Abstract

Background: Despite the largely preventable causative factors, maternal mortality is still a problem in many societies in the world. Anemia during pregnancy is one of the risk factors for maternal mortality and morbidity. Iron supplementation alone or in combination with folic acid is the strategy to alleviate iron deficiency anemia during pregnancy. However, non adherence is an issue for not reducing the problem in these populations.

Objective: To determine non-adherence to Iron/Folate Supplementation and associated factors among pregnant women who attending antenatal care in selected public health institutions at Hosanna Town, Southern Ethiopia.

Methodology: The study was conducted at public health facilities in Hossana town, Southern Ethiopia. An institutional based cross-sectional study was performed. Randomly selected three hundred and a sixty five (365) pregnant women were included in the study. Collected data were edited, coded and entered to Epi info version 3.1 and exported to` STATA Version 14 for further analysis. The association of every independent variable with the response variable was evaluated using bivariate binary logistic regression analysis. Multiple binary logistic regressions were used to identify factors associated with non-adherence to Iron/Folate. Presence of confounders and interaction effects was investigated by computing relative changes on ß coefficients at a cutoff point 15%. Statistically significant variables were considered at p-value<0.05.

Results: Among women participated in the study, 30.41% were non adherent to iron/folate supplementation. Compared to women aged 15-24 years, women above 35 years of age 4.16 (95% CI: 1.24, 3.95) had higher non adherence than adhered women. Women who didn’t get nutrition counseling 3.19 (95% CI: 1.16, 3.74) and women lacking knowledge of anemia 16 (95% CI: 4.34, 6.92) were associated with a higher likely hood of non adherence as compared with those adhered women.

Conclusions and recommendations: Considerable proportion of pregnant women was non-adhered. Age, income, knowledge about hemoglobin status, knowledge about anemia and nutritional counseling were significant predictors for non adherence. Therefore, promoting the benefits of iron/folic supplementation, increasing the awareness of women about anemia and nutrition counseling through health education activities is vital for decreasing non adherence.

Key Words: IFA, Iron /Folic acid supplement, Non adherence, Pregnancy, Anemia