Abstract:
Background: Pregnant mother are at high risk of iron and folic acid deficiency due to their
increased requirements. Iron and folic acid supplementation is the most widely employed strategy
to alleviate iron deficiency anemia and neural tube defects. Adherence to iron and folic acid is
crucial for the prevention of birth defect and anemia during pregnancy. In Woldia town northern
Ethiopia, despite the efforts made to reduce iron deficiency anemia during pregnancy, information
about adherence to iron and folic acid supplementation and its associated factors are lacking.
Objective: The main aim of this study was to assess the adherence status and factors associated
with iron and folic acid supplementation among pregnant women attending antenatal care in public
health facility at Woldia town, Northern Ethiopia.
Methods: An institution based quantitative cross sectional study supplemented by
phenomenological qualitative study design was employed, on 422 pregnant women in Woldia
town, Northern Ethiopia from January 29- March 16 /2018. Systematic random sampling and
purposive sampling methods were used to select study participants for the quantitative and
qualitative study respectively.
Results: The overall adherence status of pregnant women attending antenatal clinic was found to
be 43.1% (95% CI, 38.6%-48.1%). Obtained counseling about IFAS (AOR=2.93, 95%CI: 1.43-
6.03), having four or more ANC visit (AOR=2.94, 95%CI: 1.39-6.21), early registration time
(AOR=3.04, 95%CI: 1.85-5.01), good knowledge of anemia (AOR=2.25, 95%CI: 1.32-3.82) and
good knowledge of IFAS (AOR=2.47, 95%CI: 1.47-4.16) were statistically and positively
associated with pregnant mothers adherence to iron and folic acid supplementation.
Conclusions: This study revealed that the adherence status to iron and folic acid supplementation
among pregnant women attending antenatal care was low. ANC follow up, knowledge of anemia,
knowledge of IFAS, ANC registration time and obtained counseling were factors associated with
pregnant women’s adherence. Therefore, much work is needed to improve adherence status by
providing adequate counseling and health education
