Dataset Information

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania.

ABSTRACT: Introduction:Pregnant women are at a high risk of anaemia, with iron-folate deficiency being the most common cause of anaemia among pregnant women. Despite the well-known importance of iron and folic acid supplementation (IFAS) during pregnancy, adherence to these supplements is relatively low and associated factors were not well identified in the study area. This study is aimed at investigating adherence to IFAS and associated factors among pregnant women in Kasulu district, north-western Tanzania. Methods:A health facility cross-sectional survey with a mixed-method approach was conducted in Kasulu district from March to April 2019. A structured questionnaire was given to 320 women with children aged 0-6 months to assess factors associated with adherence to IFAS among pregnant women. Data were entered into SPSS version 22.0 for analysis. Binary logistic regression was further employed to determine the factors associated with adherence to IFAS. Focus group discussions were done with 19 pregnant women and 15 mothers of children aged 0-6 months to obtain more clarifications on the factors associated with adherence to IFAS. Furthermore, in-depth interviews were done with six health care providers to explore their perceptions of IFAS. Results:Out of the 320 respondents of the survey, 20.3% (n = 65) adhered to IFAS. Factors associated with adherence to IFAS among pregnant women included time to start ANC (AOR = 3.72, 95% CI: 1.42, 9.79), knowledge of anaemia (AOR = 3.84, 95% CI: 1.335, 10.66), counseling on the importance of the iron-folic acid (AOR = 3.86, 95% CI: 1.42, 10.50), IFAS given during clinical visit (AOR = 15.72, 95% CI: 5.34, 46.31), number of meals consumed (AOR = 3.44, 95% CI: 1.28, 9.21), number of children (AOR = 3.462, 95% CI: 1.035, 11.58), and distance to health facility (AOR = 0.34, 95% CI: 0.131, 0.886). Qualitative findings revealed that delayed first ANC visit, lack of remainder for pregnant women to take IFAS, low awareness about the negative effects of anaemia, low of knowledge of IFAS and management of side effects, negative beliefs about the use of IFAS, and follow-up mechanism were major reasons for poor adherence. Conclusion:Adherence to iron-folic acid supplementation during pregnancy was low. Strengthening systems for creating reminding mechanism, raising community awareness through educational programs to pregnant women and health providers could improve adherence to IFAS.

SUBMITTER: Lyoba WB

PROVIDER: S-EPMC7293754 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania.

Lyoba Winfrida B WB Mwakatoga Joyce D JD Festo Charles C Mrema Jackline J Elisaria Ester E

International journal of reproductive medicine 20200604

<h4>Introduction</h4>Pregnant women are at a high risk of anaemia, with iron-folate deficiency being the most common cause of anaemia among pregnant women. Despite the well-known importance of iron and folic acid supplementation (IFAS) during pregnancy, adherence to these supplements is relatively low and associated factors were not well identified in the study area. This study is aimed at investigating adherence to IFAS and associated factors among pregnant women in Kasulu district, north-weste ...[more]

PMID: 32566646

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Project description:BACKGROUND:Despite the supplementation of iron-folic acid is the recommended strategy during the antenatal period; iron deficiency anemia is the commonest hematologic complication during pregnancy. Therefore, this systematic review and meta-analysis aimed to assess the level of adherence to iron-folic acid supplementation and its associated factors among pregnant women in Ethiopia. METHODS:Systematic review and meta-analysis guideline was followed for this study. Different online databases were used for the review: PubMed, HINARI, EMBASE, Google Scholar and African Journals Online. Different searching terms were applied based on the adapted PICO principles to achieve and access all the essential articles. The data were entered and analyzed using Microsoft Excel and Stata 11 software respectively. RESULTS:Fifteen studies were included in this systematic review and meta-analysis with a total of 5808 pregnant women. The overall pooled prevalence of adherence to iron-folic acid supplementation among pregnant women in Ethiopia was 41.38% (95% CI: 33.09, 49.67). Having secondary and above educational status of the women (AOR:2.68,95%CI:1.25, 5.74), having an early registration of antenatal care follow-up (?16?weeks) (AOR:2.54,95%CI:1.99, 3.24), having anemia complication during current pregnancy (AOR:3.01,95%CI:1.88, 4.81), having good knowledge of iron-folic acid supplementation (AOR: 2.96, 95%CI:1.76, 4.99), having four times or more antenatal care follow up (AOR:3.66, 95%CI:2.81, 4.77), getting health education about benefit of iron and folic acid (AOR:2.62,95%CI:1.46,4.72), and having good knowledge about anemia (AOR:2.99,95%CI:2.32, 3.85) were associated risk factors for adherence to iron-folic acid supplementation. CONCLUSION:The overall pooled prevalence adherence of IFAS among pregnant women was lower than the WHO recommendations. Educational status, early registration of ANC, anemia in the current pregnancy, good knowledge of IFAS, number of ANC visits, good knowledge of anemia and receiving health education about the benefit of IFAS were factors associated with the adherence of IFAS among pregnant women in Ethiopia. This finding is important to design strategic policies and to prevent anemia and congenital anomaly resulted from inadequate intake of iron and folic acid.

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.

Project description:Anemia is common in pregnancy and increases the risk of adverse outcomes. Iron deficiency is a leading cause of anemia in sub-Saharan Africa, and iron supplementation is the standard of care during pregnancy; however, recent trials among children have raised concerns regarding the safety of iron supplementation in malaria-endemic regions. There is limited evidence on the safety of iron supplementation during pregnancy in these areas.To evaluate the safety and efficacy of iron supplementation during pregnancy in a malaria-endemic region.We conducted a randomized, double-blind, placebo-controlled clinical trial among pregnant women presenting for antenatal care in Dar es Salaam, Tanzania, from September 28, 2010, through October 4, 2012. Iron-replete, nonanemic women were eligible if they were uninfected with human immunodeficiency virus, primigravidae or secundigravidae, and at or before 27 weeks of gestation. Screening of 21,316 women continued until the target enrollment of 1500 was reached. Analyses followed the intent-to-treat principle and included all randomized participants.Participants were randomized to receive 60 mg of iron or placebo, returning every 4 weeks for standard prenatal care, including malaria screening, prophylaxis with the combination of sulfadoxine and pyrimethamine, and treatment, as needed.The primary outcomes were placental malaria, maternal hemoglobin level at delivery, and birth weight.Among 1500 study participants (750 randomized for each group), 731 in iron group and 738 in placebo group had known birth outcomes and 493 in iron group and 510 in placebo group had placental samples included in the analysis. Maternal characteristics were similar at baseline in the iron and placebo groups, and 1354 (91.7%) used malaria control measures. The risk of placental malaria was not increased by maternal iron supplementation (relative risk [RR], 1.03; 95% CI, 0.65-1.65), and iron supplementation did not significantly affect birth weight (3155 vs 3137 g, P =?.89). Compared with placebo, iron supplementation significantly improved the mean increase from baseline to delivery for hemoglobin (0.1 vs -0.7 g/dL, P <?.001) and serum ferritin (41.3 vs 11.3 µg/L, P <?.001). Iron supplementation significantly decreased the risk of anemia at delivery by 40% (RR, 0.60; 95% CI, 0.51-0.71) but not severe anemia (RR, 0.68; 95% CI, 0.41-1.14). Iron supplementation significantly reduced the risk of maternal iron deficiency at delivery by 52% (RR, 0.48; 95% CI, 0.32-0.70) and the risk of iron deficiency anemia by 66% (RR, 0.34; 95% CI, 0.19-0.62).Prenatal iron supplementation among iron-replete, nonanemic women was not associated with an increased risk of placental malaria or other adverse events in the context of good malaria control. Participants receiving supplementation had improved hematologic and iron status at delivery compared with the placebo group. These findings provide support for continued administration of iron during pregnancy in malaria-endemic regions.clinicaltrials.gov Identifier: NCT01119612.

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.

Dataset Information

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania.

Publications

Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania.

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