Compliance with Iron and folic acid supplementation (IFAS) and associated factors among pregnant women: results from a cross-sectional study in Kiambu County, Kenya

Abstract

BackgroundMacro and micronutrients including iron and folic acid deficiencies are prevalent in Kenya, particularly during pregnancy resulting in anaemia. Despite efforts to control anaemia in pregnancy by adopting Iron and Folic Acid Supplementation (IFAS), this public health problem has persisted contributing to significant morbidity and mortality. The problem notwithstanding, there is poor IFAS compliance, whose reasons remain poorly understood, calling for their investigations. We sought to determine compliance status with IFAS and associated factors among pregnant women.MethodsThis was a cross-sectional study involving 364 pregnant women aged 15–49 years. Using two stage cluster sampling, one Sub-County and five public health facilities in Kiambu County were selected. All pregnant women attending antenatal clinics who met inclusion criteria and consented to participate in the study were recruited. Compliance with IFAS was defined as taking supplements at least 5 out of 7 days per week. A structured interviewer-administered questionnaire consisting of sociodemographic data, IFAS maternal knowledge and compliance practices was pretested and administered. Descriptive and inferential statistics were computed using STATA.ResultsOf the 364 respondents interviewed, 32.7% were IFAS compliant and 40.9% scored high on its knowledge. Of those with high IFAS knowledge, 48.3% were compliant compared to those with low knowledge (21.4%, n = 46, PR = 2.25;95%CI = 1.59–3.17, p < 0.001). Women who were multigravid (30.4%) were less likely to comply compared to primigravid (37.2%, n = 45, PR = 0.68;95%CI = 0.47–0.99, p = 0.004). Multivariate analysis revealed that respondents counselled on management of IFAS side effects (100%, n = 4) were more compliant (76.2%, n = 112, aPR = 1.31;95%CI = 1.19–1.44, p < 0.001).ConclusionFew pregnant women were compliant with IFAS regimen, associated with: knowledgeability on IFAS, primi-gravidity, and IFAS counselling especially on management of its side effects. These underscore the need for approaches to scale up health awareness on the benefits of IFAS, mitigation measures for the side effects, as well as targeted counselling.

Compliance to Iron-Folic Acid Supplementation and Its Association with the Number of ANC Visits in Ethiopia: Systematic Review and Meta-Analysis

“…A er duplication was removed, 99 articles remained of which 78 were excluded as a result of not ful lling to our inclusion criteria by reviewing for their titles and abstracts. en 21 full-text articles were accessed based on inclusion criteria [16,17,[35][36][37][38][39][40][41][42][43][44][45]. Finally, 12 studies which ful lled the inclusion criteria [16][17][18][19][20][21][22][23][24][25][26][27] were included in the meta-analysis ( Figure 1).…”

Implementation fidelity of Iron and Folic Acid supplementation (IFAs) and associated challenges among pregnant women in Uasin Gishu County Kenya

“…A similar nding was established in Nyeri County in Kenya where 58% received counselling information about IFAs [32]. Counselling and knowledge on IFAs has been established in literature to have a signi cant association with adherence [30,33,50,[52][53][54]. Similarly knowledge on usefulness of IFAs and health provider's strict instructions were established to be the greatest motivation to adherence by almost half of the compliant respondents.…”

“…This was a higher proportion compared to 47% who received folic acid, of which almost half (43%) did not have any idea about its usefulness while most others reported a wide variety of misconceptions. Lack of knowledge on folic acid supplements is common among pregnant women in LMICs for example in Kenya and Croatia where 59.1% and 48% of the respondents respectively did not know what FA is [49,50] Frequency integrity was low, only 18% and 15% of the respondents received 90 or more iron and folic acid pills respectively during their entire pregnancy period. However, based on a standard dose of 60 mg iron and 400 μg folic acid daily for six months, each woman should receive a minimum of 180 pills in the entire pregnancy period.…”

Do Early Antenatal Booking Predicts Maternal Services Utilization? An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey

“…In low resources countries, women become pregnant while anemic. The state of their anemia become worsens with pregnancy and childbirth [6]. The process of providing iron and folic acid supplementation improves their health status.…”