Adherence status to iron with folic acid supplementation and associated factors among pregnant women receiving antenatal care at public health facilities in Northwest Ethiopia

Abstract

Introduction: Iron and folic acid deficiency is among the most frequent nutrient inadequacies in the world, affecting expected two billion people, and causing nearly a million deaths. The adherence rate to iron with folic acid supplements remains very low in Ethiopia. Therefore, this study aimed to assess adherence status to iron with folic acid supplementation and associated factors among pregnant women receiving antenatal care at public health facilities in Northwest Ethiopia. Methods: A facility-based cross-sectional study was conducted among pregnant women at public health facilities in the Debay Tilat Gen district from 27 February 2018 to 27 March 2018. Systematic random sampling was used to select pregnant women. Data were entered into Epidata version 3.1 and analysis was performed using SPSS version 20. Binary logistic regression was used to predict the association of the dependent variable with independent variables. Variables that showed association at a p-value of less than 0.25 in the bivariable analysis were a candidate for multivariable analysis. Finally, variables at a p-value less than 0.05 with corresponding 95% confidence interval declared statistically significant factors of iron with folic acid supplementations. Results: A total of 400 participants were included in the study. The mean (± standard deviation) age of study participants was 26.64 (±4.37 standard deviation) years. This study revealed that about 52.8% of pregnant women attending antenatal care clinics were adherent to iron with folic acid supplementation. Counseling on iron with folic acid supplementations (adjusted odd ratio = 2.53, 95% confidence interval = 1.37–4.66; p-value < 0.003), having current anemia (adjusted odd ratio = 4.21, 95% confidence interval = 1.77–9.94; p-value < 0.001), and good knowledge of iron with folic acid supplementations (adjusted odd ratio = 2.1, 95% confidence interval = 1.29–3.44; p-value < 0.003) showed statistically significant associations with adherence to iron with folic acid supplementation. Conclusion: This study revealed that more than half of pregnant women were adherent to iron with folic acid supplementation. Knowledge of iron with folic acid supplementations, current anemia, and being counseled were factors associated with pregnant women’s adherence to iron with folic acid supplementation. Therefore, counseling and awareness creation should be strengthened by health institutions.