ADHERENCE TO IRON FOLIC ACID SUPPLEMENTATION AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN IN SIMADA DISTRICT, NORTH WEST ETHIOPIA: ACCORDING TO HEALTH BELIEF MODEL PERSPECTIVE

Abstract

Abstract Introduction: Globally anemia in pregnancy is estimated to be 38% and it is around 46.3% in Africa. According to Ethiopian demographic and health survey 2016, anemia was a moderate public health problem (29%) among pregnant women in the country. Even though there are many studies on adherence to iron-folic acid supplementation, there are limited evidences on adherence to iron-folic acid supplementation of pregnant women on the perspective of health belief model in Ethiopia. Objective: To assess adherence of iron-folic acid supplementation and associated factors on the perspective of health belief model among pregnant women who attend antenatal care in health centers at Simada district, Northwest Ethiopia. Methods: A facility based cross sectional study was conducted from February 24 - March23/ 2020. Systematic random sampling technique was used to select 422 study participants. Adherence to iron-folic acid supplementation was measured by self-reports of mothers they took the supplement in the last one month. Variables with a p value of <0.2 during a bivariable analysis were incorporated into the multivariable logistic regression. Significant independent factors were declared at 95% confidence interval and P-value of less than 0.05 as cut off point. Results: In this study, the prevalence of adherence to iron-folic acid supplementation among pregnant women was 67.6% (95% CI = 63.3, 72.5). Pregnant women who had a history of preterm delivery [AOR = 3.75, 95% (CI) = (1.46, 9.65], counseling on iron-folic acid supplementation [AOR = 2.22, 95% CI = (1.10, 4.49)], high perceived threat [AOR = 6.31, 95% CI = (1.72, 23.15)], high perceived benefit [AOR = 2.75, 95% CI = (1.27, 5.97)] and high selfefficacy [AOR = 3.63, 95% CI = (1.70, 7.78)] were adherent to iron-folic acid supplementation.

Conclusions

and recommendation: Adherence to iron-folic acid supplementation among pregnant women is higher in the study area. Past history of preterm delivery, counseling on ironfolic

acid supplementation, perceived threat, perceived benefit and self-efficiency had association with adherence to iron-folic acid supplementation. Proper counseling and health education about iron-folic acid supplementation based on perceived threat, perceived benefit and self-efficacy should be given to pregnant women to increase their adherence. Keywords: Adherence, Iron-folic acid supplementation, pregnant women, Ethiopia, health belief model.