Effect of routine iron–folic acid supplementation among rural pregnant women living in low- and high-groundwater-iron areas in Bangladesh

2019 ◽  
Vol 22 (15) ◽  
pp. 2844-2855 ◽  
Author(s):  
Faruk Ahmed ◽  
Moududur Rahman Khan ◽  
Ireen Akhtar Chowdhury ◽  
Rubhana Raqib ◽  
Anjan Kumar Roy ◽  
...  

AbstractObjective:The present study investigated the risks and benefits of routine Fe–folic acid (IFA) supplementation in pregnant women living in low- and high-groundwater-Fe areas in Bangladesh.Design:A case-controlled prospective longitudinal study design was used to compare the effect of daily Fe (60 mg) and folic acid (400 μg) supplementation for 3·5 months.Setting:A rural community in Bangladesh.Participants:Pregnant women living in low-groundwater-Fe areas (n 260) and high-groundwater-Fe areas (n 262).Results:Mean Hb and serum ferritin concentrations at baseline were significantly higher in pregnant women in the high-groundwater-Fe areas. After supplementation, the mean change in Hb concentration in the women in the low-groundwater-Fe areas (0·10 mg/dl) was higher than that in the pregnant women in the high-groundwater-Fe areas (–0·08 mg/dl; P = 0·052). No significant changes in the prevalence of anaemia or Fe deficiency (ID) in either group were observed after IFA supplementation; however, the prevalence of Fe-deficiency anaemia (IDA) decreased significantly in the women in the low-groundwater-Fe areas. The risk of anaemia, ID and IDA after supplementation did not differ significantly between the groups. None of the participants had Fe overload. However, a significant proportion of the women in the high- and low-groundwater-Fe areas remained anaemic and Fe-deficient after supplementation.Conclusion:IFA supplementation significantly increased the Hb concentration in pregnant women living in the low-groundwater-Fe areas. Routine supplementation with 60 mg Fe and 400 μg folic acid does not pose any significant risk of haemoconcentration or Fe overload. Further research to identify other nutritional and non-nutritional contributors to anaemia is warranted to prevent and treat anaemia.

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Negussie Boti ◽  
Tezera Bekele ◽  
Wanzahun Godana ◽  
Eskeziyaw Getahun ◽  
Feleke Gebremeskel ◽  
...  

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.


2019 ◽  
Author(s):  
Wondwossen Niguse

AbstractIntroductionGlobally 41.8% of pregnant women are anemic with the highest proportion affected in developing countries. Nationally, only 0.4% of the pregnant women take Iron supplements more than 90 days of the recommended 180 days. In Oromiya region 75.3% of pregnant women do not take any iron tablets or syrup during their last pregnancy, while 10.8% take for less than 60 days, 0.4% took for 60-89 days and only 0.3% took for 90 days or more.ObjectiveTo assess the adherence rate to iron and folic acid supplements among pregnant women attending antenatal clinics in Asella Town, south east EthiopiaMethod and materialsInstitution based cross-sectional quantitative study design was conducted in Asella town from September 2015 to June 2016. A purposive sampling technique used to select the health institution. There are six health institutions selected for this study. The sample size 317 was selected with systematic random sampling method. Ten percent of pre-test was conducted in one institution which is not included in data collection. Data were collected using structured pre-tested questionnaire. Before data collection verbal consent was obtained. The collected data were analyzed using Epi-data and SPSS version 22.00 packages.ResultThe study revealed that Out of 317 pregnant women 296 (93%) responded to the questioner. The study revealed that 177 (59.8%) of pregnant mothers in the town adhered to the iron/folic acid supplement.Conclusion and recommendationAdherence of iron/folic acid supplementation found in this study is very low. Consequently, maternal education, adequate supplement supply to the health facility, early starting antenatal visit, and health education on duration of supplementation


2019 ◽  
Author(s):  
Tewachew Muche liyeh ◽  
Yitayal Ayalew Goshu ◽  
Amare Simegn Ayele ◽  
Yibeltal Abebe

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


2019 ◽  
Vol 22 (18) ◽  
pp. 3486-3488
Author(s):  
Faruk Ahmed ◽  
Moududur Rahman Khan ◽  
Ireen Akhtar Chowdhury ◽  
Rubhana Raqib ◽  
Anjan Kumar Roy ◽  
...  

2008 ◽  
Vol 11 (6) ◽  
pp. 596-605 ◽  
Author(s):  
Binetou C Seck ◽  
Robert T Jackson

AbstractBackgroundCommunity iron supplementation programmes for pregnant women have lacked effectiveness, partly because of low compliance.ObjectiveTo determine factors that influence compliance among pregnant women in Senegal.DesignTwo hundred and twenty-one pregnant women, recruited from six health centres in Dakar during their first prenatal visit, were randomly assigned to receive either a prescription to purchase iron/folic acid tablets (control, n = 112) to be taken daily, according to official policy, or to receive free tablets (treatment, n = 109). Compliance was assessed 20 weeks after enrolment through interviews and pill count. Women with low or high compliance (<70% or ≥70%) were asked to explain what influenced their adherence to supplementation.ResultsOverall compliance was 69%; it was significantly higher in the treatment than in the control group (86% vs. 48%; P < 0.0001). Women with high compliance (58%) were motivated by: (1) the perception of improved health upon taking the tablets (treatment = 24%, control = 10%); (2) the insistence by midwives that they take the tablets; and (3) the mention that the tablets would improve health. Women with low compliance (42%) reported: (1) the experience of side-effects that they associated with the tablets (treatment = 13%, control = 14%); (2) misunderstanding that they needed to continue taking the tablets throughout pregnancy (treatment = 0%, control = 18%); and (3) forgetfulness.ConclusionCompliance with iron/folic acid supplementation in Senegal can be increased by providing women with clear instructions about tablet intake and educating them on the health benefits of the tablets.


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