Adherence to iron and folic acid supplementation among antenatal mothers attending a tertiary care center, Puducherry: A mixed-methods study

Lavanya, P.; Ramakrishnan, Jayalakshmy; Rajaa, Sathish; Thulasingam, Mahalakshmy

doi:10.4103/jfmpc.jfmpc_721_20

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…Equally, most of the respondents who admitted not having adhered to IFA supplementation during their gestation period mentioned side effects (41.3%), forgetfulness (37.3%) and the bad smell of the supplements (10.3%) as the main challenges. Similar reasons for non-adherence have also been reported among pregnant women in India 34 and Ghana 28 . In Ethiopia, Nasir et al observed that more than half of the mothers who were IFA non-compliant either attributed the poor trend to IFA related side effects or forgetfulness 35 .…”

Section: Discussionsupporting

confidence: 75%

Adherence to iron and folic acid supplementation during pregnancy among postnatal mothers seeking maternal and child healthcare at Kakamega level 5 hospital in Kenya: a cross-sectional study

2021

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Background: Maternal anaemia is a public health problem worldwide, and its aetiology is linked to iron deficiency. The high nutrient demand during pregnancy exacerbates the condition. To meet the increased nutritional demand, supplementation of iron and folic acid (IFA) is key. The supplements are provided freely to pregnant women during antenatal visits at public health facilities, however, their uptake and adherence in Kenya remain unacceptably low. Methods: A hospital-based cross-sectional study involving 241 postnatal mothers seeking maternal and child healthcare (MCH) care at Kakamega level 5 hospital was conducted. Both quantitative and qualitative data were collected. Quantitative data were collected from 241 eligible postnatal mothers, while qualitative data were obtained through key informant interviews with community health volunteers and healthcare providers. Results: There was a moderate adherence to IFA supplementation (60.6%) during pregnancy among postnatal mothers seeking MCH care at Kakamega level 5 hospital. Some of the reasons for non-adherence stated by the respondents included; IFA related side effects (41.3%), forgetfulness (37.3%) and bad smell of the IFA supplements (10.3%). Higher IFA adherence was noted among the primigravida participants (OR=2.704; 95% CI: 1.262, 5.793; p=0.010) compared to multigravida participants, and those with a higher knowledge level of anaemia (OR=3.215; 95% CI: 1.346, 7.68; p=0.009) compared to their counterparts with low anaemia knowledge. Other factors that showed correlation with IFA adherence were: IFA education, pregnancy counselling before conception and the number of antenatal care visits attained. Conclusion: There is a moderate adherence to IFA supplementation during pregnancy among mothers seeking MCH at Kakamega level 5 hospital. The greatest impediments of IFA compliance during pregnancy are IFA side effects, forgetfulness and the bad smell of the IFA tablets. Therefore, providing IFA education to pregnant mothers incorporated with probable ways of managing the IFA side effects would contribute to IFA supplementation adherence.

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Section: Discussionsupporting

confidence: 75%

Adherence to iron and folic acid supplementation during pregnancy among postnatal mothers seeking maternal and child healthcare at Kakamega level 5 hospital in Kenya: a cross-sectional study

2021

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“…Present study reported that the second most common reason for non-adherence was side effects. This was concordant with the results of other studies conducted elsewhere [14] , [15] , [17] , [27] , [28] . The most common side effect reported in this study was nausea and vomiting (23.2 %), followed by constipation 18.8 % and gastric irritation 18.4 %.…”

Section: Discussionsupporting

confidence: 93%

“…The current study showed that the most common reason for non-adherence was forgetfulness (24 %). These findings were like studies conducted in Mangalore [14], Puducherry 32 % [17] , Nigeria 27.2 % [26] , Southern Ethiopia [15] , and West Iran [27] . Studies reported a very high forgetfulness rate in India (60 %) [7] and Africa (70.1 %) [25] .…”

Section: Discussionsupporting

confidence: 83%

“…In contrast, in the present study, 100 % consumption of the prescribed oral IFAS by anemic pregnant women in a month was operationally defined as adherence. Higher adherence was reported in studies conducted in Puducherry (63.8 %) and Sudan (92.1 %) [17] , [18] . This might be because these studies were conducted at tertiary institutions that offer adequate counseling and continuous product availability.…”

Section: Discussionmentioning

confidence: 60%

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Telephonic intervention to combat non-adherence to oral iron-folic acid supplementation in pregnancy: A randomized controlled trial

Sharma,

Smitha,

Balakrishnan

2023

European Journal of Obstetrics & Gynecology and Reproductiv

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“…However, the adherence to IFA among pregnant mothers is quite low. 9 In routine practice, pregnant women are usually advised to consume IFA tablets with vitamin C-rich foods. Though this may improve the iron absorption, pregnant…”

Section: Discussionmentioning

confidence: 99%

Effect of iron folic acid with tablet vitamin C compared to iron folic acid with routine verbal advice of vitamin C rich foods on the hemoglobin levels of anemic pregnant women attending a tertiary care hospital in Puducherry: protocol for a pragmatic trial

Prince

Ramakrishnan

Prabhu³

et al. 2023

Int J Clin Trials

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Background: In routine practice, pregnant women are advised to take iron folic acid (IFA) tablets with vitamin C-rich foods. If vitamin C tablets are given instead, there may be an improvement in the hemoglobin levels of pregnant women. The study aims to find the effectiveness of IFA tablet with vitamin C tablet compared to IFA tablet with verbal advice of vitamin C rich foods, over 6 weeks, on the hemoglobin levels of anemic pregnant women (13-33 weeks) attending a tertiary care hospital in Puducherry. Methods: A pragmatic trial will be conducted in the antenatal OPD of a hospital in Puducherry. Anemic pregnant women will be consecutively recruited until a sample size of 86 is attained. Permuted block randomization and allocation concealment will be used. After eligibility assessment, participants will be randomly assigned two arms. The intervention arm will receive IFA tablets with vitamin C tablets, while the control arm will be advised to take IFA tablets with vitamin C-rich food. Participants will be followed up at 6 weeks. The intention-to-treat approach will be used. Linear regression will be performed followed by multivariable linear regression to adjust for confounding variables. Conclusions: This study protocol is designed to investigate whether the hemoglobin status and control of anemia in anemic mothers can be improved by giving IFA tablets with vitamin C tablets in routine practice, rather than verbal advice to take IFA tablets with vitamin C-rich foods.

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Adherence to iron and folic acid supplementation among antenatal mothers attending a tertiary care center, Puducherry: A mixed-methods study

Cited by 13 publications

References 11 publications

Adherence to iron and folic acid supplementation during pregnancy among postnatal mothers seeking maternal and child healthcare at Kakamega level 5 hospital in Kenya: a cross-sectional study

Adherence to iron and folic acid supplementation during pregnancy among postnatal mothers seeking maternal and child healthcare at Kakamega level 5 hospital in Kenya: a cross-sectional study

Telephonic intervention to combat non-adherence to oral iron-folic acid supplementation in pregnancy: A randomized controlled trial

Effect of iron folic acid with tablet vitamin C compared to iron folic acid with routine verbal advice of vitamin C rich foods on the hemoglobin levels of anemic pregnant women attending a tertiary care hospital in Puducherry: protocol for a pragmatic trial

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