ADHERENCE TO PRENATAL IRON-FOLIC ACID SUPPLEMENTATION AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN IN ENOR DISTRICT: COMMUNITY BASED CROSS-SECTIONALSTUDY

Abstract

Introduction: Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anemia and neural tube defects. Adherence to iron and folic acid is crucial for the prevention of birth defect and anemia during pregnancy. In Ethiopia, the national data suggests that from all pregnant women supplemented with IFA tablets only 0.4% consumed more than 90 tablets during their pregnancy time. The factors for this low adherence are not clearly known.Objective: To assess adherence to prenatal iron folic acid supplementation and associated factors among pregnant women attending antenatal care services in Enor district, South Ethiopia, 2023.Methods: A community based cross-sectional study was conducted in 388 pregnant women attending antenatal care from 20th of March to 20th of April 2023 in Enor district, South Ethiopia. The study participants were selected using systematic random sampling technique. The level of adherence was assessed based on the reported number of iron folic acid tablet doses taken by pregnant women ≥ 4 times per a week in the previous one month preceding the survey during the data collection period. Data were entered in to Epi Data version 3.1 and exported to SPSS version 26 for analysis. Variables having P ≤ 0.05 in the bivariate analysis were entered in to a multivariable logistic regression analysis in order to detect association with adherence to iron folic acid supplementation. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value < 0.05.Results: The adherence rate in this study was 53.6% (95% CI: 49.5 – 57.9). Factors significantly associated with adherence to Iron/folic acid supplementation in the multivariable logistic regression model were history of still birth (AOR: 2.957: 95% CI: 1.098 - 7.965), history of abortion (AOR: 3.444: 95% CI: 1.290 - 9.191), early registration during the first ANC visit (AOR: 2.768: 95% CI: 1.182 - 6.486), knowledge of anemia (AOR: 2.093: 95% CI: 1.106 -3.961), and knowledge of Iron folic acid supplement (AOR: 2.1: 95% CI: 1.108 - 3.981). Conclusion: This study revealed that the adherence status of pregnant women to iron folic acid supplement was low in the study area. Improving the knowledge of pregnant women on anemia and iron folic acid supplement by delivering health education on the cause, consequence and prevention of anemia during pregnancy was primarily recommended to increase adherence level.