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

Abstract

IntroductionNutritional anemia is a major public health problem throughout the world, particularly in developing countries. Iron with folic acid supplementation (IFAS) is recommended to mitigate anemia and its resulting complications during pregnancy. There has been limited study on IFAS adherence of pregnant women in the study area. The aim of this study was to assess adherence to IFAS and its associated factors among pregnant women attending antenatal care service in Debre Tabor General Hospital, Ethiopia.MethodsAn institution-based cross-sectional study was conducted from January 9 to April 8, 2017, at Debre Tabor General Hospital. A total of 262 study participants were included and selected by systematic random sampling. The entire interviewed questionnaire was checked and entered into EpiData version 3.1 and then exported to SPSS version 20 for windows for analysis. IFAS adherence status was defined as, if pregnant mothers took 65% or more of the IFAS which is equivalent to taking IFAS at least 4 days a week during the 1-month period preceding the study. Regressions were fitted to identify independent predictors of IFAS adherence. A P-value of less than 0.05 was used to declare statistical significance.ResultsA total of 241 pregnant women were included (92% response rate), of which 107 (44%) were adherent to IFAS. Only 39% received IFAS counseling, and 52% had some knowledge of IFAS. Gravidity (AOR = 2.92 95% CI (1.61, 5.30)), gestational age at first ANC visit (AOR = 3.67, 95% CI (1.94, 6.97)), pregnant women who got advice about IFAS (AOR = 2.04, 95%CI (1.12, 3.75)), current anemia (AOR = 2.22, 95%CI (1.45, 4.29)), and had knowledge about IFAS (AOR = 3.27, 95% CI (1.80, 5.95)) were statistically associated with adherence to IFAS among pregnant women.ConclusionOverall, IFAS adherence among pregnant women was low. The associated factors with adherence of IFAS were counseling and knowledge, early ANC attendance, pregnancy history, and current anemia diagnosis. IFAS counseling by health workers was low but, when given, was associated with improved IFAS adherence. Health workers and health extension workers should consistently counsel on IFAS benefits during ANC visit, to improve IFAS adherence during the current and subsequent pregnancies.

Adherence to iron and folic acid supplementation and prevalence of anemia among pregnant women attending antenatal care clinic at Tikur Anbessa Specialized Hospital, Ethiopia

“…In the present study, adherence was higher by 1.87 times for women who started their ANC follow-up at first trimester as compared to those who started at second or third trimester. Similar findings were reported in different studies [3,28]. The possible justification might be pregnant women who started early for ANC service might have more exposure to the health care provider and could acquire a better knowledge of perceived risk and benefit of IFAS to prevent anemia during pregnancy.…”

“…This study revealed that 159 (63.6%) of the participants were adherent to IFAS which is concordant with the study conducted in south India 64.7% [27] and Eritrean refugee camps, in northern Ethiopia 64.7% [4]. But it was higher than the study conducted in Mecha district, Western Amhara 20.4%, North Western Zone of Tigray 37.2%, Debre Tabor 44% and Northwest Ethiopia 55.3% [3,19,20,28]. This inconsistency might be attributed to accessibility to quality health services as well as availability of IFAS for free since the study was conducted in…”

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania

“…The probable reasons for adherence to IFAS could be the maternal-related experience. Studies conducted in Debre Tabor-Ethiopia and Ismailia government reported that gravidity had an association with adherence to IFAS [17,34].…”

Magnitude and determinants of adherence to iron supplementation among Ethiopian pregnant women: A cross sectional study from a national survey

“…The study conducted in University of Gondar Hospital indicated that mothers who made the first ANC visit during the first trimester of pregnancy were 2.4 times more likely adhere to IFA supplementation during pregnancy. Another study conducted in Debre Tabor General Hospital also showed that mothers who started ANC follow up before 16 weeks of gestation were 3.67 times more likely be adherent to IFA supplementation [12]. This finding can be explained by the fact that women who initiate ANC at early stages of pregnancy could also made frequent ANC visits.…”

“…Researches mentioned that different factors can be associated with iron supplementation compliance during pregnancy. These factors can be socio demographic factors (maternal age, maternal education, place of residence wealth index, maternal employment status, marital status, family size or obstetric factors (number of antenatal care (ANC) visits, no of living children, develop complications during the previous pregnancy, timing of first ANC visit and gravidity [6,[8][9][10][11][12][13].…”