BMC Pregnancy Childbirth. 2025 Nov 3;25(1):1155. doi: 10.1186/s12884-025-08295-4.
ABSTRACT
BACKGROUND: Iron folic acid supplementation is one of the most global public health interventions to alleviate iron deficiency anemia during pregnancy. Both folic acid and iron deficiencies constitute the major micronutrient deficiencies in Ethiopian women. Non-adherence to folic acid supplementation is a factor for iron deficiency anemia among pregnant women including at selected study area, OBJECTIVE: To identify determinants of non-adherence to iron-folic acid intake among pregnant women who attended antenatal care in Bishoftu town public health facilities, Ethiopia 2022.
METHODS: Facility-based unmatched case-control study was conducted from April 1 to May 30, 2022. A total of 105 cases and 211 controls of pregnant women participated in the study by using systematic random sampling methods for control and consecutive sampling was used for the case. Cases were pregnant women who started ANC service and take iron/folate supplements one month before data collection and who received IFA tablets less than 4 days per week. Controls were pregnant women who started ANC service and take iron/folate supplements one month before data collection and who take IFA tablets greater or equal to 4 days per week. Data were collected by trained health workers using interviewer administered structured questionnaires, entered into Epi-data version 4.6, and exported to Statistical Package for Social Sciences version 25 for analysis. Logistic regression was used to identify determinants of the non-adherence to iron-folic acid supplementation, and the variables with p-value < 0.25 were recruited for multivariable analysis, and an adjusted odds ratio with a 95% confidence interval and a p-value of ≤ 0.05 was used to declare the statistical significance of the variables.
RESULTS: Of the identified determinants of non-adherence to iron-folic acid supplementation:- women aged 15-24 years and 25-34 years [AOR = 5.0, 95% CI (3.04, 12.80), AOR = 11.8, 95% CI (8.01, 12.60)], women who started first ANC > 16 weeks (AOR = 2.41, 95% CI:1.11, 5.25), women who received ANC visit two and three [AOR = 5.17, 95% CI (2.50, 13.02), AOR = 2.95 95% CI (1.26, 6.80)], women with inadequate knowledge (AOR = 3.5,95% CI:1.70,7.20), women who received 30 and below tablets (AOR = 7.80, 95% CI:4.01, 18.02) were the determinants of non-adherence to iron-folic acid supplementation.
CONCLUSIONS: Women’s age, pregnancy weeks during first ANC, frequency of ANC follow-up, knowledge of women on iron-folic acid supplementation, women who received 30 and below tablets were significant predictors for non-adherence to folic acid supplementation. Thus, the town health office should work on non-adherence to folic acid supplementation during pregnancy to improve knowledge of all age groups of women during ANC visits with concerned stakeholders.
PMID:41184769 | DOI:10.1186/s12884-025-08295-4
