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
International Journal of Nutrition and Food Sciences
Volume 4, Issue 2, March 2015, Pages: 161-168
Received: Feb. 10, 2015; Accepted: Feb. 26, 2015; Published: Mar. 3, 2015
Views 4528      Downloads 832
Authors
Abel Gebre, College of Health Science, Department of Public Health, Samara University, Samara, Ethiopia
Afework Mulugeta, College of Health Science, Department of Public Health, Mekelle University, Mekelle, Ethiopia
Belachew Etana, College of Health Science, Department of Public Health, Mekelle University, Mekelle, Ethiopia
Article Tools
Follow on us
Abstract
Introduction: Iron deficiency is the leading nutrient deficiency in the world affecting the lives of more than 2 billion people, accounting to over 30% of the world’s population. Pregnant women are particularly at high risk of iron deficiency. Objective: To determine and compare the adherence rate and identify factors associated with iron folic acid supplementation among urban and rural pregnant women attending antenatal clinics in North Western Zone of Tigray, Ethiopia. Methods: An institution based comparative cross sectional study was employed among 358 urban and 356 rural pregnant women attending antenatal clinics in North Western Zone of Tigray from March to April 2014. Logistic regression analysis was used to identify factors associated with adherence to iron-folic acid supplementation among urban and rural pregnant women. All tests were two-sided and p value < 0.05 was considered statistically significant. Results: The rate of adherence to iron folic acid supplementation among the pregnant women in the urban and rural communities was 37.2% (95%CI, 32.26%-42.25%) and 28.9% (95%CI, 24.4%-33.81%) respectively indicating that there was no significant difference among the two groups with regard to adherence to iron-folic acid supplementation. The independent predictors for maternal adherence to iron folic acid supplementation were early registration (AOR= 1.778, 95% CI= 1.076– 2.936), having four or more visits (AOR=3.784, 95%CI=2.073-6.909), previous anemia (AOR=1.913, 95%CI=1.135-3.223), and current anemia (AOR= 0.408, 95%CI=0.224-0.744) for urban pregnant women. Similarly, elderly age (AOR=0.527, 95%CI=0.315-0.881), early registration (AOR=1.918, 95%CI=1.116-3.296), previous anemia (AOR= 2.472, 95%CI=1.352-4.517) and current anemia (AOR=0.400, 95%CI=0.214-0.749) were the independent predictors for maternal adherence to iron folic acid supplementation for the rural pregnant women. Conclusion: Adherence rate to iron-folic acid supplementation in both urban and rural communities were very low. Comprehensive nutrition education should focus on the importance of adherence to iron folic acid tablets both for urban and rural pregnant women.
Keywords
Adherence, Pregnant, Iron-folic Acid, Tigray, Ethiopia
To cite this article
Abel Gebre, Afework Mulugeta, Belachew Etana, 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, International Journal of Nutrition and Food Sciences. Vol. 4, No. 2, 2015, pp. 161-168. doi: 10.11648/j.ijnfs.20150402.16
References
[1]
Lucy N, Gathig.I: Factors Influencing Utilization of Iron and Folic Acid supplementation Services among Women Attending Antenatal Clinic at Nyeri Provincial Hospital Kenya. University of Nairobi/Dissertation.2011: http://www.kemri.org.com.
[2]
Yakoob YM, Bhutta AZ: Effect of routine iron supplementation with or without folic acid on anemia during pregnancy.BMC Public Health 2011, 11(Suppl 3):S21. http://www .biomedcentral .com/ 1471-2458/11/S3/S21.
[3]
Haidar AJ, Pobocik SR: Iron deficiency anemia is not a rare problem among women of reproductive ages in Ethiopia: BMC Blood Disorders. 2009, 9:7, doi:10.1186/1471-2326-9-7.
[4]
ZAKIA M, Ibrahim, M.D, Seham Abd El-Hamid, M.D, Hend Mikhail, M.Sc, Maged S, Khattab M.D: Assessment of Adherence to Iron and Folic Acid Supplementation and Prevalence of Anemia in Pregnant Women Ismailia governorate, Egypt. Med. J. Cairo Univ., Vol. 79, No. 2, June 2011, 115-121, www.medicaljournalofcairouniversity.com.
[5]
Begum S. Factors associated with adherence to Iron Folic acid supplementations during Pregnancy in Uttar Pradesh: Volume 14 (2), 2012, www.ijmch.org.
[6]
Sengpiel V, Bacelis , Myhre R, Solveig Myking2, Devold A, Haugen M, BrantsæterA, Meltzer H, Nilsen RM: Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study. BMC Pregnancy and Childbirth 2013 13:160. doi:10.1186/1471-2393-13-160.
[7]
Ogundipe O, Hoyo C, Stbye T, Oneko O, Manongi R, Terje R, Kjersti D: :factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in urban areas Tanzania: a cross-sectional hospital based study. BMC Public Health 2012; 12:481. http://www.biomedcentral.com/1471-2458/12/481.
[8]
Marquardt H: hematological conditions. Family practice obstetrics, 2000; section E: 209.
[9]
Lacerte P, Pradipasen M, Temcharoen P, Imamee N, Vorapongsathorn T: Determinants of Adherence to Iron/Folate Supplementation During Pregnancy in Two Provinces in Cambodia. Asia Pac J Public Health 2011;23(3):315-23.
[10]
Bilimale A, Anjum J, Sangolli HN, Mallapur M: Improving Adherence to Oral Iron Supplementation during pregnancy. AMJ 2010; 3(5):281-90.
[11]
Ethiopian Central Statistical Agency and ICF International: 2011 Ethiopia Demographic and Health Survey: Key Findings. Calverton, Maryland, USA: CSA and ICF International; 2012.: http://www.measuredhs.com.
[12]
SPRING/FMOH: A Rapid, Initial Assessment of the Distribution and Consumption of Iron-Folic Acid Tab-lets through Antenatal Care in Ethiopia in selected four regions: March, 2013: www.spring-nutrition.org.
[13]
Mahomed, K: Iron supplementation in pregnancy. Cochrane Database of systematic Reviews; 2000, Issue-1; http://www.thecochranelibrary.com.
[14]
FMOH. National guideline for control and prevention of micronutrient deficiencies. Addis Ababa: Family Health Department, Federal Ministry of Health, Government of Ethiopia, 2009.
[15]
WHO: Iron and Folic acid Supplementation. Standards for Maternal & Neonatal Care. Integrated Management of Pregnancy and Childbirth (IMPAC). Vol. 1.8, Geneva, Switzerland: World Health Organization. Department of Making Pregnancy Safer (MPS):2006, 1-6. http://www.thecochranelibrary.com.
[16]
WHO, Guideline: Daily iron and folic acid supplementation in pregnant women: 2006, issue-2: (http://www.who.int/about/licensing/copyright_form/en/index.html).
[17]
FMOH: Programme implementation manual of national nutrition programme, June 2013–June 2015 Addis Ababa, Ethiopia.
[18]
Kulkarni B, Christian P, C LeClerq S, K Khatry KS: Determinants of compliance to antenatal micronutrient supplementation and women’s perceptions of supplement use in rural Nepal. Public Health Nutrition: May 2009,13(1), 82–90: 19.
[19]
Galloway R, McGuire J: Determinants of compliance with iron supplementation: supplies, side effects, or psychology? Soc Sci Med. 2007; 39:381-390.
[20]
STEINER J.F, EARNEST M.A: The language of medication-taking. Ann. Intern. Med., 132: 926-930, 2000.
[21]
Centers for Disease Control and Prevention. Pregnancy risk assessment monitoring system(PRAMS), phase 5 standard questions, 2007: http://www.pramS.org.com.
[22]
Zerfu AT, Ayele TH: Micronutrients and pregnancy; effect of supplementation on pregnancy and pregnancy outcomes: a systematic review. Nutrition Journal 2013 12:20. doi:10.1186/1475-2891-12-20.
[23]
Dairo MD, Lawovin TO: Demographic factors determining compliance to iron supplementation in pregnancy in Oyo State, Nigeria. Nigerian Journal of Medicine 2007; 15: 241–4.
[24]
Thirukkanesh S, Zahara AM: compliance to vitamin and mineral supplementation among pregnant women in urban and rural areas of Malaysia.Pakistan journal of nut.9(8): 744-750,2010.
[25]
Lynette A: Factors associated with adherence to iron/folate supplementation among pregnant women attending antenatal clinic at thika district Hospital in kiambu county, Kenya. University of Kenyata/diss.2013: http://www.linetaoko@yahoo.com.
[26]
Roy MP, Mohan U, Singh SK, Singh VK, Srivastava AK: Socio-Economic Determinants of Adherence to Iron and Folic Acid Tablets among Rural Ante-natal Mothers in Lucknow, India. Natl J Community Med 2013; 4(3):386-391.
[27]
Lutsey LP, Dawe D, Villate E, Valencia S, Lopez O: Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutr 2008, 11:76–82.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186