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. 2018 Apr 5;18(1):83.
doi: 10.1186/s12884-018-1716-2.

Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia

Mekdemariam Getachew  1 , Mebrahtu Abay  2 , Hiwet Zelalem  3 , Tirhas Gebremedhin  4 , Teklit Grum  4 , Alemayehu Bayray  5
Affiliations

Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia

Mekdemariam Getachew et al. BMC Pregnancy Childbirth. .

Abstract

Background: Globally, 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.

Methods: Institution 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.

Results: The 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.

Conclusions: Adherence 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.

Keywords: Adherence; Anemia; Eritrean refugee camps; Ethiopia; Iron-folic acid supplementation; Pregnant women.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical clearance and approval were obtained from the Institutional Review Board of College of Health Sciences of Aksum University. Supporting letters were written by the ARRA head office ethical review committee to ARRA Shire Zonal coordination office and to each camp. The purpose of the study was explained to each study participant, including procedures, potential risks and benefits and verbal consent was obtained from the respondents because most respondents are unable to read and agreed on verbal consent. The institutional review board also approved that verbal consent is enough. Confidentiality of the information was assured and data were collected anonymously.

Consent for publication

Not Applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Sampling procedure for the quantitative data among pregnant women in Eritrean refugee camps, northern Ethiopia
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