The effect of early antenatal booking on adherence to Iron/folic acid supplementation among antenatal care attendees in Libo kemkem district, Ethiopia

Abstract Background Iron and folic acid supplementation is the feasible and cost effective strategy to control and prevent anemia in pregnancy. Pregnant women are vulnerable for iron deficiency anemia due to increased nutrient requirement during pregnancy. In Ethiopia, the national data suggests that from all pregnant women supplemented with these tablets, only 5.1% consumed more than 90 tablets during their pregnancy time. The factors for this low adherence are not clearly known. Objective: To assess factors associated with adherence to iron-folic acid supplementation among pregnant women attending antenatal care service in Libo Kemkem district, Ethiopia 2017. Method: Hospital based cross sectional study was conducted using quantitative methods on 406 pregnant women attending antenatal care at Libo Kemkem district public health institutions. Systematic random sampling method was used. An interview with pre tested semi structured questionnaire was carried out. The collected data was entered in Epi data 4.1 and analyzed with SPSS version 20. Bivariate and multivariable logistic regression model were used. Odds ratio with 95% interval was computed and P- value <0.05% considered as level of significance. Result: About 406 respondents were included in the study. The adherence rate of iron-folic acid supplementation was 49.3% (95% CI= 44.3%-54.2%). Factors significantly associated with adherence to iron-folic acid utilization were urban residence (AOR =4.8, 95% CI=1.82-12.79), women aged 21-30 (AOR = 4.3, 95% CI=1.60-11.42) ,women aged 31-40 (AOR =4.2, 95% CI=1.33-13.41),early ANC booking (AOR =4.1, 95% CI=1.80-9.30) and getting medical advice (AOR = 2.5, 95% CI = 1.04 – 6.16). Fear of side effects, forgetfulness and too many pills were the major reasons for missing the doses of tablets. Conclusion: adherence rate of iron and folic acid supplementation was low. Residence, maternal age, early ANC booking and getting medical advice were significantly associated with adherence to iron and folic acid. Key Words: Iron-folic acid, pregnant women and adherence