Adherence to Iron and Folic Acid Supplementation (IFAS) intake among pregnant women: A systematic review meta-analysis

Midwifery ◽  
2021 ◽  
pp. 103185
Author(s):  
Ita Daryanti Saragih ◽  
Eva Felipe Dimog ◽  
Ice Septriani Saragih ◽  
Chia-Ju Lin
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Acid Supplementation ◽  
Iron And Folic Acid

scholarly journals Compliance with Iron and Folic Acid Supplementation (IFAS) and associated factors among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249789
Author(s):  
Meseret Belete Fite ◽  
Kedir Teji Roba ◽  
Lemessa Oljira ◽  
Abera Kenay Tura ◽  
Tesfaye Assebe Yadeta
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Sub Saharan Africa ◽  
Global Public Health ◽  
Acid Supplementation ◽  
Iron And Folic Acid ◽  
Sub Saharan

Background Anemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was conducted very carefully in order to give up the pooled compliance of Iron and Folic-Acid Supplementation in Sub-Saharan Africa. Methods To conduct this brief systematic review and meta-analysis, a related literature search was done from different sources, PubMed Medline and Google Scholar Journals. Then IFA Supplementation related searching engine was used to make the work more meaningful and intensive. Moreover, we used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to assess the quality of the study in terms of their inclusion. Then, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to carry out the work in a carful manner. Finally, the pooled effect size was computed using the review manager and Compressive Meta-analysis software. Results Twenty-three studies, which encompassed 24272 pregnant women, were chosen for the analysis. From those an overall prevalence of compliance with Iron and Folic Acid Supplementation (IFAS) in pregnancy in SSA was 39.2%. However, the result from meta-analysis showed that women who were counseled on IFAS in their courses of pregnancy were 1.96 times more likely to adhere to IFAS compared to those who were not counseled [OR:1.96, 95% CI (1.76-,5.93)]. Moreover, it showed that women who had knowledge of IFAS were 2.71 times more likely to have compliance with IFAS as compared to those who had no knowledge of IFAS [OR:2.71, 95% CI (1.33,5.54)]. Also it revealed that those women who had knowledge of anemia were 5.42 times more likely to have compliance with IFAS as compared with those who had no knowledge of anemia [OR5.42, 95% CI (1.52, 19.43)]. Furthermore, women who had received fourth visit for ANC were 1.54 times more likely to have compliance with IFAS as compared to those who had not received for ANC [OR 1.54, 95% CI (0.66, 3.58.43)]. Conclusions Our finding from this systematic review and meta-analysis shows the low case in prevalence of compliance to IFAS among pregnant women in SSA. Predictors for this includes: knowledge about anemia, knowledge about IFAS, counseling on IFAS and receiving fourth antenatal care visit were statistically correlated positively with compliance to IFAS. This demands careful appraisal of effect of prevention work for functioning policy, programs and plan nutrition intrusions for refining maternal dietary intake in gestation. Also dietary education intrusion requires to be planned to satisfy the needs of pregnant women. So we hope that the result of this study might be essential as a bridging stone for policy makers of Africa; exclusively for maternal and child health care. Finally, we recommended further studies to be conducted in the area of the study for more intensive and detailed suggestions.

scholarly journals Adherence of iron and folic acid supplementation and determinants among pregnant women in Ethiopia: a systematic review and meta-analysis

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Melaku Desta ◽  
Bekalu Kassie ◽  
Habtamu Chanie ◽  
Henok Mulugeta ◽  
Tadesse Yirga ◽  
...  
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Side Effects ◽  
Pregnant Women ◽  
Meta Analysis ◽  
National Level ◽  
Folic Acid Supplementation ◽  
Acid Supplementation ◽  
Life Years ◽  
Iron And Folic Acid

Abstract Background Iron and folic acid deficiency anaemia are one of the global public health challenges that pose 1.45% of all disability-adjusted life-years. It is recognized as a cause for an unacceptably high proportion of maternal and perinatal morbidity and mortality. Adherence to iron and folic acid supplementation during the antenatal period is paramount to reduce anaemia and its associated morbidities. Although several studies have been conducted across the country, their reports were inconsistent and inconclusive for intervention. Therefore, this systematic review and meta-analysis were aimed to estimate the pooled national level adherence to iron and folic acid supplementation and its determinants among pregnant women in Ethiopia. Methods This systematic review and meta-analysis were pursued the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guideline. An extensive search of databases including, PubMed, Google Scholar, and African Journals Online were conducted to access articles. The Newcastle- Ottawa quality assessment tool was used to assess the quality of each study and meta-analysis was conducted using a random-effects model. I2 test and Egger’s test were used to assess the heterogeneity and publication bias respectively. The meta-analysis of estimating national level adherence were done using STATA version 11 with 95% CI. Results Twenty studies with a total of 16,818 pregnant women were included in this meta-analysis. The pooled national level iron and folic acid supplementation’s adherence were 46.15% (95%CI:34.75,57.55). The highest adherence was observed in Addis Abeba, 60% (95%CI: 55.93, 64.07) followed by Tigray, 58.9% (95% CI: 33.86, 84.03). Women who received supplemental information [OR = 2.34, 95%CI: 1.05, 5.24], who had good knowledge [OR = 2.2, 95%CI: 1.05, 5.24], began the ANC visit before 16 weeks [OR = 2.41, 95%CI: 1.76, 3.29], and had ≥4 ANC visits [OR = 2.59, 95% CI: 1.09, 6.15] were more likely adhere to the supplementation. Fear of side effects (46.4, 95% CI: 30.9 61.8) and forgetfulness (30.7, 95% CI: 17.6, 43.8) were the major barriers of adherence of the supplementations. Conclusions More than four of nine pregnant women have adhered to the iron and folic acid supplementation. This meta-analysis revealed that receiving supplemental counselling, knowledge of the supplement; early registration and frequent ANC visit were significantly associated with the adherence of the iron and folic acid supplementation. Therefore, provision of strengthened supplemental counselling service, antenatal care services, and improving the knowledge of the supplementation is a crucial strategy to increase the adherence among pregnant women in Ethiopia. Besides, addressing the barriers of the adherence of the supplement mainly counseling or managing of side effects and reducing of forgetfulness to take the tablet through getting family support or male involvement during visit is mandatory.

scholarly journals Prevalence and determinants of Anemia among pregnant women in sub-Saharan Africa: a systematic review and Meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Meseret Belete Fite ◽  
Nega Assefa ◽  
Bizatu Mengiste
Keyword(s):  
Systematic Review ◽  
Folic Acid ◽  
Pregnant Women ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Sub Saharan Africa ◽  
Acid Supplementation ◽  
Iron And Folic Acid ◽  
Sub Saharan

Abstract Background Anemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was carried out very prudently in order to give up the pooled prevalence and determinants of anemia in Sub-Saharan Africa. Methodology To carry out this ephemeral systematic review and meta-analysis, a correlated literature review was done from various sources, PubMed Medline and Google Scholar Journals. Anemia related searching engine was used to make the study more evocative and intensive. We used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to evaluate the quality of the study in relations of their inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was tracked to conduct this study. The pooled effect size was computed using the review manager and Compressive Meta-analysis software. Results Twenty-fife studies, which encompassed 15,061 pregnant women, were chosen for the analysis. From those an overall prevalence of anemia in pregnancy in SSA was 35.6%. However, the result from meta-analysis showed that women who were infected with intestinal parasite were 3.59 times more likely to develop anemia compared to those who were not infected [OR:3.59, 95% CI (2.44,5.28)].The result showed that women who had no iron and folic-acid supplementation were 1.82 times more likely to develop anemia compared to those women who had iron and folic-acid supplementation {OR:1.82, 95% CI (1.22,2.70]. Women who had women were in third trimester pregnancy were 2.37 times more likely to develop anemia compared to those who were in first and second trimester [OR:2.37, 95% CI (1.78, 3.24)]. Women who had low dietary diversity score were 3.59 times more likely to develop anemia compared to those who had high dietary diversity score [OR: 3.59, 95% CI (2.44, 5.28]. Conclusions Our finding from this systematic review and meta-analysis displays the high case in prevalence of anemia among pregnant women in Sub-Saharan Africa. Predictors for this includes: intestinal parasite, iron and folic-acid supplementation, third trimester pregnancy and dietary diversified intake score were statistically correlated positively with anemia in pregnancy. These need cautious evaluation of impact of prevention effort for operational policy, programs and design nutrition intrusions for refining maternal food consumption during pregnancy. Also, dietary education intrusion requires to be prearranged to satisfy the desires of pregnant women. The finding of this work will be used as an evidences for policy makers of Africa; entirely for maternal and child health care. Lastly, we suggested further investigations to be carried out in the area of the study for more rigorous and comprehensive recommendations.

scholarly journals Adherence to Iron-Folate Supplementation and Associated Factors among Pastoralist’s Pregnant Women in Burji Districts, Segen Area People’s Zone, Southern Ethiopia: Community-Based Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Negussie Boti ◽  
Tezera Bekele ◽  
Wanzahun Godana ◽  
Eskeziyaw Getahun ◽  
Feleke Gebremeskel ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Associated Factors ◽  
Folic Acid Supplementation ◽  
Deficiency Anemia ◽  
Southern Ethiopia ◽  
Acid Supplementation ◽  
Iron And Folic Acid ◽  
Iron Folic Acid Supplementation ◽  
Iron Folic Acid

Background. Iron deficiency anemia among pregnant women is one of the most common public health problems in developing country particularly in Ethiopia. Iron/folic acid supplementation with optimal adherence is the main cost-effective strategy for prevention and control of iron deficiency anemia in pregnant women. However, level of adherence to iron/folic acid supplementation and its associated factors were not well identified in study area. Therefore, the aim of this study was to determine the level of adherence to iron/folic acid supplementation and associated factors among pregnant women in Burji Districts, southern Ethiopia. Methods. A community-based cross-sectional study was conducted among 317 pregnant women in Burji Districts from March to April 2017 using interviewer administered questionnaires. Data were entered into Epi Info 3.5.1 and exported to SPSS version 20.0 for analysis. Binary and multivariable logistic regression was used to identify factors associated with iron/folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value <0.05 were used to declare statistical significance. Results. Among women participating in the study, 163(51.4%) were adherent to iron/folate acid supplementation. Factors significantly associated with adherence to iron and folic acid supplementation were maternal educational status (AOR: 2.47, 95% CI: 1.13-4.97), early registration for ANC (AOR: 2.49, 95% CI: 1.45 – 4.27), history of anemia during current pregnancy (AOR: 2.02, 95% CI: 1.09-3.72), and knowledge about iron and folic acid supplementation (AOR: 1.96, 95% CI: 1.02-3.76). Forgetfulness and fear of side effects were among the leading reasons of pregnant women for nonadherence to iron and folic acid supplementation. Conclusions. This study revealed that adherence to iron /folic acid supplementation was found to be 51.4%. Maternal educational status, early registration for ANC, history of anemia during current pregnancy, and knowledge about iron and folic acid supplementation were significant factors associated with adherence to iron/folic acid supplementation among pastoralist’s pregnant women. Therefore, anemia prevention strategy should include strengthening giving awareness, counseling, strengthening community health education, and participation in health programs which are necessary to improve the uptake of iron/folic acid supplements.

scholarly journals Association between iron and folic acid supplementation and birth weight in Ethiopia: systemic review and meta analysis

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Andualem Zenebe ◽  
Kaleab Tesfaye Tegegne ◽  
Berhanu Bifato ◽  
Abiyu Ayalew Assefa
Keyword(s):  
Folic Acid ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Systemic Review ◽  
Cochrane Library ◽  
Main Body ◽  
Acid Supplementation ◽  
Iron And Folic Acid

Abstract Background Previous studies on iron with folic acid supplementation and low birth weight indicated different findings. The aim of the current systemic review and meta-analysis was to examine the relationship between iron and folic acid supplementation and birth weight in Ethiopia. Main body The databases searched were PubMed, Google Scholar, Web of Science and Cochrane Library in January 2021. AZ, KTT and AAA carried out the data extraction and independently assessed the articles for inclusion in the review using risk-of-bias tool guided by PRISMA checklist. The combined Odds ratio with 95% confidence interval was calculated using random effect model. Twenty four observational studies involving 10,989 participants, 2423 newborns who were born LBW were included. The combined effect size (OR) for low birth weight comparing women who have Iron and Folic acid supplementation versus women who did not have iron and folic acid supplementation was 0.39 (95% CI 0.27–0.59, p < 0.00001, I2 = 91%). There was significant heterogeneity (Q = 264.16, I2 = 91%, p < 0.00001). No publication bias was observed (Egger’s test: p = 0.742, Begg’s test: p = 0.372). Overall 69.5% of women reported having iron and folic acid supplementation during current pregnancy. And the overall proportion of low birth weight was 22.1%. Conclusions Women who were supplied with iron and folic acid during pregnancy had a 67% decreased chance of delivering low birth weight new born in Ethiopia.

scholarly journals Implementation fidelity of Iron and Folic Acid supplementation (IFAs) and associated challenges among pregnant women in Uasin Gishu County Kenya

2020 ◽  
Author(s):  
Roselyter Monchari Riang'a ◽  
Anne Kisaka Nangulu ◽  
Jacqueline E.W. Broerse
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Implementation Fidelity ◽  
First Trimester ◽  
Folic Acid Supplementation ◽  
Community Based ◽  
Acid Supplementation ◽  
Nutritional Counselling ◽  
Effective Implementation ◽  
Iron And Folic Acid

Abstract Introduction While Iron and Folic Acid Supplementation (IFAs) policy is offered free of charge in Kenya and has been implemented in Kenya and other low and middle-income-countries for decades, effectiveness of this intervention in improving maternal nutrition status has been inadequate. This study aims to acquire insight into the degree to which IFAs policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity. Methods Data was collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among programme recipients (n=188) and semi-structured interviews with programme implementers (n=6). Themes emerging from data are critically discussed using a conceptual framework based on programme theory and the programme implementation fidelity framework. Results Coverage of IFAs is widespread. However, policy content, frequency and participant responsiveness is not fully implemented. Only 10% accessed intervention within the first trimester as recommended by policy guidelines, only 18% and 15% of the respondents received 90 or more iron and folic acid pills respectively during their entire pregnancy period only 28% reported receiving nutritional counselling, and 66% completed taking the IFAs pills that were issued to them. Late initial bookings to antenatal care, drug stock shortage, staff shortage and long queues, confusing dosage instructions, side effects of the pills were established to be the main challenges to effective implementation fidelity. Anticipated health consequences and emphasis by the health officer to take the pills were established to be motivations for adherence to supplements. Conclusions Rather than targeting pregnant women who turn up for care at the health facilities, IFAs interventions should introduce community-based outreach programmes and make use of community-based health workers. This will not only relief the crowded health facilities for effective implementation integrity, but will also reach out to pregnant women within the first trimester when IFAs impact on health is greater and reach out to those women do not turn up at all for interventions at a health facility. Due to shortage and low compliance to IFAs pills, nutritional counselling is vital to promote consumption of locally available micro-nutrient rich food sources.

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