Predictors of compliance with Iron Folic Acid Supplementation among pregnant women in North Shoa Zone, Ethiopia

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Abstract Background Iron deficiency is the world's highly prevalent micronutrient deficiency, affecting more than 30% of the global population. Pregnant women commonly use iron folic acid (IFA) supplements to prevent iron deficiency, anemia and neural tube anomalies during gestation. IFA supplementation is a crucial component of antenatal care (ANC) in Ethiopia, although its efficacy and success have been hindered primarily by the non-compliance seen among women who are pregnant. Despite this, factors that determine the compliance of women to the recommended IFA supplementation are not well studied. Therefore, the purpose of this study was to investigate the predictors of compliance with IFA supplementation among pregnant women attending ANC. Method An institutional-based cross-sectional study was conducted among 302 pregnant women from March 20 – April 5, 2021. Based on the stated number of IFA pills consumed in the seven days prior to the survey, compliance with IFA supplementation was assessed. Systematic random sampling technique was used to select the study subjects. Face-to-face interviews were used to gather data using a pretested and structured questionnaire. Data were entered into epi-data and exported to SPSS for analysis. Binary logistic regression model was used and variables with a P-value < 0.25 in a bivariate analysis were included in multivariable logistic regression to identify independent predictors of compliance with IFA. Statistically significant was declared at P-value of 0.05 or lower. Result The compliance with Iron folic acid supplementation was 47.0% (95% CI: 43.1–51.2). Educational status of the women (AOR = 4.42; 95% CI: 1.32, 13.50), distance of ≤ 4km to health facility (AOR = 2.46; 95% CI: 1.32, 4.57), place of antenatal care follow-up (AOR = 2.23; 95%CI: 1.17, 4.51), family size (AOR = 4.99; 95% CI:2.43, 10.24) and source of information (AOR = 5.52; 95%CI: 1.30, 23.54) were found to be independent predictors of pregnant women’s compliance with IFA supplementation. Conclusion Less than half of the pregnant women were compliant with iron folic acid utilization. Generally, educational status, distance to the health facility, family size, and source of information were the major reasons for compliance with iron folic acid utilization.

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