Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017

• Published in: PloS one Vol. 14; no. 1; p. e0210086
• Main Authors: Gebremariam, Alemayehu Digssie, Tiruneh, Sofonyas Abebaw, Abate, Bedilu Abebe, Engidaw, Melaku Tadege, Asnakew, Desalegn Tesfa
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07-01-2019; Public Library of Science (PLoS)
• Subjects: Acids; Adhesion; Adhesions; Adolescent; Adult; Analysis; Anemia; Anemia, Iron-Deficiency - prevention & control; Birth weight; Complications; Cross-Sectional Studies; Developing countries; Dietary Supplements; Ethiopia; Female; Folic acid; Folic Acid - administration & dosage; Follow-Up Studies; Gestational age; Health aspects; Health Knowledge, Attitudes, Practice; Health sciences; Health services; Health surveys; Hematinics - administration & dosage; Humans; Iron; Iron - administration & dosage; LDCs; Maternal & child health; Medical personnel; Medication Adherence - statistics & numerical data; Medicine and Health Sciences; Mortality; Mothers; Nutrition; Nutritional Status; Physical Sciences; Postpartum period; Pregnancy; Pregnancy complications; Pregnancy Complications - prevention & control; Pregnant Women - psychology; Premature birth; Prenatal care; Public health; Random sampling; Regression analysis; Statistical sampling; Studies; Vitamin B; Womens health; Workers; Young Adult; Ethiopia; Africa; Addis Ababa Ethiopia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210086

Nutritional anemia is a major public health problem throughout the world, particularly in developing countries. Iron with folic acid supplementation (IFAS) is recommended to mitigate anemia and its resulting complications during pregnancy. There has been limited study on IFAS adherence of pregnant women in the study area. The aim of this study was to assess adherence to IFAS and its associated factors among pregnant women attending antenatal care service in Debre Tabor General Hospital, Ethiopia.
An institution-based cross-sectional study was conducted from January 9 to April 8, 2017, at Debre Tabor General Hospital. A total of 262 study participants were included and selected by systematic random sampling. The entire interviewed questionnaire was checked and entered into EpiData version 3.1 and then exported to SPSS version 20 for windows for analysis. IFAS adherence status was defined as, if pregnant mothers took 65% or more of the IFAS which is equivalent to taking IFAS at least 4 days a week during the 1-month period preceding the study. Regressions were fitted to identify independent predictors of IFAS adherence. A P-value of less than 0.05 was used to declare statistical significance.
A total of 241 pregnant women were included (92% response rate), of which 107 (44%) were adherent to IFAS. Only 39% received IFAS counseling, and 52% had some knowledge of IFAS. Gravidity (AOR = 2.92 95% CI (1.61, 5.30)), gestational age at first ANC visit (AOR = 3.67, 95% CI (1.94, 6.97)), pregnant women who got advice about IFAS (AOR = 2.04, 95%CI (1.12, 3.75)), current anemia (AOR = 2.22, 95%CI (1.45, 4.29)), and had knowledge about IFAS (AOR = 3.27, 95% CI (1.80, 5.95)) were statistically associated with adherence to IFAS among pregnant women.
Overall, IFAS adherence among pregnant women was low. The associated factors with adherence of IFAS were counseling and knowledge, early ANC attendance, pregnancy history, and current anemia diagnosis. IFAS counseling by health workers was low but, when given, was associated with improved IFAS adherence. Health workers and health extension workers should consistently counsel on IFAS benefits during ANC visit, to improve IFAS adherence during the current and subsequent pregnancies.