Trends and factors associated with iron supplementation during pregnancy among women who had pregnancy in the preceding five years of the 2016 EDHS: Multivariate decomposition analysis

Abstract

Introduction: Study estimated in 2019 iron deficiency related anemia accounts 1.89% and 1.07% of total disability adjusted life years (DALYS) to reproductive age women globally and sub saran Africa respectively. Anemia at the time of pregnancy may cause small sized baby, preterm birth, and perinatal, neonatal and maternal mortality. Iron and folic acid supplementation during pregnancy will minimize the risk of iron deficiency and risk of anemia.Methods: For this time series analysis, dataset of 2005, 2011 and Ethiopian demographic health surveys was used. A total weighted sample of 7234 in 2005, 7786 in 2011 and 7543 in 2016 are encompassed in this study. The Logit based Multivariate decomposition analysis for non-linear response outcome was calibrated to detect the factors contributed to the change in iron supplementation between 2005 and 2016 study period. The Logit based multivariate decomposition analysis utilizes the output from the logistic regression model to assign the observed change in iron supplementation over time into two components. Stata version 16.0 was used to analysis the data.Results: Proportion of iron supplementation during pregnancy increased by more than a third (32%) between the period of 2005 and 2016. From the output of multivariate decomposition regression, major of the change in iron supplementation was due to change in coefficients. Women’s age, working s status and region of living (all except Dire Dawa) were variables as sources of change in iron supplementation under the category of change in coefficients. Additionally, age, region, wealth status, employment status/working status, ANC follow up to the last pregnancy and media exposure were variables attributable to the change of iron supplementation during pregnancy under the category of endowment.Conclusion: Rate of iron supplementation at the time of pregnancy increased dramatically over the last decade in Ethiopia. Change in the proportion of women aged ≥ 35 years, population of each region, wealth status (poorer, middle & richer), working women, ANC follow up and media exposed as well as change in behavior of women aged ≥ 35 years, employed women and region of living were sources of change for iron supplementation between 2005 and 2016 period.