MAGNITUDE AND FACTORS ASSOCIATED WITH ADHERENCE TO IRON FOLIC ACID SUPPLEMENTATION AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE AT ST. PAUL’S HO SPITAL MILLENIUM MEDICAL COLLEDGE, ADDIS ABABA, ETHIOPIA
Abstract
Background. Iron deficiency is the leading nutrient deficiency globally affecting the lives of more than two billion people worldwide. Pregnant women are at higher risk of iron and folic acid deficiency due to lack of iron and folic acid or due to poor adherence. However, studies that address this area of adherence are very limited.
Objective: To assess adherence to iron and folic acid supplement during pregnancy and associated factors among pregnant women attending antenatal care at SPHMMC.
Methods. Institution-based cross-sectional study was conducted from May 1/2020 to April 30/2021. A convenience sampling technique was used to select a total of 399 pregnant women with gestational age 37 weeks and beyond at the antenatal care clinic of SPHMMC. Data were collected using a structured and pretested interviewer-administered questionnaire. Descriptive, bivariable and multivariable binary logistic regression analysis were used to identify factors associated with adherence to iron and folic acid supplement among pregnant women. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to assess the strength and significance of the association. Variables with a p-value less than 0.05 had been considered statistically significant.
Results: The adherence rate was found to be 29.8% 95% CI (25%, 34%). Women who were having good knowledge about anemia [AOR; 31.07 95% CI (16.75, 57.62)] and good knowledge on iron-folic acid supplementation [AOR; 123.94 95% CI (52.79, 290.97)], ANC initiation prior to 16 weeks [AOR; 38.86 95% CI (20.88, 72.31)], and those who were having three or more antenatal care visits [AOR; 49.60 95% CI (23.55, 104.44)] were significantly associated with adherence to iron-folic acid supplementation. Urban residence [AOR; 23.40 95% CI (8.39, 65.28)], previous history of three or more child birth [AOR; 27.59 95% CI (14.48, 52.56)] as well as previous history of abortion [AOR; 36.80 95% CI (19.64, 68.94)] were also significantly associated with adherence to iron-folic acid supplementation.
Conclusion Adherence to iron and folic acid was only 29.8% in the current study. Knowledge about anemia, knowledge on iron-folic acid supplementation, ANC initiation prior to 16 weeks, having three or more antenatal care visits, urban residence, previous history of three or more child birth and previous history of abortion were factors significantly associated with adherence to iron and folic acid supplement.
Recommendations. Anemia prevention strategy via improved iron and folic acid supplement adherence should comprise strategies of educating pregnant mothers and early antenatal care registration that can improve adherence to iron and folic acid supplement.