SJIF(2020): 5.702

International Journal of Advanced Research and Publications

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Adherence Level To Iron-Folic Acid Supplement And Associated Factors Among Pregnant Women Attending Antenatal Care In Selected Public Health Facilities Of Ilu Aba Bor Zone, Southwest, Ethiopia 2018.

Volume 5 - Issue 5, May 2022 Edition
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Tariku Nigussie, Ebisa Negera, Keneni Chali, Keneni Chali Regassa
Adherence, Ethiopia, Iron Folic acid, Pregnant women
Background: Nearly half (41.8%) of pregnant women in the world are anemic and more than 50% of anemia is due to iron deficiency anemia. Iron supplementation has been a major and effective strategy to reduce iron deficiency anemia in pregnancy. However, poor adherence to iron-folic acid supplements hinders the effectiveness of the iron-folic acid supplementation program. This study aimed to assess adherence levels to iron-folic acid supplements and associated factors among pregnant women. Methods: An institution-based cross-sectional study was conducted in selected public health facilities in Ilu Aba Bor Zone from April–to May 2021. A systematic sampling technique was employed to select 527 study participants. A Binary logistic regression model was used to determine the association of covariates and dependent variable Result: A total of 511 pregnant women participated in the study, making the response rate 96.9%. The adherence level to the IFA supplement was found to be 45.8 %. In multivariable analysis, knowledge of pregnant women on anemia (AOR: 8.2, 95%CI :( 4.23, 15.98)), knowledge of pregnant women on IFA supplement (AOR: 2.79, (95%CI: 1.42, 5.51)), experienced side effects (AOR: 0.04, 95%CI: (0.02, 0.07)), complaining faced problem (AOR: 0:33, 95%CI: (0.16, 0.67)) and health education during prenatal follow up(AOR:2.27, 95%CI: (1.17, 4.40)) were significantly associated with adherence level to IFA supplement. Conclusion and Recommendation: The adherence level to iron-folic acid was low among pregnant women. Knowledge of anemia, knowledge of IFA & health education were positively associated factors. While experienced side effects & facing problems were negatively associated. Strengthen health education to improve knowledge of pregnant women on anemia, preparing guidance to manage side effects of IFA supplements were recommended.
[1]. WHO. World Health Statistics. 2010.

[2]. Jasti S, Siega-riz AM, Cogswell ME, Hartzema AG, Bentley ME. Community and International Nutrition Pill Count Adherence to Prenatal Multivitamin / Mineral Supplement Use among Low-Income Women 1. Am Soc Nutr Sci. 2021;

[3]. Gold DT. Medication Adherence: A Challenge for Patients With Postmenopausal Osteoporosis and Other Chronic Illnesses. 2006

[4]. Division N. CHAPTER 1 AN OVERVIEW OF THE LANDSCAPE AND APPROACH FOR. 2017;17(2):11848–64.

[5]. Mclean E, Cogswell M, Egli I, Wojdyla D, Benoist B De. Worldwide prevalence of anemia, WHO Vitamin and Mineral Nutrition Information System, 1993 – 2005. 2008;12(4):444–54.

[6]. Database WHOG. Worldwide prevalence of anemia. 2005.

[7]. G. B, A. Z. Assessment of iron deficiency and anemia in pregnant women in France: An observational study. Value Heal [Internet]. 2015;18(7): A662. Available from: http://ovidsp.ovid.com/ovidweb.

[8]. Report KI. FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA Demographic and Health Survey 2016.

[9]. Scholl TO, Johnson WG. Folic acid : influence on the outcome of pregnancy 1 – 4. Am J Clin Nutr 2000

[10]. Software NCH. Iron status during pregnancy : setting the stage for mother and. m J Clin Nutr 2005 May;81(5)1218S-1222S Iron. 2005;5(c)

[11]. Issn O. Revista Brasileira de Saúde Materno Infantil Factors associated with non-adherence to prescribed iron supplement use : a study with pregnant women in the city of Rio de Janeiro. Rev Bras Saude Mater Infant. 2017

[12]. Kuril BM, Janbade C, Lone DK, Hirani S, Ankushe RT, Doibale MK. Study of adherence and effect of iron and folic acid supplement on hemoglobin level among adolescent girls in the rural area. Int J Community Med Public Heal. 2016;3(4):906–11

[13]. Gebre A, Mulugeta A, Etana B. Assessment of Factors Associated with Adherence to Iron-Folic Acid Supplementation Among Urban and Rural Pregnant Women in North Western Zone of Tigray, Ethiopia : Comparative Study. 4(2):161–8.

[14]. WHO recommendations on antenatal care for a positive pregnancy experience 2016.

[15]. Samuel A. Coverage, compliance, and factors associated with utilization of iron supplementation during pregnancy in eight rural ... Coverage, compliance, and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Et. 2014;14(1):1–8.

[16]. Women P, Antenatal A, Town A, Niguse W, Murugan R. Determinants of Adherence to Iron Folic Acid Supplementation among Pregnant Women Attending Antenatal Clinic in Asella Town, Ethiopia. 2021;(April).

[17]. Gonzalez-casanova I, Nguyen PH, Young MF, Harding KB, Reinhart G, Nguyen H, et al. Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam. 2017;17:1–9.

[18]. Town M, Zone BM. Journal of Pregnancy and Child Adherence and Associated Factors of Prenatal Iron Folic Acid Supplementation among Pregnant Women Who Attend Ante Natal Care in Health Facility at. 2011;4(3).

[19]. Sadore AA, Gebretsadik LA, Hussen MA. Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia : Community Based Cross-Sectional Study. 2015;2015

[20]. Health N, Engineering F. Compliance to Prenatal Iron and Folic Acid Supplement and Associated Factors among Women during Pregnancy in South East Ethiopia : A Cross-Sectional Study. 2011;7(2).


[22]. Bekele T, Gedefaw Abeje AM. Open Access. Pan African Med J –. 2015;8688:1–7


[24]. Ongvichit P, Isaranurug S, Nanthamongkolchai S, Voramongkol N. Compliance of Pregnant Women Regarding Iron Supplementation in Vientiane Municipality, Lao P . D . R . J Public Heal Dev. 2003;11(1):41–52.

[25]. Ugwu EO, Olibe AO, Obi SN, Ugwu AO. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. 17(5):608–12.

[26]. 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 Regrets. :1–11. Available from: http://dx.doi.org/10.1371/journal.pone.0169415

[27]. Ibrahim ZM, El-Hamid SABD, Mikhail H, Khattab MS. Assessment of Adherence to Iron and Folic Acid Supplementation and Prevalence of Anemia in Pregnant Women. 2011;79(2)

[28]. Ugwu EO, Olibe AO, Obi SN, Ugwu AO. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. 17(5):608–12.

[29]. Seck BC, Jackson RT. Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr. 2007