Coverage of and compliance to iron supplementation under the National Iron Plus Initiative among reproductive age-group women in urban Puducherry – a cross-sectional study

Abstract

Background Anaemia is a global health problem and an important cause of morbidity in all age groups, especially among women and children. Various programmes have been implemented to combat anaemia in India and National Iron Plus Initiative (NIPI) is the latest programme to be implemented. Aim To ascertain the proportion of reproductive age women receiving iron supplementation under the NIPI and assess the compliance and factors hindering the implementation and compliance of the programme. Materials and methods A cross-sectional study was conducted among women of reproductive age (15–49 years) during November 2017. The participants were interviewed at their household using a pre-tested semi-structured questionnaire to obtain information on socio-demographic details, whether they were receiving iron supplements and compliance to the programme. Results Out of 302 study participants, only 138 (45.7%) were found to be receiving the supplements under the NIPI. The major source of iron supplementation was various health facilities (69.4%). Of those not receiving the tablets, 96.3% were non-pregnant non-lactating women. The proportion of study participants receiving iron supplementation through house visits by auxiliary nurse mid-wives (ANMs) was only 1.45%. Of the 138 women receiving supplementation, 85 (61%) were compliant with their medication. Compliance also tended to be higher among pregnant and lactating women. The most important reasons for non-compliance were adverse effects and forgetfulness. The presence of regular house visits by ANMs had a significant association with reception of tablets [prevalence ratio (PR)–1.43]. Pregnant women had a significant association with both reception (PR–2.19) and compliance (PR–1.8) with iron supplementation. Conclusion The current NIPI programme needs to be regularly evaluated to ensure its effective implementation. Importance should be given to non-pregnant non-lactating women to increase coverage among them.

How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6–59 Months Old Children in India?

“…A cross-sectional study evaluating the compliance of the NIPI program among a group of reproductive aged (15–49 years) females in Puducherry found that only 45.7% of them were receiving the supplements under the NIPI program ( 27 ). Among the women who received supplementation, only 61% reported compliance ( 27 ). A qualitative study in Odisha showed the necessity of monitoring and evaluation to strengthen the implementation of the NIPI program ( 28 ).…”

“…A study that evaluated the NNAC program in the Dharwad taluk also found an issue of irregular supply of the supplements (26). A cross-sectional study evaluating the compliance of the NIPI program among a group of reproductive aged (15-49 years) females in Puducherry found that only 45.7% of them were receiving the supplements under the NIPI program (27). Among the women who received supplementation, only 61% reported compliance (27).…”

Effect of direct monitoring by family members and counseling by health professionals on iron-folic acid supplementation: A cross-sectional study among pregnant women in Puducherry, India

“…Data were collected through a structured and pretested questionnaire developed through a series of focus group discussions with subject experts (two pharmacologists, two clinical pharmacists, and one obstetrics/gynecology specialist) and a review of the literature. [ 10 11 12 13 14 15 16 17 18 19 ] The questionnaire was prepared in English, translated into Tamil and then translated back into English for the accuracy of translation. There was pilot testing before the administration to the participants.…”

“…Adherence is defined by the WHO as “the degree to which the person's behavior corresponds with the agreed recommendations from a healthcare provider.”[ 9 ] Although studies have been conducted to assess adherence to IFAS in different regions of India,[ 10 11 12 13 ] only one study has evaluated the implementation of NIPI in urban Puducherry,[ 14 ] our region of interest. Moreover, although direct monitoring of IFAS[ 11 15 16 ] and appropriate counseling[ 16 17 18 ] have been reported to be crucial for achieving positive outcomes, no study investigating these variables specifically has been conducted in Puducherry.…”

The Administration of Iron Supplements for Anemia Prevention in Pregnant Women: Scoping Review

“…Bleeding after childbirth is the primary cause of death as a result of anemia (Astapani, Harahap Anggriani, 2020). Generally, anemia occurs due to iron deficiency (Gayathri et al, 2021). Anemia in pregnancy affects the mother and fetus.…”