Iron and folic acid supplementation adherence among pregnant women attending antenatal care in North Wollo Zone northern Ethiopia: institution based cross-sectional study.
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SUBMITTER: Demis A
PROVIDER: S-EPMC6889669 | biostudies-literature | 2019 Mar
REPOSITORIES: biostudies-literature
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Iron and folic acid supplementation adherence among pregnant women attending antenatal care in North Wollo Zone northern Ethiopia: institution based cross-sectional study.
Demis Asmamaw A Geda Biftu B Alemayehu Tadesse T Abebe Haimanot H
BMC research notes 20190305 1
<h4>Objectives</h4>The main aim of this study was to assess iron and folic acid supplementation adherence among pregnant mothers attending antenatal care in public health facilities of North Wollo Zone northern Ethiopia. An institution based quantitative cross-sectional study design was employed, on 422 pregnant women in North Wollo Zone, northern Ethiopia. Systematic random sampling and purposive sampling methods were used to select study participants for the quantitative and qualitative studie ...[more]
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Project description:INTRODUCTION:Anemia during pregnancy has a significant adverse effect on both the mother and fetus. Iron and folic acid supplementation (IFAS) is the feasible and cost effective strategy to control and prevent anemia in pregnancy. However, the success of this strategy is suboptimal due to poor maternal adherences to the regimen. The aim of this study was to assess prevalence of anemia, rate of adherence to IFAS and associated factors among pregnant women at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. METHOD:Institution based cross sectional study was conducted among 250 pregnant women who were selected using systematic random sampling from antenatal care clinic (ANC) attendants of TASH. Data was collected through interview and medical chart review by using structured questionnaire. The data was analyzed by SPSS v.24. Binary logistic regression was used to identify the associated factors for IFAS and P < 0.05 was used to declare the association. RESULTS:The prevalence of anemia was 4.8% and half of the study participants were knowledgeable about anemia. The rate of adherence to IFAS was 63.6%. Forgetfulness and fear of side effect were the commonest reasons for poor adherence to IFAS. Gestational age at first ANC visit and educational level were significantly associated with adherence to IFAS. Thus, pregnant women who started their ANC follow up at first trimester (AOR = 1.87, 95% CI (1.18-3.36)) and education level of college and above (AOR = 4.236, 95% CI (1.35-13.25)) and completed secondary education (AOR = 4.09, 95% CI (1.39-12.02)) were more likely to be adherent to IFAS compared with their comparators. CONCLUSION:Even though anemia prevalence was very low among the study participants, adherence to IFAS was still a challenge during pregnancy. Therefore, counseling about IFAS and anemia prevention and promoting the benefits of early ANC visit are recommended to improve adherence to IFAS.
| S-EPMC7197778 | biostudies-literature
Project description:IntroductionNutritional 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.MethodsAn 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.ResultsA 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.ConclusionOverall, 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.
| S-EPMC6322725 | biostudies-literature
Project description:BACKGROUND:Iron-folic acid supplementation during pregnancy is among the very effective interventions to prevent iron deficiency anemia, low birth weight, and prematurity. There is a need of having recent studies on adherence to the supplement that consider the very recent interventions targeted to scale up the use of iron-folic acid (IFA) supplement. Therefore we sought to assess adherence to IFA supplement and its associated factors among antenatal care attending pregnant mothers in governmental health institutions of Adwa town. METHODS:Institution-based cross-sectional study was conducted among 629 antenatal care attending pregnant mothers. Systematic random sampling method was used to select the study subjects. Data were collected through face-to-face interview and chart-review. Bivariable and multivariable binary logistic regression was computed. Variables with P-value <0.05 were considered statistically significant at 95% confidence interval (CI). RESULT:Only 40.9% (95%CI: 37.0%- 44.7%) of participants were adherent (took four or more tablets per week). Women in the age group of 25-29 years [AOR: 2.22(1.21-4.07)] had increased odds of adherence as compared to those in the age group ? 35 years. Women who received nutrition counseling [AOR: 4.12(2.12-8.03)] and partner support [AOR: 2.23 (1.42-3.49)] had increased odds of adherence as compared to those who didn't receive nutrition counseling and partner support respectively. Similarly, women who had satisfactory knowledge on IFA supplement (AOR: 2.16(1.37-3.40)) had increased odds of adherence as compared to those who didn't have satisfactory knowledge on IFA supplement. CONCLUSION:Adherence to the supplement was low. Efforts shall be done to improve awareness of pregnant mothers about IFA supplement through targeted nutrition counseling that includes the engagement of a partner.
| S-EPMC6946125 | biostudies-literature
Project description:Timely entries to antenatal care have various benefits for pregnant women and birth outcomes. The aim of antenatal care is to assure that every pregnancy culminates in the delivery of a healthy baby without negative effects on the health of pregnant women through health promotion and disease prevention, early detection, and treatment of complications and existing diseases. Hence, this study assessed the late initiation of antenatal care and associated factors among pregnant women attending antenatal clinics at public health centers of Ilu Ababor Zone, southwest Ethiopia. An Institution-based cross-sectional study was carried out among 389 pregnant women who were attending antenatal care service at twelve randomly selected health centers. A systematic sampling technique was employed to recruit pregnant women. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Those women who started antenatal care follow up after 12 weeks of gestational age were categorized as booked lately. Bivariable and multivariable logistic regression was employed to identify an association between the independent predictors and the outcome variable. In this study, 277 (71.2%) of the participants were booked their first antenatal care visit lately. Having family size of ≥ 4 (AOR: 2.25; 95% CI: 1.07-4.74), maternal age ≥ 25 years (AOR: 2.30; 95%CI: 1.02-5.18) and perceived the right time of booking > 12 weeks of gestation (AOR: 2.39; 95% CI: 1.13-5.04) had higher odds of late antenatal care initiation. Similarly, not being a member of women's health developmental army (AOR: 2.35; 95%CI: 1.09-5.07) and ANC not attended previously (AOR: 3.32; 95% CI: 1.17-9.42) had also a more likelihood of booking antenatal care lately. In this study, the majority of women started antenatal care lately. Thus, the provision of health education on the importance of attending first antenatal care early is recommended.
| S-EPMC7845970 | biostudies-literature
Project description:BackgroundZinc is an essential mineral known to be important for the normal physiological functions of the immune system. It is one of the basic nutrients required during pregnancy for the normal development and growth of the fetus. However, Zinc deficiency during pregnancy causes irreversible effects on the newborn such as growth impairment, spontaneous abortion, congenital malformations and poor birth outcomes. Even though, the effect of Zinc deficiency is devastating during pregnancy, there is scarcity of evidence on Zinc deficiency and related factors among pregnant women in the current study area.ObjectiveTo assess Zinc deficiency and associated factors among pregnant women attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia.MethodsInstitution based cross-sectional study was conducted among randomly selected 424 pregnant mothers. Data were collected using pre tested questionnaire (for interview part), and 5 blood sample was drawn for serum zinc level determination. Data were entered to Epi-Data version 3.1 software and exported to SPSS version 25 for analysis. Binary logistic regression analysis was computed and independent variables with a p-value ≤ 0.25 were included in multivariable analysis. Serum zinc level was determined using atomic absorption spectroscopy by applying clean and standard procedures in the laboratory. Finally adjusted odds ratio with 95% confidence level, P-value < 0.05 was used to identify significant factors for Zinc deficiency.ResultThe prevalence of Zinc deficiency was found to be 128 (30.26%) with the mean serum zinc level of 0.56±0.12 g/dl. Age, 25-34 years [AOR 2.14 (1.19,3.82)], and 35-49 years [AOR 2.59 (1.15, 5.85)], type of occupation, farming [AOR 6.17 (1.36, 28.06)], lack of antenatal follow up during pregnancy [AOR 3.57 (1.05,12.14)], lack of freedom to purchase food items from market [AOR 3.61 (1.27, 10.27)], and inadequate knowledge on nutrition [AOR 3.10(1.58, 6.08)] were factors associated with Zinc deficiency.ConclusionZinc deficiency is a public health problem among pregnant mothers in the current study area. Improving maternal nutritional knowledge, motivating to have frequent antenatal follow up, and empowering to have financial freedom to purchase food items from market were the modifiable factors to reduce Zinc deficiency. Nutritional intervention that focused on improving nutritional knowledge and insuring access to Zinc sources food items should be delivered for pregnant mothers.
| S-EPMC9262205 | biostudies-literature
Project description:BACKGROUND:Anemia is a common clinical problem contributing to increased maternal and fetal morbidity and mortality during pregnancy. Anemia can be caused by different factors apart from known diseases. The main aim of this study was to identify determinants of anemia among pregnant women attending antenatal care at the public health facilities of Horo Guduru Wollega Zone, West Ethiopia, 2017. METHODS:Health facility-based unmatched case-control study was conducted among 191 anemic and 382 non-anemic pregnant women from September 7, 2017, to October 25, 2017, in Horo Guduru Wollega Zone, West Ethiopia. Data were collected using pre-tested questionnaires from nine health facilities. Hemoglobin level determination, hemo-parasite diagnosis, venereal disease research laboratory (VDRL) test, and stool examination were done in the laboratories of the respective health centers. Cleaned and coded data were entered and analyzed using SPSS version 20. Frequency, proportion, mean and standard deviation were computed to summarize the data and presented by tables and bar graphs. Multivariate binary logistic regression analysis was used to determine the association of predictors and response variables at P ≤ 0.05. Adjusted odds ratio with 95% CI was used to show the strength of association between predictors and outcome variables. RESULTS:A total of 573 pregnant women were enrolled in this study. Monthly income < 500 Ethiopian birr (AOR = 9.16, 95% CI: 4.23, 19.82), heavy menstrual bleeding (AOR = 2.38, 95%CI: 1.38, 4.09), taking iron supplement irregularly (AOR = 2.87, 95%CI:1.41, 5.84), Mid-upper Arm Circumference (MUAC) < 23 cm (AOR = 3.42, 95%CI: 2.07, 5.63), low dietary diversity score (AOR = 12.30, 95%CI: 4.64, 32.72), medium dietary diversity score (AOR = 3.40, 95%CI:1.48, 7.84) and intestinal helminthic infections (AOR = 6.31, 95%CI: 3.44, 11.58) were significantly associated with anemia during pregnancy. CONCLUSION:Average monthly income < 500 Ethiopian birr, heavy menstrual bleeding, low and medium dietary diversity score, taking of iron supplements irregularly, MUAC < 23 cm and intestinal helminthic infections were identified as independent determinants of anemia during pregnancy. Therefore, improving dietary diversity intake, routine deworming and empowering women on taking iron regularly are vital to prevent anemia during pregnancy.
| S-EPMC6822753 | biostudies-literature
Project description:IntroductionAnemia affects around 38.2% and 22% of pregnant women at a global and national level respectively. In developing countries, women start pregnancy with already depleted body stores of iron and other vitamins with significant variation of anemia within and between regions.ObjectiveTo identify the determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia.MethodsA health facility based unmatched case control study was conducted among 112 cases and 336 controls from January to March 2016 G.C. The sample size was determined by using Epi Info version 7.1.5.2. Study subjects were selected using consecutive sampling technique. Data were collected using a structured questionnaire, entered using Epi Data version 3.1 and analyzed using SPSS version 20. Bivariable and multivariable logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value<0.05 were used to see the significant association.ResultsFailure to take dark green leafy vegetables per two weeks (AOR = 5.02, 95% CI: 2.16, 11.71), didn't take chicken per two weeks (AOR = 2.68, 95% CI: 1.22, 5.86), 1st trimester (AOR = 2.07, 95% CI: 1.12, 3.84), 3rd trimester (AOR = 2.96, 95% CI: 1.53, 5.72), HIV infection (AOR = 6.78, 95% CI: 2.28, 20.18) and medication (AOR = 3.57 95% CI: 1.60, 7.98) were positively associated with anemia.ConclusionsInadequate intake of dark green leafy vegetables, inadequate consumption of chicken, trimester of the current pregnancy, HIV infection and medication were the determinants of anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of adequate intake of dark green leafy vegetables and chicken, increase meal pattern during the entire pregnancy and strengthen the prevention of mother to child HIV transmission/antenatal care programs.
| S-EPMC5348124 | biostudies-literature
Project description:Background The timing of initiation of first antenatal care visit is paramount for ensuring optimal care and health outcomes for women and children. However, the existing evidence from developing countries, including Ethiopia, indicates that most pregnant women are attending antenatal care in late pregnancy. Thus, this study was aimed to assess timely initiation of antenatal care and associated factors among pregnant women attending antenatal care services in Southwest Ethiopia. Methods Institutional based cross-sectional study was conducted among 375 pregnant women from April 15 to June 15, 2019 in Southwest Ethiopia. A structured and pre-tested face-to-face interviewer-administered questionnaire technique was used to collect data. Systematic random sampling technique was employed to recruit pregnant women. The data were entered into Epi data version 4.4.2 and analyzed using SPSS version 25. Frequency tables, charts and measures of central tendency were used to describe the data. The effect of each variable on timely initiation of antenatal care was assessed using bi-variable logistic regression. A multivariable logistic regression model was used to identify factors associated with timely initiation of antenatal care. The adjusted odds ratio with 95% confidence interval and p<0.05 was used to identify factors associated with timely initiation of antenatal care. Results The study revealed that 41.9% of pregnant women started antenatal care timely. Pregnant women who had good knowledge of timely initiation of antenatal care (AOR = 3.8, 95% CI: 2.2–6.5), planned to be pregnant (AOR = 5.1, 95% CI: 2.9–8.9), being primigravida (AOR = 2.6, 95% CI: 1.4–4.7) and confirmed their pregnancy by urine test (AOR = 4.1, 95% CI: 2.4–6.9) were found to be significant predictors for timely initiation of antenatal care. Conclusions Despite the efforts made to make ANC visit services freely available, timely initiation of antenatal care among pregnant women in the study area was low. Pregnant women who had good knowledge of timely initiation of antenatal care, planned to be pregnant, being primigravida and confirmed pregnancy by urine test were found to be significant predictors for timely initiation of antenatal care. Therefore, efforts that strengthen awareness on antenatal care and its right time of commencement, increase pregnant women’s knowledge of timing of antenatal care services and reducing unplanned pregnancies should be organized.
| S-EPMC9387795 | biostudies-literature
Project description:BackgroundGlobally, anemia is a public health problem affecting the life of more than two billion people. Pregnant women are at high risk of iron deficiency anemia due to increased nutrient requirement during pregnancy. Iron-folic acid supplementation is the main strategy for prevention and control of iron deficiency anemia and its effectiveness depends on adherence to Iron-Folic Acid tablets. In the refugee camps of Ethiopia, despite the efforts made to reduce iron deficiency anemia during pregnancy, information about adherence to iron-folic acid supplementation and its associated factors are lacking. The objective of this study was to assess magnitude and factors associated with adherence to iron-folic acid supplementation, among pregnant women, in Shire refugee camps.MethodsInstitution based cross-sectional study with mixed design (quantitative and qualitative) was carried out among pregnant women in Shire refugee camps from September to November 2015. For quantitative data, a sample of 320 pregnant women was systematically selected and data were collected via interview administered structured questionnaire. Quantitative data were coded and entered into Epi-info version 3.5.1 and exported into a statistical package for social sciences (SPSS) Version 19.0 software for analysis. Bivariable and multivariable logistic regressions were employed to identify the predictors at p-value <?0.2 and 0.05 respectively. For the qualitative part, six focus group discussions and three key informant interviews were conducted on purposely-selected individuals. Open-Code version 3.6.2.0 was used for analysis. Identified themes were arranged into coherent groupings and triangulated with quantitative findings.ResultsThe adherence rate was found to be 64.7% [95% CI (59.7%, 70.0%)]. Women who were having lower knowledge about anemia [AOR; 0.23 95% CI (0.14, 0.38)] and not receiving information about importance of iron-folic acid supplementation [AOR; 0.43 95% CI (0.25, 0.74)] were negatively associated with adherence to iron and folic acid., Having four or more antenatal care visits [AOR; 2.83 95% CI (1.46, 5.48)] were positively significantly associated with adherence to iron-folic acid supplementation.ConclusionsAdherence rate of iron-folic acid supplementation during pregnancy in the study area is relatively low. Proper counseling and health promotion about Iron-Folic Acid tablet intake, promoting the benefits of early and frequent ANC visit, health promotion on anemia prevention and health benefits of the importance of iron-folic acid supplements are recommended to increase adherence with iron-folic acid supplementation.
| S-EPMC5887183 | biostudies-literature
Project description:BACKGROUND:Hepatitis B virus (HBV) infection is a serious public health problem in sub-Saharan Africa pregnant women. HBV Infection has high tendency of vertical transmission and have adverse effect on both the mother and child. However, there is no evidence on prevalence of hepatitis B virus among pregnant women in Wolaita Zone. Therefore, this study aims to determine prevalence and associated factors of hepatitis B virus infection among pregnant attending Antenatal clinics of public Hospitals of Wolaita Zone. METHOD:An institution based cross sectional study was conducted among pregnant women attending antenatal clinics of Wolaita Zone from October-November, 2018. Systematic random sampling was used to get respondents. A pretested, structured questionnaire was used to collect socio-demographic characteristics and other variables. In addition, 5 ml of venous blood was collected from each study participants and serum was tested for Hepatitis B surface antigen. Data was entered to Epidata 3.1 version and exported Statistical Package for Social Sciences Version 20.0 for descriptive and logistic regression analysis. All variables in bivariate analysis with p<0.25 were taken to multivariable analysis. P-value and Odds ratio with 95% CI was used to measure the presence and strength of the association respectively. RESULT:The prevalence of Hepatitis B surface Antigen among pregnant women was 49(7.3%). History of multiple sexual partners (AOR = 2.675, 95%CI = 1.107-6.463), surgical procedure (AOR = 3.218, 95%CI = 1.446-7.163), genital mutilation (AOR = 2.72, 95% CI = 1.407-5.263), and tooth extraction (AOR = 2.049, 95%CI = 1.061-3.956) were statistically associated with HBV. CONCLUSION AND RECOMMENDATION:Intermediate endemicity of Hepatitis B Virus (7.3%) was observed among mothers attending antenatal clinics of Wolaita Zone. History of tooth extraction, history of surgical procedure, history of genital mutilation and history multiple sexual partners were factors associated with acquisition of Hepatitis B Virus infection. Therefore, we recommend that the health education programs should be done to avoid traditional and non-sterile tooth extraction methods, female genital mutilation and avoiding having multiple sexual partner and its consequences to community and to raise the awareness of mothers attending antenatal clinics. Facilities should strictly follow sterile procedures in every surgical procedure.
| S-EPMC7205295 | biostudies-literature