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Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana

Received: 28 December 2022    Accepted: 15 April 2023    Published: 20 June 2023
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Abstract

Globally, 40% of pregnant women are affected by anaemia. Anaemia, low haemoglobin level in the bloodstream, has many negative effects on pregnancy. The World Health Organisation recommends supplementation with iron and folic acid to prevent the incidence of anaemia in pregnancy. In Ghana, iron and folic acid supplementation has been through Ante Natal Clinics. Despite this intervention, Anaemia in Pregnancy prevalence in Bekwai has been above 37% for three years, higher than the national average of 25%. This study found out the compliance level and determining factors among ANC clients. This facility-based quantitative descriptive cross-sectional study was carried out in two sub-districts using multistage sampling. Data was collected using structured questionnaire. Data entered into SPSS was exported to Stata version for analysis. Demographic and obstetric data were analysed into frequencies and percentages. Bivariate and multivariate analyses were conducted to identify factors affecting compliance. Compliance was low (38.8%), despite high knowledge (90.3%). Gravidity (p-value 0.025 AOR= 5.88, 95% CI= 2.214-15.542) and level of knowledge (P-Value 0.01, AOR 2.89, 95%CI= 0.592-12.10) positively affected compliance. It was recommended that health education at ANC be improved, and adherence partners introduced to help prevent forgetfulness.

Published in International Journal of Nutrition and Food Sciences (Volume 12, Issue 3)
DOI 10.11648/j.ijnfs.20231203.11
Page(s) 65-76
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Compliance, Iron-Folic, Supplementation, Pregnant Women, Bekwai, Ghana

References
[1] (United tates Agency for International Dvelopmemt, “A rapid Initial Assessment of the Distribution and Consumption of Iron-Folic Acid Tablets Through Antenatal Care in Ghana,.” 2019, [Online]. Available: https://www.spring-nutrition.org/publications/briefs/iron-folic-acid-ass..
[2] WHO, “e-Library of Evidence for Nutrition Actions (eLENA) Daily iron and folic acid supplementation during pregnancy,” WHO Recomendation, 2019. https://www.who.int/elena/titles/daily_iron_pregnancy/en/.
[3] World Health Organization, “The global prevalence of anaemia in 2011,” WHO, 2015..
[4] WHO, “WHO recommendations on antenatal care for a positive pregnancy experience.” p. 14, 2016, doi: 10.1192/bjp.111.479.1009-a.
[5] J. P. Pena-Rosas, L. M. De-Regil, M. N. Garcia-Casal, and T. Dowswell, “Daily oral iron supplementation during pregnancy,” Cochrane Database Syetemic Rev., no. 7, 2015, doi: 10.1002/14651858.CD0047...
[6] T. G. Sanghvi, P. W. J. Harvey, and E. Wainwright, “Maternal iron-folic acid supplementation programs: evidence of impact and implementation.,” Food Nutr. Bull., vol. 31, no. 2 Suppl, pp. S100-7, Jun. 2010, doi: 10.1177/15648265100312S202.
[7] A. Bilimale, J. Anjum, H. N. Sangolli, and M. Mallapur, “Improving adherence to oral iron supplementation during pregnancy,” Australas. Med. J., vol. 1, no. 5, pp. 281–290, 2010, doi: 10.4066/AMJ.2010.291.
[8] R. G. Viveki, A. B. Halappanavar, P. R. Viveki, S. B. Halki, V. S. Maled, and P. S. Deshpande, “Prevalence of Anaemia and Its Epidemiological Determinants in Pregnant Women,” Al Ameen J. Med. Sci., vol. 5, no. 3, pp. 216–223, 2012.
[9] G. Abel and A. Mulugu, “Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethopia: A Cross-Sectoral Study.,” J. Nutr. Metab., vol. 2015, pp. 1–12, 2015, [Online]. Available: https://www.hindawi.com/journals/jnme/2015/165430/.
[10] Ghana Health Service, “2016 Annual Report,” 2017. doi: 10.1136/bjo.2010.193169.
[11] GHS, “Ghana Health Service Annual Reprot,” 2017.
[12] Bekwai Municipal Health Directorate, “2018 Annual Report,” 2019.
[13] W. G. Cochran, Sampling Techniques, 3rd ed. New York: John Wiley & Sons, 1977.
[14] K. P. Appiah, D. Nkuah, and B. A. Duut, “Knowledge of and Adherence to Anaemia Prevention Strategies among Pregnant Women Attending Antenatal Care Facilities in Juaboso District in Western-North Region, Ghana,” J. Pregnancy, vol. 2020, pp. 1–8, 2020, doi: 10.1155/2020/2139892.
[15] B. B. Nasir, A. M. Fentie, and M. K. Adisu, “Adherence to iron and folic acid supplementation and prevalence of anaemia among pregnant women attending antenatal care clinic at Tikur Anbessa Specialized Hospital, Ethiopia,” PLoS One, vol. 15, no. 5, 2020.
[16] M. Atoobey, “Iron and Folic Acid Supplementation and Compliance Among Pregnant Women in Nanumba North District of Northern Region, Ghana,” Kwame Nkrumah University of Science and Technocology, 2019.
[17] Z. Y. Kassa, T. Awraris, A. K. Daba, and Z. Tenaw, “Compliance with iron folic acid and associated factors among pregnant women through pill count in Hawassa city, South Ethiopia: A community based cross-sectional study,” Reprod. Health, vol. 16, no. 1, Feb. 2019, doi: 10.1186/s12978-019-0679-8.
[18] P. Mithra et al., “Compliance with Iron-folic acid (IFA) therapy among pregnant women in an urban area of South India,” Afr. Health Sci., vol. 14, no. 1, p. 255, Mar. 2014, doi: 10.4314/ahs.v14i1.39.
[19] S. Debi, G. Basu, R. Mondal, S. Chakrabarti, S. K. Roy, and S. Ghosh, “Compliance to iron-folic-acid supplementation and associated factors among pregnant women: A cross- sectional survey in a district of West Bengal, India with,” India. J Fam. Med Prim Care, vol. 9, pp. 3632–8, 2020, doi: 10.4103/jfmpc.jfmpc.
[20] N. Boti et al., “Adherence to Iron-Folate Supplementation and Associated Factors among Pastoralist Pregnant Women in Burji Districts, Segen Area People’s Zone, South Ethiopia: Community-Based Cross-Sectional Study,” Interntional J. Reprod. Med., vol. 2018, pp. 1–8, 2018, doi: 10.1155/2018/2365362.
[21] G. T. Gebrehiwot, H. Hansa, and T. G. Gereziher, “Time to start and adherence to iron-folate supplement for pregnant women in antenatal care follow up ; Northern Ethiopia,” Patients Prefer Adheence, vol. 13, pp. 1057–1063, 2019, doi: 10.2147/PPA.S184168.
[22] D. Patience, “Knowledge and perception of risk of anaemia during pregnancy among pregnant women in Ablekuma South.” University of Ghana, 2016.
[23] M. Getachew, M. Abay, H. Zelalem, T. Gebremedhin, T. Grum, and A. Bayray, “Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia,” BMC Pregnancy Childbirth, vol. 18, no. 1, Apr. 2018, doi: 10.1186/s12884-018-1716-2.
[24] M. W. Kamau, W. Mirie, and S. T. Kimani, “Maternal knowledge on iron and folic acid supplementation and associated factors among pregnant women in a rural County in Kenya,” Int. J. Africa Nurs. Sci., vol. 10, pp. 74–80, Jan. 2019, doi: 10.1016/j.ijans.2019.01.005.
[25] A. Demis, B. Geda, T. Alemayehu, and H. Abebe, “Iron and folic acid supplementation adherence among pregnant women attending antenatal care in North Wollo Zone northern Ethiopia: Institution based cross-sectional study 11 Medical and Health Sciences 1117 Public Health and Health Services,” BMC Res. Notes, vol. 12, no. 1, Mar. 2019, doi: 10.1186/s13104-019-4142-2.
[26] A. Wemakor, H. Garti, M. M. Akai, A. A. Napari, and J. Dankyi-Frimpomaa, “Prevalence and factors associated with compliance to iron and folic acid supplementation in pregnancy in Tamale Metropolis, Ghana,” Nutrire, vol. 45, no. 2, pp. 1–10, 2020, doi: 10.1186/s41110-020-00120-6.
[27] A. J. Dutta, P. Patel, and R. K. Bansal, “COMPLIANCE TO IRON SUPPLEMENTATION AMONG PREGNANT WOMEN : A CROSS SECTIONAL STUDY IN,” Natl. J. Community Med., vol. 5, no. 4, pp. 457–462, 2014.
[28] H. Assefa, S. M. Abebe, and M. Sisay, “Magnitude and factors associated with adherence to Iron and folic acid supplementation among pregnant women in Aykel town, Northwest Ethiopia,” BMC Pregnancy Childbirth, vol. 19, no. 1, p. 296, 2019, doi: 10.1186/s12884-019-2422-4.
[29] K. D. Yadav, U. N. Yadav, R. R. Wagle, D. N. Thakur, and S. Dhakal, “Compliance of iron and folic acid supplementation and status of anaemia during pregnancy in the Eastern Terai of Nepal: Findings from hospital based cross sectional study,” BMC Res. Notes, vol. 12, no. 1, Mar. 2019, doi: 10.1186/s13104-019-4167-6.
[30] T. Molla, T. Guadu, E. A. Muhammad, and M. T. Hunegnaw, “Factors associated with adherence to iron folate supplementation among pregnant women in West Dembia district, northwest Ethiopia: A cross sectional study,” BMC Res. Notes, vol. 12, no. 1, 2019, doi: 10.1186/s13104-019-4045-2.
[31] H. E. kofi Kordorwu, “Factors Associated with Anaemia in pregnancy among Antenatal Care Attendants in Keta Municipality,” University Of Ghana, 2018.
[32] K. Begum et al., “Prevalence of and factors associated with antenatal care seeking and adherence to recommended iron-folic acid supplementation among pregnant women in Zinder, Niger,” Matern. Child Nutr., vol. 14, Feb. 2018, doi: 10.1111/mcn.12466.
[33] I. Gonzalez-Casanova et al., “Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam,” BMC Public Health, vol. 17, no. 1, May 2017, doi: 10.1186/s12889-017-4379-4.
[34] P. Mithra et al., “Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India,” Afr. Health Sci., vol. 13, no. 4, pp. 880–885, 2013, doi: 10.4314/ahs.v13i4.3.
[35] X. Mbhenyane, M. Cherane, and H. Nutrition, “Compliance with the consumption of iron and folate supplements by pregnant women in Mafikeng local municipality, North West province, South Africa,” Afr. Health Sci., vol. 17, no. 3, pp. 657–670, 2017, doi: 10.4314/ahs.v17i3.8.
[36] W. Lyoba, J. Mwakatoga, C. Festo, … J. M.-I. J. of, and U. 2020, “Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania,” Int. J. Reprod. Med., vol. 2020, p. 11, 2020, doi: https://doi.org/10.1155/2020/3127245 Research.
[37] T. S. Kiwanuka, S. Ononge, P. Kiondo, and F. Namusoke, “Adherence to iron supplements among women receiving antenatal care at Mulago National Referral Hospital, Uganda-cross-sectional study,” BMC Res. Notes, vol. 10, no. 1, 2017, doi: 10.1186/s13104-017-2834-z.
[38] T. M. Birhanu, M. K. Birarra, and F. A. Mekonnen, “Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia,” BMC Res. Notes, 2018, doi: 10.1186/s13104-018-3433-3.
[39] D, Morisky., L Green,., & D Levine,. Morisky Medication Adherance Scales: MMAS-8. www.the nationalcouncil.org/wp-1986.
[40] N. G. Onyeneho, N. I’Aronu, N. Chukwu, U. P. Agbawodikeizu, M. Chalupowski, and S. V. Subramanian, “Factors associated with compliance to recommended micronutrients uptake for prevention of anemia during pregnancy in urban, peri-urban, and rural communities in Southeast Nigeria,” J. Health. Popul. Nutr., vol. 35, no. 1, 2016, doi: 10.1186/s41043-016-0068-7.
[41] M. Desta et al., “Adherence of iron and folic acid supplementation and determinants among pregnant women in Ethiopia: A systematic review and meta-analysis,” Reproductive Health, vol. 16, no. 1. BioMed Central Ltd., Dec. 21, 2019, doi: 10.1186/s12978-019-0848-9.
[42] S. Soraya, S. Sina, S. Hossien, M. A. Marjan, R. Fateme, and B. Maryam, “Determinants of Compliance With Iron and Folate Supplementation Among Pregnant Women in West Iran : A Population Based Cross- Sectional Study,” J. Fam. Reprod. Heal., vol. 12, no. 4, pp. 197–203, 2018, [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581656/.
[43] D. M. Ba et al., “Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study,” Curr. Dev. Nutr., vol. 3, no. 12, p. nzz120, Oct. 2019, doi: 10.1093/cdn/nzz120.
[44] H. M. Nge’the and C. Muthui, “Effects on non-compliance to iron, folic acid supplementation during pregnancy,” J. Food, Nutr. Popul. Heal., vol. 2, 2018.
[45] F. W. Sendeku, G. G. Azeze, and S. L. Fenta, “Adherence to iron-folic acid supplementation among pregnant women in Ethiopia: A systematic review and meta-analysis,” BMC Pregnancy Childbirth, vol. 20, no. 1, Mar. 2020, doi: 10.1186/s12884-020-2835-0.
[46] Z. Y. Kassa, T. Awraris, A. K. Daba, and Z. Tenaw, “Compliance with iron folic acid and associated factors among pregnant through pill count in Hawassa city, South Ethopia: a community based cross-sectional study,” Reprod. Health, vol. 16, no. 14, 2019, [Online]. Available: https://reproductive-health-journal.biomedcentral.com/articles/10.1186...
[47] G. C. Klemm et al., “Integrating Calcium Into Antenatal Iron-Folic Acid Supplementation in Ethiopia : Women ’ s Experiences, Perceptions of Acceptability, and Strategies to Support Calcium Supplement Adherence,” Glob. Heal. Sci. Pract., vol. 8, no. 3, pp. 413–430, 2020, doi: 10.9745/GHSP-D-20-00008.
[48] F. Y. Fouelifack, D. J. Sama, and C. E. Sone, “Assessment of Adherence to iron supplementation among pregnant women in the Yaounde gynaecolo-obstertric and paediatric Hospital,” Pan Afr. Med. J., vol. 34, no. 211, 2019, doi: 10.11604/pamj.2019.34.211.16446.
[49] S. Siabani, M. M. Arya, F. Rezaei, and S. Siabani, “Determinants of Adherence to Iron and Folate Supplementation among Pregnant Women in West Iran: A Population Based Cross-Sectional Study,” Qual. Prim. Care, vol. 25, no. 3, pp. 157–163, 2017.
[50] G. Singh, M. Lal, and S. Singh, “Utilization of iron folic acid tablets among pregnant women in rural Punjab : an interventional study,” Int. J. community Med., vol. 7, no. 4, pp. 1307–1312, 2020, doi: http://dx.doi.org/10.18203/2394-6040.ijcmph20201033.
[51] S. L. Martin et al., “Adherence partners are an acceptable behaviour change strategy to support calcium and iron-folic acid supplementation among pregnant women in Ethiopia and Kenya,” Matern. Child Nutr., vol. 13, no. 3, Jul. 2017, doi: 10.1111/mcn.12331.
[52] A. Chourasia, C. M. Pandey, and A. Awasthi, “Factors influencing the consumption of iron and folic acid supplementations in high focus states of India,” Clin. Epidemiol. Glob. Heal., vol. 5, no. 4, 2017, doi: 10.1016/j.cegh.2017.04.004.
Cite This Article
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    Kingsley Atuahene Ampratwum, Isaac Nyanor, John Ndebugri Alem. (2023). Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana. International Journal of Nutrition and Food Sciences, 12(3), 65-76. https://doi.org/10.11648/j.ijnfs.20231203.11

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    Kingsley Atuahene Ampratwum; Isaac Nyanor; John Ndebugri Alem. Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana. Int. J. Nutr. Food Sci. 2023, 12(3), 65-76. doi: 10.11648/j.ijnfs.20231203.11

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    AMA Style

    Kingsley Atuahene Ampratwum, Isaac Nyanor, John Ndebugri Alem. Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana. Int J Nutr Food Sci. 2023;12(3):65-76. doi: 10.11648/j.ijnfs.20231203.11

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  • @article{10.11648/j.ijnfs.20231203.11,
      author = {Kingsley Atuahene Ampratwum and Isaac Nyanor and John Ndebugri Alem},
      title = {Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana},
      journal = {International Journal of Nutrition and Food Sciences},
      volume = {12},
      number = {3},
      pages = {65-76},
      doi = {10.11648/j.ijnfs.20231203.11},
      url = {https://doi.org/10.11648/j.ijnfs.20231203.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnfs.20231203.11},
      abstract = {Globally, 40% of pregnant women are affected by anaemia. Anaemia, low haemoglobin level in the bloodstream, has many negative effects on pregnancy. The World Health Organisation recommends supplementation with iron and folic acid to prevent the incidence of anaemia in pregnancy. In Ghana, iron and folic acid supplementation has been through Ante Natal Clinics. Despite this intervention, Anaemia in Pregnancy prevalence in Bekwai has been above 37% for three years, higher than the national average of 25%. This study found out the compliance level and determining factors among ANC clients. This facility-based quantitative descriptive cross-sectional study was carried out in two sub-districts using multistage sampling. Data was collected using structured questionnaire. Data entered into SPSS was exported to Stata version for analysis. Demographic and obstetric data were analysed into frequencies and percentages. Bivariate and multivariate analyses were conducted to identify factors affecting compliance. Compliance was low (38.8%), despite high knowledge (90.3%). Gravidity (p-value 0.025 AOR= 5.88, 95% CI= 2.214-15.542) and level of knowledge (P-Value 0.01, AOR 2.89, 95%CI= 0.592-12.10) positively affected compliance. It was recommended that health education at ANC be improved, and adherence partners introduced to help prevent forgetfulness.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in the Bekwai Municipality, Ghana
    AU  - Kingsley Atuahene Ampratwum
    AU  - Isaac Nyanor
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    T2  - International Journal of Nutrition and Food Sciences
    JF  - International Journal of Nutrition and Food Sciences
    JO  - International Journal of Nutrition and Food Sciences
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.ijnfs.20231203.11
    AB  - Globally, 40% of pregnant women are affected by anaemia. Anaemia, low haemoglobin level in the bloodstream, has many negative effects on pregnancy. The World Health Organisation recommends supplementation with iron and folic acid to prevent the incidence of anaemia in pregnancy. In Ghana, iron and folic acid supplementation has been through Ante Natal Clinics. Despite this intervention, Anaemia in Pregnancy prevalence in Bekwai has been above 37% for three years, higher than the national average of 25%. This study found out the compliance level and determining factors among ANC clients. This facility-based quantitative descriptive cross-sectional study was carried out in two sub-districts using multistage sampling. Data was collected using structured questionnaire. Data entered into SPSS was exported to Stata version for analysis. Demographic and obstetric data were analysed into frequencies and percentages. Bivariate and multivariate analyses were conducted to identify factors affecting compliance. Compliance was low (38.8%), despite high knowledge (90.3%). Gravidity (p-value 0.025 AOR= 5.88, 95% CI= 2.214-15.542) and level of knowledge (P-Value 0.01, AOR 2.89, 95%CI= 0.592-12.10) positively affected compliance. It was recommended that health education at ANC be improved, and adherence partners introduced to help prevent forgetfulness.
    VL  - 12
    IS  - 3
    ER  - 

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Author Information
  • Disease Control and Surveillance Department, Kumasi Metropolitan Health Directorate, Kumasi, Ghana

  • Deaprtment of Research and Development Komfo Anokye Teaching Hospital, Kumasi, Ghana

  • Faculty of Health and Allied Sciences, Catholic University of Ghana, Sunyani, Ghana

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