Adherence to Iron-Folic Acid Supplementation and Associated Factors among Antenatal Care Attendants in Public Health Institutions: The Case of Borena District, Amhara, Ethiopia: Cross-Sectional Study
DOI:
https://doi.org/10.6000/1929-4247.2022.11.01.5Keywords:
Adherence, supplementation, Iron, folic acid, pregnantAbstract
Introduction: Globally, iron deficiency is estimated to be responsible for half of all anemia cases. The reduction of iron deficiency anemia in pregnant women relies largely on their adherence to IFA supplementation. This study aimed to assess the factors associated with adherence to IFA supplementation among women attending antenatal checkups at health centers in Borena district, Ethiopia.
Methods: Institution-based cross-sectional study design was conducted on 348 pregnant women. The data were analyzed using SPSS version 20. Variables with a p-value of ≤0.2 in the univariable logistic regression analysis were included in the multivariable analysis. Adjusted odds ratio with 95% confidence interval was reported, and variables with p<0.05 were considered statistically significant.
Result: A total of 340 pregnant women were enrolled. The study revealed that 45.6% (95% CI: 40.27, 50.92%) of women adhered to the IFA supplement use. Women of husbands with primary education [AOR: 1.95; 95% CI: 1.07, 3.57] and who had taken IFA for two months [AOR: 2.81; 95% CI: 1.37, 5.79] were positively associated with adherence to IFA supplementation. However, women with a previous history of abortion [AOR: 0.16; 95% CI: 0.50, 0.53], who had disease other than anemia [AOR: 0.48; 95% CI: 0.28-0.79] and lack of family support [AOR: 0.12; 95% CI: 0.04, 0.39] were less likely to adhere to the supplement.
Conclusion: This study revealed that nearly nine in twenty women adhered to the IFA supplement. Therefore, strengthening nutritional counseling, health education, and information on iron-folic acid supplementation in a health institution is important to improve adherence.
References
Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016. Ethiopia Demographic and Health Survey, 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF.
WHO. WHO recommendations on antenatal care for a positive pregnancy experience. Luxembourg 2016.
Ibrahim ZM, Abd-el-Hamid S, Mikhail H, Khattab MS. Assessment of adherence to iron and folic acid supplementation and prevalence of anemia in pregnant women. The Medical Journal of Cairo University 2011; 79(2): 115-121.
Gebre A, Mulugeta A, Etana B. Assessment of factors associated with adherence to iron-folic acid supplementation among urban and rural pregnant women in north western zone of tigray, Ethiopia: comparative study. International Journal of Nutrition and Food Sciences 2015; 4(2): 161-168. https://doi.org/10.11648/j.ijnfs.20150402.16
Biswas M, Baruah R. Maternal anaemia associated with socio-demographic factors among pregnant women of Boko-Bongaon Block Kamrup, Assam. Indian Journal of Basic and Applied Medical Research 2014; 3(2): 712-721.
Ethiopian Public Health Institute (EPHI) [Ethiopia] and ICF. 2019. Ethiopia Mini Demographic and Health Survey 2019: Key Indicators. Rockville, Maryland, USA: EPHI and ICF. Available at: https://www.unicef.org/ethiopia/media/1721/file/ The%202019%20Ethiopia%20Mini%20Demographic%20and%20Health%20Survey%20.pdf
Lacerte P, Pradipasen M, Temcharoen P, Imamee N, Vorapongsathorn T. Determinants of adherence to iron/folate supplementation during pregnancy in two provinces in cambodia. Asia Pacific Journal of Public Health 2011; 23(3): 315-323. https://doi.org/10.1177/1010539511403133
Galloway R, McGuire J. Determinants of compliance with iron supplementation: Supplies, side effect or psychology. Social Science and Medicine 1994; 39(3): 381-390. https://doi.org/10.1016/0277-9536(94)90135-X
Samuel A, Mamo G, Moges T, Assefa T. Coverage, compliance, and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Ethiopia: a cross-sectional study. BMC Public Health 2014; 14(1): 607. https://doi.org/10.1186/1471-2458-14-607
Olibe AO, Obi SN, Ugwu AO. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Nigerian Journal of Clinical Practice 2014; 17(5): 608-612. https://doi.org/10.4103/1119-3077.141427
Central Statistical Agency (CSA) [Ethiopia] and ICF. 2011. Ethiopia Demographic and Health Survey. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF 2011. Available at: https://dhsprogram.com/pubs/pdf/fr255/fr255.pdf
Gebremariam AD, Tiruneh SA, Abate BA, Engidaw MT, Asnakew DT. Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017. PLoS ONE 2019; 14(1): e0210086. https://doi.org/10.1371/journal.pone.0210086
Zahara TS, AM. Compliance to vitamin and mineral supplementation among pregnant women inurban and rural areas in Malaysia. PakistanJournal of Nutrition 2010; 9(8): 744-750.
Taye B, Abeje G, Mekonen A. Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: A cross-sectional study. Pan African Medical Journal 2015; 20: 1-7. https://doi.org/10.11604/pamj.2015.20.43.4894
Arega Sadore A, Abebe Gebretsadik L, Aman Hussen M. Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha District, South Ethiopia: Community based cross-sectional study. Journal of Environmental and Public Health. Hindawi Publishing Corporation 2015; pp. 1-7. https://doi.org/10.1155/2015/781973
Gebreamlak B, Dadi AF, Atnafu A. High Adherence to Iron/Folic Acid Supplementation during Pregnancy Time among Antenatal and Postnatal Care Attendant Mothers in Governmental Health Centers in Akaki Kality Sub City, Addis Ababa, Ethiopia: Hierarchical Negative Binomial Poisson Regression. PLoS ONE 2017; 12(1): e0169415. https://doi.org/10.1371/journal.pone.0169415
Birhanu TM, Birarra MK, Mekonnen FA. Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia. BMC Research Notes 2018; 11: 345. https://doi.org/10.1186/s13104-018-3433-3
Niguse W, Murugan R. Determinants of adherence to iron folic acid supplementation among pregnant women attending antenatal clinic in asella town, Ethiopia. International Journal of Therapeutic Applications 2018; 35: 60-67.
Ogundipe O, Hoyo C, Østbye T, Oneko O, Manongi R, Lie RT. Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: A cross-sectional hospital-based study. BMC Public Health 2012; 12(1): 481. https://doi.org/10.1186/1471-2458-12-481
Kulkarni B, Christian P, LeClerq SC, Khatry SK. Determinants of compliance to antenatal micronutrient supplementation and women's perceptions of supplement use in rural Nepal. Public Health Nutrition 2010; 13(1): 82-90. https://doi.org/10.1017/S1368980009005862
Lutsey PL, Dawe D, Villate E, Valencia S, Lopez O. Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutrition 2008; 11(1): pp. 76-82. https://doi.org/10.1017/S1368980007000237
Gebremichael TG, Welesamuel TG. Adherence to iron-folic acid supplement and associated factors among antenatal care attending pregnant mothers in governmental health institutions of Adwa town, Tigray, Ethiopia: Cross-sectional study. PLoS ONE 2020; 15(1): e0227090. https://doi.org/10.1371/journal.pone.0227090
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .