Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Anemia | Research article

Magnitude and factors associated with adherence to Iron and folic acid supplementation among pregnant women in Aykel town, Northwest Ethiopia

Authors: Habtamu Assefa, Solomon Mekonnen Abebe, Mekonnen Sisay

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

Login to get access

Abstract

Introduction

Physiological changes during pregnancy, foetal growth and development increase the requirement for Iron and Folic Acid. The increased demand of these nutrients is not meet through diet alone due to decreased bioavailability of nutrients during pregnancy. In 2004, Ethiopia adopted the global Iron and Folic Acid supplementation strategy targeting to reduce the prevalence of Iron deficiency anemia in women of reproductive age and children under five, by one third. However, the prevalence of anemia remains high and only 5% of pregnant women took Iron and Folic Acid tablets for 90 days or more during their most recent pregnancy in Ethiopia. Therefore, we conducted this study to assess the magnitude and associated factors of adherence to Iron and Folic Acid supplementation during pregnancy.

Methods

A facility based cross sectional study was conducted from February to May, 2018 among pregnant women in Northwest Ethiopia. Systematic random sampling technique was used to select 418 study subjects. Bivariable and multivariable logistic regression analyses were computed to identify predictor variables.

Results

Rate of adherence to Iron and Folic Acid supplementation among pregnant women was 47.6%. Pregnant women who had a past history of abortion, knowledge of anemia and received health education were more likely to be adherent with Iron and Folic Acid supplementation. Furthermore, knowledge about benefits of the supplement and not facing any problem in the health facilities during Iron and Folic Acid tablet collection were factors associated with Iron and Folic Acid supplementation adherence.

Conclusions

Rate of adherence to Iron and Folic Acid supplementation was low in Aykel town. Therefore, strengthening and promoting health education, creating awareness and avoiding discouraging conditions in health facilities during tablet collection are very crucial to improve and increase the low rate of Iron and Folic Acid supplementation adherence in the study area.
Literature
1.
go back to reference Marti-Carvaja A.L. et al, Prevalence of anemia during pregnancy: results of Valencia (Venezuela) anemia during pregnancy study. 2002. Marti-Carvaja A.L. et al, Prevalence of anemia during pregnancy: results of Valencia (Venezuela) anemia during pregnancy study. 2002.
2.
go back to reference World Health Organization. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015. World Health Organization. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.
3.
go back to reference Central Statistical Agency, A.A., Ethiopia. Ethiopian Demographic and Health Survey. Rockville: The DHS Program ICF; 2016. Key Indicators Report Central Statistical Agency, A.A., Ethiopia. Ethiopian Demographic and Health Survey. Rockville: The DHS Program ICF; 2016. Key Indicators Report
4.
go back to reference WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva: World Health Organization; 2012. WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva: World Health Organization; 2012.
5.
go back to reference World Health Organization, World Health Organization Guideline: Iron supplementation in postpartum women. Library cataloguing-in-publication data, 2016. World Health Organization, World Health Organization Guideline: Iron supplementation in postpartum women. Library cataloguing-in-publication data, 2016.
7.
go back to reference Malek L, Makrides W, Zhou M, Shao J. Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross-sectional analysis. Aust N Z J Public Health. 2016;40(5):424–9.CrossRef Malek L, Makrides W, Zhou M, Shao J. Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross-sectional analysis. Aust N Z J Public Health. 2016;40(5):424–9.CrossRef
8.
go back to reference Titilayo, et al. Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: analysis of data from the 2010 Malawi demographic and health survey. Malawi Med J. 2016;28(1):1–5.CrossRef Titilayo, et al. Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: analysis of data from the 2010 Malawi demographic and health survey. Malawi Med J. 2016;28(1):1–5.CrossRef
9.
go back to reference Birhanu TM, et al. Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia. BMC Res Notes. 2018;11:345.CrossRef Birhanu TM, et al. Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia. BMC Res Notes. 2018;11:345.CrossRef
10.
go back to reference Organization:, W.H. Global nutrition targets 2025: anaemia policy brief. Geneva: World Health Organization; 2014. Organization:, W.H. Global nutrition targets 2025: anaemia policy brief. Geneva: World Health Organization; 2014.
11.
go back to reference Federal Ministry of Health of Ethiopia, A.A., Ethiopia, National guideline for control and prevention of micronutrient deficiencies. 2004. Federal Ministry of Health of Ethiopia, A.A., Ethiopia, National guideline for control and prevention of micronutrient deficiencies. 2004.
12.
go back to reference Central statistics agency of Ethiopia, National survey report. 2017. Central statistics agency of Ethiopia, National survey report. 2017.
13.
go back to reference Chilga district health office, Maternal and child health department report. 2018. Chilga district health office, Maternal and child health department report. 2018.
14.
go back to reference Abebaw B. Adherence status and associated factors of iron and folic acid supplementation among pregnant women attending antenatal care service in debre markos town. Northwest Ethiopia: Health Institution Based Cross Sectional Study; 2016. Abebaw B. Adherence status and associated factors of iron and folic acid supplementation among pregnant women attending antenatal care service in debre markos town. Northwest Ethiopia: Health Institution Based Cross Sectional Study; 2016.
15.
go back to reference Jasti S, Siega-Riz AM, Cogs-Well ME, Hartzema AG, Bently ME. Pill Count Adherence to Prenatal Multivitamin/Mineral Sup-plement Use among Low-Income Women. J Nutr. 2005;135:1093–101.CrossRef Jasti S, Siega-Riz AM, Cogs-Well ME, Hartzema AG, Bently ME. Pill Count Adherence to Prenatal Multivitamin/Mineral Sup-plement Use among Low-Income Women. J Nutr. 2005;135:1093–101.CrossRef
16.
go back to reference Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10:348–54 [PMC free article] [PubMed] [Google Scholar].CrossRef Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10:348–54 [PMC free article] [PubMed] [Google Scholar].CrossRef
18.
go back to reference Wendesen N. Adherence and associated factors to iron/folic acid supplementation among pregnant women attending antenatal clinic in ASELLA town, South East Ethiopia; 2016. Wendesen N. Adherence and associated factors to iron/folic acid supplementation among pregnant women attending antenatal clinic in ASELLA town, South East Ethiopia; 2016.
19.
go back to reference Getachew M, Abay M, Zelalem H, Gebremedhin T, Grum T, Bayray A. Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia. BMC Pregnancy Childbirth. 2018;18:83.CrossRef Getachew M, Abay M, Zelalem H, Gebremedhin T, Grum T, Bayray A. Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia. BMC Pregnancy Childbirth. 2018;18:83.CrossRef
20.
go back to reference Shewasinad S, et al. Adherence and associated factors of prenatal Iron folic acid supplementation among pregnant women who attend ante Natal Care in Health Facility at Mizan-Aman town, bench Maji zone, Ethiopia. J Pregnancy Child Health. 2017;4:3.CrossRef Shewasinad S, et al. Adherence and associated factors of prenatal Iron folic acid supplementation among pregnant women who attend ante Natal Care in Health Facility at Mizan-Aman town, bench Maji zone, Ethiopia. J Pregnancy Child Health. 2017;4:3.CrossRef
21.
go back to reference Chourasia A, Pandey CM, Awasthi A. Factors influencing the consumption of iron and folic acid supplementations in high focus states of India. Clin Epidemiol Glob Health. 2017;5:4. Chourasia A, Pandey CM, Awasthi A. Factors influencing the consumption of iron and folic acid supplementations in high focus states of India. Clin Epidemiol Glob Health. 2017;5:4.
22.
go back to reference Gebre, A., et al., Determinants of compliance to iron-folic acid supplementation among pregnant women in pastoral communities of afar region: the cases of mille and assaita districts, Afar, Etiopia. 2015. Gebre, A., et al., Determinants of compliance to iron-folic acid supplementation among pregnant women in pastoral communities of afar region: the cases of mille and assaita districts, Afar, Etiopia. 2015.
23.
go back to reference Tegegne M. Compliance to prenatal Iron and folic acid supplement and associated factors among women during pregnancy in south East Ethiopia: a cross-sectional study. Glob J Med Res. 2017;17(1). Tegegne M. Compliance to prenatal Iron and folic acid supplement and associated factors among women during pregnancy in south East Ethiopia: a cross-sectional study. Glob J Med Res. 2017;17(1).
24.
go back to reference Arega A. Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in misha district, south ethiopia: community based cross-sectional study; 2015. Arega A. Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in misha district, south ethiopia: community based cross-sectional study; 2015.
25.
go back to reference Nwaru BI, et al. Adherence in a pragmatic randomized controlled trial on prophylactic iron supplementation during pregnancy in Maputo, Mozambique. Public Health Nutr. 2015;18(6):1127–34.CrossRef Nwaru BI, et al. Adherence in a pragmatic randomized controlled trial on prophylactic iron supplementation during pregnancy in Maputo, Mozambique. Public Health Nutr. 2015;18(6):1127–34.CrossRef
26.
go back to reference Siabani S, et al. Determinants of adherence to Iron and folate supplementation among pregnant women in West Iran: a population based cross-sectional study. Qual Prim Care. 2017;25(3):157–63. Siabani S, et al. Determinants of adherence to Iron and folate supplementation among pregnant women in West Iran: a population based cross-sectional study. Qual Prim Care. 2017;25(3):157–63.
27.
go back to reference Gebreamlak B, Dadi AF, Atnafu A. High adherence to iron/folic acid supplementation during pregnancy time among antenatal and postnatal care attendant mothers in governmental health centers in Akaki Kality Sub City, Addis Ababa, Ethiopia: hierarchical negative binomial poisson regression. PloS one. 2017;12:1.CrossRef Gebreamlak B, Dadi AF, Atnafu A. High adherence to iron/folic acid supplementation during pregnancy time among antenatal and postnatal care attendant mothers in governmental health centers in Akaki Kality Sub City, Addis Ababa, Ethiopia: hierarchical negative binomial poisson regression. PloS one. 2017;12:1.CrossRef
28.
go back to reference Niquini RP, et al. Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro. Rev Bras Saúde Materno Infant. 2016;16(2):189–99.CrossRef Niquini RP, et al. Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro. Rev Bras Saúde Materno Infant. 2016;16(2):189–99.CrossRef
29.
go back to reference Neupane N, Sharma S, Kaphle HP. Factors affecting compliance of iron and folic acid among pregnant women attaining Western regional hospital, Pokhara, Nepal. Int J Res Current Dev. 2015;1(1):43–7. Neupane N, Sharma S, Kaphle HP. Factors affecting compliance of iron and folic acid among pregnant women attaining Western regional hospital, Pokhara, Nepal. Int J Res Current Dev. 2015;1(1):43–7.
30.
go back to reference Chakma T, Rao PV, Meshram PK. Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India. Public Health Nutr. 2013;16(2):377–80.CrossRef Chakma T, Rao PV, Meshram PK. Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India. Public Health Nutr. 2013;16(2):377–80.CrossRef
31.
go back to reference Ugwu E, Olibe AO, Obi S, Ugwu A. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Niger J Clin Pract. 2014;17:5. Ugwu E, Olibe AO, Obi S, Ugwu A. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Niger J Clin Pract. 2014;17:5.
32.
go back to reference Mithra et al. Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of South India. Afr Health Sci. 2013;13(4):880–5.CrossRef Mithra et al. Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of South India. Afr Health Sci. 2013;13(4):880–5.CrossRef
33.
go back to reference Ratanasiri T, Koju R. Effect of knowledge and perception on adherence to iron and folate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thail. 2014;97(10):S67–74. Ratanasiri T, Koju R. Effect of knowledge and perception on adherence to iron and folate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thail. 2014;97(10):S67–74.
Metadata
Title
Magnitude and factors associated with adherence to Iron and folic acid supplementation among pregnant women in Aykel town, Northwest Ethiopia
Authors
Habtamu Assefa
Solomon Mekonnen Abebe
Mekonnen Sisay
Publication date
01-12-2019
Publisher
BioMed Central
Keywords
Anemia
Folic Acid
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2422-4

Other articles of this Issue 1/2019

BMC Pregnancy and Childbirth 1/2019 Go to the issue