Adherence to prenatal iron–folic acid supplementation and associated factors among pregnant women attending antenatal care services in Dilla town, South Ethiopia

Abstract

Background: During pregnancy, due to the physiological and hormonal change, the requirement of iron–folic acid is enhanced. Therefore, the occurrence of iron/folic acid deficiency is relatively high and it is responsible for 95% of anemia during pregnancy. Objectives: The aim of this study was to assess adherence to prenatal iron–folic acid supplementation (IFAS) and associated factors among pregnant women attending antenatal care services at public health facilities of Dilla town. Methods: Facility-based cross-sectional study design was employed selecting 403 pregnant women attending antenatal care services in three public health institutions of Dilla town. The women were included in the study by simple random sampling. Data were collected by interview and document review. Then it was entered into EPI Data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression techniques were used to identify independent predictors. A p-value <0.05 was taken as indication of statistical significance. Results: From the total of planned 403 pregnant women, 396 participated in the study, with a response rate of 98.2%. Of these, 172 (43.4%) pregnant women were adhered to IFAS. The study also revealed that history of previous anemia (adjusted odds ratio (AOR) = 1.87; 95% confidence interval (CI): (1.01–3.47); p = 0.04), frequency of antenatal care center (ANC) visits (AOR = 2.51; 95% CI: (1.17–5.37); p = 0.01), knowledge of IFA supplement (AOR = 2.28; 95% CI: (1.36–3.82); p = 0.002), and knowledge of anemia (AOR = 2.30; 95% CI: (1.40–3.77); p = 0.001) were independent predictors of adherence to IFAS. Conclusion: The finding of this study showed that less than half of the pregnant women were adhered to IFAS. History of previous anemia, frequency of ANC visits, knowledge of IFA supplement, and knowledge of anemia were the factors associated with adherence to IFA supplement.

Utilization and compliance with iron supplementation and predictors among pregnant women in Southeast Ethiopia

“…In this study, the overall compliance rate of iron supplementation during pregnancy was found to be 92.4%. The current finding was higher than many previous reports in Ethiopia, such as the compliance rate, which varied from 60 to 63.6% in Addis Ababa 32 , 44 , 45 , 87.6% in Ethiopia 37 , Dire Dawa 46 , Shalla District 47 , 43.4% Dilla town 48 , 38.3% Hadassah 28 , 51.4% Burin district 49 , 52.9% Debbie 50 , 28.1% Denbiya District 36 , 28.7% Lay Armachiho 31 , 55% Gondar 51 , 47.6% Aykal town 30 , 44% Debre Tabor 52 , 43% Wollo 53 and 74.9% in four regions of Ethiopia 20 , 67.6% Simada district 54 , 52.8% Debay Tilat Gen district 55 , 37.2% Northwestern zone of Ethiopia 35 , 55.5% Debre Markos town 56 , 76.9% Dangila, Northern Ethiopia 57 , 40.9% in Adwa town 58 , and meta-analyses, 46.15, 46.1, 41.38 and 43.63% 59 – 62 . The present finding was also higher than many others, for example, a meta-analysis in SSA 63 , Uganda 64 , Kenya 65 , Nigeria 24 , Northwest Tanzania 66 , Northern Tanzania 67 , 22 sub-Saharan African countries 23 , Niger 68 , West Iran 69 , Cambodia 34 , Nepal 70 , 71 , India 72 , and Sri Lanka 73 .…”

Adherence to Iron and Folic Acid Supplementation and Prevalence of Anaemia Among Pregnant Women at a Tertiary Care Hospital

“…11 The adherence rate in similar study contexts was reported to be 43.4% and 38.3% in Ethiopian institution-based crosssectional research. 15,16 Differences in lifestyle, pregnant women's understanding of IFAS, and respondents' educational status could be contributing factors.…”

Effect of knowledge and counseling on adherence to iron supplementation in pregnant women: A systematic literature review

“…An analysis of the effect of anemia knowledge and iron tablet supplementation on pregnant women's adherence to consuming iron tablets was obtained from the ten articles reviewed. Eight articles stated that knowledge about anemia and iron tablet supplementation was one of the significant factors related to adherence [6,9,12,14,[16][17][18][19], while the other two articles did not find a significant association between knowledge and the adherence of pregnant women to consuming iron tablets [10,17].…”

“…Anemia knowledge questionnaire items include signs and symptoms of anemia, risk factors, causes, consequences of anemia on the mother and fetus, and knowing how to prevent and treat anemia. After carrying out a binary multivariate logistic test, it was found that mothers who had good knowledge about anemia were 2-5 times more likely to comply than mothers who had poor knowledge [6,9,11,14,16,19]. Knowledge of iron tablet supplementation increases the chances of adherence 2-3 times.…”