Background: Iron deficiency is the leading nutrient deficiency in the world affecting the lives of more than 2 billion people, accounting to over 30% of the world's population. Pregnant women are particularly at high risk of iron and folic acid deficiency.Objective: The aim of this study was to assess Adherence to Iron and folic acid supplement during pregnancy and its associated factors among pregnant women attending antenatal care. Methods:Institution based cross-sectional study was employed from February 2016 to March 2017. Systematic random sampling technique was used to select the study participants. Data was collected using a structured and pretested interviewer-administered questionnaire. Bivariable and multivariable logistic regression analysis were used to identify associated factors with Adherence to prenatal iron and folic acid supplement among pregnant women. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Those variables with a p-value less than 0.05 had been considered as significant.Result: Adherence to Iron and folic acid was 28.7% with 95% C.I. (24.3, 33.6%). Educational status of mothers(AOR= 9.27 (95%CI: 2.47, 34.71), Educational status of husband (AOR= 0.31(95% CI: 0.11,0.88), Mothers who had a family size of four(AOR=3.70(1.08,12.76), Mothers who had family size of five and above (AOR= 4.88(95% CI: 1.20, 19.85),Mothers who had 2500-3500 birr household average monthly income (AOR= 0.46(95% CI: 0.24,0.89), Mothers who had registered at 17-24weeks with (AOR=0.40(95% CI: 0.22-0.74), registered at 25-28weeks (AOR=0.20(95% CI 0.10, 0.41), Mothers who had collected their iron and folic acid started at first visit at first month of pregnancy and duration of iron and folic acid is taken (AOR= 2.42(95% CI:1.05, 5.58) had significant association with iron and folic acid adherence. Conclusion and recommendation:Adherence of Iron and folic acid was relatively low. Maternal and husband education status, family size, registration time, economic status and first visit in the first month with duration of iron and folic acid taken were factors significantly associated with adherence to iron and folic acid supplement. Educating pregnant mothers, improving economic status, early ANC registration can improve adherence to iron and folic acid supplement.
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