Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study

Abstract

Background. In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia. Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. The sample size was determined using single population proportion to 303. Simple random sampling technique was used to select the study participants. Bivariate and multivariable logistic regression analyses were employed to identify factors associated with compliance to iron-folate supplement. Results. The compliance rate was found to be 39.2%. Mothers knowledge of anemia (AOR = 4.451, 95% CI = (2.027,9.777)), knowledge of iron-folate supplement (AOR = 3.509, 95% CI = (1.442,8.537)), and counseling on iron-folate supplement (AOR = 4.093, 95% CI = (2.002,8.368)) were significantly associated with compliance to iron-folate supplement. Conclusions. Compliance rate of iron-folate supplementation during pregnancy remains very low. This study showed that providing women with clear instructions about iron-folate tablet intake and educating them on the health benefits of the iron-folate tablets can increase compliance with iron-folate supplementation.

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

“…There is similarity of compliance pattern among the two counties despite their cultural and demographic diversity. These findings are consistent with reports on IFAS from similar rural settings in low and medium income countries (LMIC) notably, Pakistan (38.3%), South Ethiopia (39.2%) [ 35 ] and Western Ethiopia (20.4%) [ 36 ]. Despite efforts to promote IFAS, the finding could be attributed to the fact that compliance with medical advice depends on patients’ rational decision-making about the costs and benefits of prescribed actions, depending upon individual socio-cultural circumstances.…”

“…The IFAS compliance status was defined as the number of IFAS tablets taken in the preceding 7 days (1 week). Pregnant mothers who took at least 70% of the expected dose of the IFAS tablets in the week preceding the interview, an equivalent of five tablets per week, were considered compliant with IFAS [ 21 , 35 ]. Conversely the respondents who took less than five IFAS tablets were considered as non-compliant.…”

Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study

“…These findings were similar to a coverage of 67% reported in urban Nairobi County [40] in Kenya and 64.7% reported in India [41] respectively. However, the findings were higher than reports on IFAS coverage from low and medium income countries (LMIC) with similar rural settings namely, South Ethiopia (39.2%), Pakistan (38.3%), [38], Nigeria (37.5%) [42] and Western Ethiopia (20.4%) [20]. Nevertheless, lower coverage (18%) has been reported in a neighbouring County of Machakos, Kenya [43].…”

“…This study showed increased awareness on IFAS side effects in both groups. Studies have shown that accompanying health education with clear instructions on intake of IFAS substantially improves compliance [38,44]. This is demonstrated in another Kenyan study where advice by health workers was independently associated with higher compliance [37,45].…”

“…The IFAS compliance status was defined as the number of IFAS tablets taken in the preceding seven (7) days. Pregnant women who took at least 70% of the expected dose of the IFAS tablets in the week preceding the interview, an equivalent of five IFAS tablets per week, were considered compliant with IFAS [37,38]. Conversely, the respondents who took less than 30% of the expected IFAS dose, an equivalent of less than five IFAS tablets, were considered non-compliant.…”