Determinants of non-adherence to Iron Folic Acid Supplementation among Pregnant Women Attending Public Health Facilities in Bishoftu Town, Ethiopia: Case-Control study

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, on the other hand, is a factor in these communities' failure to reduce the problem. 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 studyby structured questionnaire and using systematic random sampling methods for control and consecutive sampling was used for the case. Characteristics of the study participants were analyzed using descriptive Statistics. Variable with P-value < 0.25 at the bivariable analysis was entered into the final multivariable logistic regressions to control potential confounders. Model fitness was also checked by Hosmer Lemeshow. An adjusted odds ratio with a 95% confidence interval and a p-value of ≤0.05 was used to declare the statistical significance of variables. Results: The study response rate was 314 (99.4%). The identified determinants were women aged 15-24 years and 25-34 years [AOR=5, 95% CI (3.04, 12.8), AOR=11.8, 95% CI (18, 20.6)], women who started first ANC >16 weeks (AOR=2.41, 95% CI:1.107, 5.252), women who receive ANC visit two and three were [AOR=5.17, 95% CI (2.5, 13), AOR=2.95 95% CI (1.26, 6.8)], women with inadequate knowledge (AOR=3.5,95% CI:1.7,7.2), women who received 30 and below tablets (AOR=7.8, 95% CI:4, 18) were 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 tabletswere significant predictors for non-adherence to folic acid supplementation.Thus, the town health office should work on non-adherence to folic acid supplementation by improving knowledge of women for all age groups of women during ANC visits with concerned stakeholders.