Adherence to iron and folate supplementation and associated factors among women attending antenatal care in public health facilities at Covid-19 pandemic in Ethiopia

Abstract

Adhesion is the degree to which a patient complies with treatment recommendations made by a health care professional. The majority of pregnant women worldwide don’t get the recommended amounts of iron and folic acid (30 to 60 mg of iron and 400 g of folic acid/day for 6 months) pregnant women are more likely to develop iron- and folic acid deficiency anemia. For iron and folate supplementation programs to be effective in Ethiopia, adherence is a significant issue. So, this study aimed to evaluate the level and barriers preventing women receiving antenatal care from taking iron and folate supplements. A phenomenological qualitative study design was added to a facility-based cross-sectional study. The sample was established using a double population proportion formula. For the quantitative and qualitative study, 308 pregnant women and the focal points for the health facilities were chosen at random, using systematic random sampling and purposive sampling techniques. For the quantitative study, a face-to-face interviewer-guided, pre-tested structured questionnaire was used; for the qualitative study, a semi-structured questionnaire was used. Data was entered twice, cross-checked by comparing the two separate entries in Epi Data version 7.2.2.6, and exported to SPSS version 25 for analysis. COR and AOR with 95% CI are used to evaluate the relationship between variables and control for confounding factors. Statistical significance was declared at a p-value < 0.05. All, 308 (100%) participants were involved. 56.5% of pregnant women attending an ANC clinic (95% CI: 51%–62.2%) adhered to Iron and folate supplementation. Mothers with primary education], Urban residents mothers, Mother who had four or more ANC visits, mothers who had registered for their first ANC at early gestational age, mothers who had good awareness about birth defects were independent predictors of adherence to Iron and folate supplementation. In our study, adherence to iron and folate supplementation was low relative to previous research findings. Promoting early and frequent ANC visits and improving pregnant women’s awareness of anemia and birth defects through education is necessary to increase the adherence status.

Influence of Demographic, Socioeconomic, and Antenatal Care Factors on Iron Supplementation Adherence Among Filipino Pregnant Women Using Hierarchical Regression

“…7 Early initiation of ANC visits during the first trimester was associated with iron supplement uptake, promoting adherence by allowing sufficient time for the recommended duration. 8 Having at least four ANC visits further facilitated iron supplementation, 4,9 emphasizing the importance of following recommended ANC guidelines…”

Assessment of Iron–Folate Adherence and Associated Factors Among Pregnant Women in Public Health Facilities of Durame Town, Southern Ethiopia

“…A similar study conducted at public hospitals in Jigjiga Town, Somali Region, in 2020 revealed that 54.9% of pregnant women were adherent to IFA supplementation ( Ridwan & Shafi, 2021b ). Another similar study conducted in Ethiopian public health facilities during the COVID-19 pandemic showed that 56.5% of pregnant women have adhered to IFA supplementation ( Tefera et al, 2023 ). A study conducted in Adwa town, Tigray, showed that 40.9% of participants were adherent (took four or more tablets per week) to IFA supplementation ( Gebremichael & Welesamuel, 2020 ).…”

“…A study conducted in Jigjiga Town showed that the time to start ANC, knowledge of anemia, counseling on the importance of the iron–folic acid, IFAS given during clinical visits, number of meals consumed, number of children, and distance to health facility were independernt predictors of adherence to IFA supplementation ( Lyoba et al, 2020 ). A study conducted in Ethiopia's public health facilities during the COVID-19 pandemic showed that mothers with primary education, urban resident mothers, mothers who had four or more ANC visits, mothers who had registered for their first ANC at early gestational age, and mothers who had good awareness about birth defects were independent predictors of adherence to IFA supplementation ( Tefera et al, 2023 ). A study conducted in Jigjiga Town showed that secondary and above-educated women, women who had more than four ANC visits, and knowledgeable women about IFA supplements were significant factors for iron–folate adherence ( Ridwan & Shafi, 2021b ).…”

Saúde pública e saúde coletiva: contribuições para o bem-estar da comunidade 2

“…Diabetes mellitus 89,90,91,95,98,101,102 F Fitoplâncton 23,33,37,38 H Hemoglobinopatias 111,112,113,114,115,116,118,119,121 ÍNDICE REMISSIVO I Índices ecológicos 22,23,24,32,33 Infecções 14,19,20,72,79,83,86,104,105,106,107 Sarampo 82,83,84,85,86,87,88 Saúde coletiva 20,22,63,102,119,120,121,126 Saúde do trabalhador 56,63,68,111 Saúde ocupacional 56,57,58,68 Sedentarismo 63,…”