Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21)

Abstract

Background: Iron and Folic Acid (IFA) supplementation is one of the highly recommended strategies to tackle anemia. Under the backdrop of high anemia prevalence, this study examines the level of non- compliance with IFA supplementation among pregnant women in India. Methods: The analysis is conducted on a sample of 151171 women, who bought or received IFA tablets/syrup during pregnancy, and was surveyed during the National Family Health Survey-5 (2019-21). Descriptive statistics and conditional probabilities are calculated to examine the initiation and attainment of different levels of IFA consumption across selected background variables. Binary logistic regressions are employed to understand the influence of socio-economic factors on non-compliance of IFA supplementation for minimum 100 days and 180 days. Results: While the probability of initiation of IFA tablets is fairly high among pregnant women in India, the probability of consuming at least 100 tablets declines drastically for pregnant women irrespective of their socio-economic profile. The chances of not taking IFA for at least 100 days and at least 180 days are lesser by 21% and 15% for urban with respect to rural women. Age is not a significant parameter. When compared to the richest, the poorest face 1.6 times higher odds for not consuming IFA for at least 100 days, and 1.96 times higher in case of non-compliance for minimum 180 days. Women with no education shows 1.73 and 1.46-times higher likelihood do be non-compliant with both criteria as compared to those with higher education. Those who have received less than four ANCs are at least two times more likely to be non-compliant. Risk of non-compliance is lesser among women with lower birth order as compared to pregnancies of third and higher birth order. Conclusion: Involvement of community health workers in awareness generation and close monitoring of IFA consumption behaviour ensuring compliance for a minimum of 180 days, might improve the scenario.