Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 6;12(9):e061900.
doi: 10.1136/bmjopen-2022-061900.

Geographical disparities and determinants of adherence to iron folate supplementation among pregnant women in Ethiopia: spatial and multilevel analysis of the Ethiopian Mini Demographic and Health Survey of 2019

Solomon Sisay Mulugeta  1
Affiliations

Geographical disparities and determinants of adherence to iron folate supplementation among pregnant women in Ethiopia: spatial and multilevel analysis of the Ethiopian Mini Demographic and Health Survey of 2019

Solomon Sisay Mulugeta. BMJ Open. .

Abstract

Objective: This study aimed to investigate geographic disparities and determinants of adherence to iron and folate supplementation among pregnant women in Ethiopia.

Method: A secondary data analysis was performed using data from the Ethiopian Mini Demographic and Health Survey 2019. A total of 2235 pregnant women aged 15-49 years were included in the analysis. ArcGIS V.10.8 and SaTScan V.9.6 were used for spatial analysis. Multilevel logistic regression analysis was used to determinants.

Result: Of the total number of participants, 80.3% of pregnant mothers took iron and folate supplements for less than the recommended days. Adherence to iron folate supplementation among pregnant women in Ethiopia was spatially clustered with Moran's global I=0.15868. The SaTScan analysis identified the most likely significant clusters found in the eastern Tigray, northeast Amhara and northwest Afar regions. Multivariable multilevel analysis showed that mothers who were living apart from their partner (adjusted OR (AOR)=10.05, 95% CI 1.84 to 55.04), had antenatal care (ANC) visits at least four times (AOR=0.53, 95% CI 0.41 to 0.69), a higher education level (AOR=0.39, 95% CI 0.25 to 0.63), big distance from health facilities (AOR=1.7, 95% CI 1.51 to 1.97) were significant factors of adherence to iron-folate supplementation. Mothers living in the Amhara and Addis Ababa regions were 0.35 (AOR=0.35, 95% CI 0.19 to 0.621), and 0.29 (AOR=0.29, 95% CI 0.15 to 0.7) times lower iron-folate supplementation intake than mother's in Tigray region.

Conclusion: In this study, 8 out of 10 pregnant women did not take iron and folate supplements during the recommended period. As a result, health education activities were necessary to raise awareness among women and the community about the importance of iron folate supplementation during pregnancy, and public health programmes should increase iron folate supplementation through women's education, ANC visits and mothers living in low-iron areas.

Keywords: anaemia; antenatal; paediatric intensive & critical care; reproductive medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Incremental spatial autocorrelation analysis of poor adherence to iron-folate supplementation among pregnant women in Ethiopia, 2019 Ethiopian Mini Demographic and Health Survey.
Figure 2
Figure 2
Spatial autocorrelation analysis poor adherence to iron-folate supplementation among pregnant women in Ethiopia, 2019 Ethiopian Mini Demographic and Health Survey. Given the Z-score of 9.38046964797, there is a less than 1% likelihood that this clustered pattern could be the result of random chance.
Figure 3
Figure 3
Hot spot analysis of poor adherence to iron-folate supplementation among pregnant women in Ethiopia, 2019 Ethiopian Mini Demographic and Health Survey.
Figure 4
Figure 4
SaTScan analysis for poor adherence to iron-folate supplementation among pregnant women in Ethiopia, 2019 Ethiopian Mini Demographic and Health Survey.
Figure 5
Figure 5
Empirical Bayesian interpolation of poor adherence to iron-folate supplementation among pregnant women in Ethiopia, 2019 Ethiopian Mini Demographic and Health Survey.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization . WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development; 2006.
    1. World Health Organization . Daily iron and folic acid supplementation during pregnancy, 2016. Available: http//wwwwhoint/elena/titles/guidance_summaries/daily_iron_pregnancy/en
    1. Imdad A, Bhutta ZA. Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes. Paediatr Perinat Epidemiol 2012;26 Suppl 1:168–77. 10.1111/j.1365-3016.2012.01312.x - DOI - PubMed
    1. World Health Organization . WHO recommendations on antenatal care for a positive pregnancy experience; 2016. - PubMed
    1. de Masi S, Bucagu M, Tunçalp Özge, et al. . Integrated person-centered health care for all women during pregnancy: implementing World Health organization recommendations on antenatal care for a positive pregnancy experience. Glob Health Sci Pract 2017;5:197–201. 10.9745/GHSP-D-17-00141 - DOI - PMC - PubMed