply chain management in Botswana; and Ministry of health officials who are involved in nutrition and reproductive health.

We expect to recruit 36 participants: 20 pregnant women, 8 nurses/ midwives, and 4 pharmacists (two from clinics and two involved in supply chain management) and 4 Ministry of Health officials (2 involved in Nutrition and 2 in reproductive health).

Study Duration: 2 years

Sponsor: National Institute of Child Health and Human Development (NICHD).