Background: Iron deficiency anaemia in young children is a major problem globally, particularly in low- and middle-income countries (LMICs). The World Health Organization (WHO) recommends preventive oral iron supplements to reduce the prevalence of iron deficiency and anaemia in high-prevalence settings.

Aim: To conduct a qualitative evidence synthesis exploring the factors influencing the acceptability, feasibility and equity of preventive oral iron supplementation in young children for the Global Evidence, Local Adaptation (GELA) project, which supports the development of evidence-informed, locally relevant guideline recommendations in three sub-Saharan countries.

Method: We searched MEDLINE, Epistemonikos, CINAHL and PsycInfo from inception to 07 July 2023 for eligible studies. We synthesised the data using thematic analysis and assessed the methodological quality of the studies (using an adaptation of the Critical Appraisal Skills Programme tool) and confidence in the review findings (using GRADE-CERQual).

Results: We included six studies, five from LMICs. Findings indicated knowledge and perceptions about iron supplementation, as well as relationships with intervention providers, can have a beneficial or detrimental influence on caregiver acceptance (moderate to high confidence); caregiver acceptance may be negatively affected by a lack of reliable information but can potentially be enhanced through community-based education (moderate confidence); healthcare workers' knowledge, resources and support may improve the feasibility of intervention provision (moderate confidence) and socio-economic challenges around access to the intervention may adversely affect equity (low confidence).

Conclusion: A complex interplay of contextual factors may impact the provision and uptake of preventive oral iron supplementation in young children.Contribution: This work provides insights into how preventative oral iron supplementation might be contextually tailored.

Keywords: acceptability; anaemia; children; equity; feasibility; iron-deficiency anaemia; low and middle-income countries; qualitative evidence synthesis.

背景：

全球范围内，特别是在低收入和中等收入国家（LMICs），婴幼儿缺铁性贫血是一个重大问题。世界卫生组织（WHO）建议在高发地区使用预防性的口服补铁来减少缺铁和贫血的流行率。

目的：

为了支持“全球证据，本地适应”（GELA）项目，在三个撒哈拉以南非洲国家中开发基于证据且符合当地实际情况的指南建议，本研究旨在开展一项定性证据综合分析，探讨影响预防口服补铁在婴幼儿中的可接受性、可行性和公平性的因素。

方法：

我们在MEDLINE、Epistemonikos、CINAHL 和 PsycInfo 中从建库开始到2023年7月7日搜索符合条件的研究。我们使用主题分析法对数据进行综合，并评估了研究的方法学质量（采用批判性评价技能计划工具的改编版本）以及对回顾结果的信心水平（采用 GRADE-CERQual 方法）。

结果：

共纳入六项研究，其中五项来自低收入和中等收入国家。结果显示，关于铁补充的知识与看法，以及与干预提供者的互动关系，可能会影响照护者接受补铁的积极或消极态度（中到高度信心）；缺乏可靠的资讯可能会对照护者的接受度产生负面影响，但通过社区为基础的教育可以潜在提高其接受程度（中等信心）；医疗工作者的知识、资源和支持可能会改善干预实施的可能性（中等信心），而与获取干预相关的经济挑战可能会影响公平性（低信心）。

结论：

预防性口服补铁在婴幼儿中的提供和使用受到多种上下文因素的复杂相互作用的影响。这项研究提供了关于如何根据具体情境对预防性口服补铁进行调整的见解。

关键词：可接受性；贫血；儿童；公平性；可行性；缺铁性贫血；低收入和中等收入国家；定性证据综合分析。