Related Experiment Video
Updated: Aug 16, 2026
A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Guidelines on anaemia: effect on primary-care midwives in The Netherlands
Pien Offerhaus1, Margot Fleuren, Michel Wensing
1Centre for Quality of Care Research (WOK), University Medical Centre, St Radboud Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Objective:
To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands.
Design:
Cross-sectional survey study.
Setting:
Primary-care midwifery in The Netherlands.
Participants:
160 midwives (60% response rate).
Measurements:
Questionnaire on the knowledge of, and attitudes and self-reported adherence to, 14 key recommendations in the guideline; attitudes to guidelines in general; and perceived barriers to implementation.
Findings:
The number of midwives agreeing with and adhering to specific recommendations varied between 29 and 90%. Most midwives had a positive attitude to the guidelines. The most relevant general barriers were related to the behaviour of general practitioners and obstetricians (32% of the midwives reported this). Larger numbers of midwives mentioned barriers to specific aspects of the guideline, particularly alternative iron supplementation or dietary supplements (59%), and not prescribing iron supplementation if haemoglobin was low but mean corpuscular volume was normal (49%).
Key Conclusions:
The guideline on anaemia was well received by primary-care midwives in The Netherlands, but implementation of specific recommendations needs further attention.
Implications For Practice:
The study provides evidence for the national organisation of midwives to continue with the development and implementation of clinical guidelines.
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