Predictors of iron consumption for at least 90 days during pregnancy: Findings from National Demographic Health Survey, Pakistan (2017–2018)

Abstract

Background Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan. Methods We analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017–2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy of the last birth. Women who had last childbirth 5 years before the survey and who responded to the question of iron intake were included in the final analysis (n = 6370). We analyzed the data that accounted for complex sampling design by including clusters, strata, and sampling weights. Results Around 30% of the women reported consumed iron tablets for ≥90 days during their last pregnancy. In the multivariable logistic regression analysis, we found that factors such as women’s age (≥ 25 years) (adjusted prevalence ratio (aPR) = 1.52; 95% CI: 1.42–1.62)], wealth index (rich/richest) (aPR = 1.25; [95% CI: 1.18–1.33]), primary education (aPR = 1.33; [95% CI: 1.24–1.43), secondary education (aPR = 1.34; [95% CI: 1.26–1.43), higher education (aPR = 2.13; [95% CI: 1.97–2.30), women’s say in choosing husband (aPR = 1.68; [95% CI: 1.57–1.80]), ≥ five antenatal care visits (aPR =2.65; [95% CI (2.43–2.89]), history of the last Caesarian-section (aPR = 1.29; [95% CI: 1.23–1.36]) were significantly associated with iron consumption for ≥90 days. Conclusion These findings demonstrate complex predictors of iron consumption during pregnancy in Pakistan. There is a need to increase the number of ANC visits and the government should take necessary steps to improve access to iron supplements by targeting disadvantaged and vulnerable women who are younger, less educated, poor, and living in rural areas.

Influence of Demographic, Socioeconomic, and Antenatal Care Factors on Iron Supplementation Adherence Among Filipino Pregnant Women Using Hierarchical Regression

“…One in four pregnant women in the Philippines were adherent to the iron supplementation over the past decade. Pregnant women aged ≥25 years were more likely to adhere to iron supplementation compared with those aged 15 to 24 years, aligning with findings from a study, 4 which could be attributed to older women's increased awareness on the importance of iron intake, higher health consciousness, and potential support from their families.…”

“…6 Pregnant women with a secondary and higher education exhibited greater odds of adherence, comparable with findings from other developing countries. 4 Educational level serves as a primary indicator of iron supplementation commitment, as educated women understand the benefit and health implications of following medical recommendation.…”

“…Rich pregnant women were more likely to take iron supplementation, similar to previous studies. 4 Higher socioeconomic status enables better health care and affordability of medication. 7 Early initiation of ANC visits during the first trimester was associated with iron supplement uptake, promoting adherence by allowing sufficient time for the recommended duration.…”

“…7 Early initiation of ANC visits during the first trimester was associated with iron supplement uptake, promoting adherence by allowing sufficient time for the recommended duration. 8 Having at least four ANC visits further facilitated iron supplementation, 4,9 emphasizing the importance of following recommended ANC guidelines…”

Analisis Kecenderungan Cakupan Pemberian Tablet Fe-3 dan Cakupan ANC K4 terhadap Kejadian Komplikasi Kehamilan di Surabaya Tahun 2019

“…This incident can be seen in Pakistan, where adherence to consuming Fe-3 tablets in mothers with previous parity experiences will increase. It is known that in Ali et al's study (2021), mothers with parity experience of >2 children had a percentage of consuming Fe-3 tablets of 56%, while mothers with parity ≤ 2 children were slightly lower (44%) 24 . Even though the coverage of Fe-3 tablets administration is good enough, if the tablets are not consumed after they are given because of the low level of adherence, pregnancy complications will still be high.…”