期刊论文详细信息
BMC Public Health
Coverage, compliance and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Ethiopia: a cross-sectional study
Tsehai Assefa3  Tibebu Moges3  Girma Mamo1  Aregash Samuel3  Samson Gebremedhin2 
[1] Micronutrient Initiative (MI), Addis Ababa, Ethiopia;School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia;Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
关键词: Compliance;    Maternal anemia;    Iron supplementation;   
Others  :  1129391
DOI  :  10.1186/1471-2458-14-607
 received in 2013-12-12, accepted in 2014-06-09,  发布年份 2014
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【 摘 要 】

Background

Despite the efforts to reduce iron deficiency during pregnancy, information on the coverage and factors associated with utilization of iron supplements is lacking. The study is intended to assess the coverage, compliance and factors associated with the use of prenatal iron supplements in eight rural districts of Ethiopia.

Methods

The study comprised two independent surveys conducted among pregnant women (n = 414) and women who gave birth in the preceding year of the survey (n = 1573). In both cases, respondents were selected using multistage sampling technique and data were collected via structured questionnaire. Predictors of iron supplement utilization (ranked categories of number of prenatal supplements taken) were identified using ordinal logistic regression. The outputs of the analysis are given using adjusted Odds Ratio (OR) with 95% Confidence Interval (CI).

Results

Among women who gave birth in the preceding year, 35.4% (95% CI: 31.3-39.5) were given/prescribed prenatal iron supplement during the index pregnancy and only 3.5% were supplemented for the recommended 91 or more days. Compared to women who had 4 or more ANC visits, those with 0, 1, 2 and 3 visits had 0.04, 0.33, 0.50 and 0.60 times less odds of iron supplement utilization, respectively. Women lacking comprehensive knowledge of anemia (OR = 0. 75 (95% CI: 0.57-0.97)) and those who weren’t informed about the importance of iron supplementation during the pregnancy (OR = 0. 05 (95% CI: 0.04-0.07)) had significantly lower utilization. On the other hand, in pregnant women the prevalence of anemia was 33.2%. Among pregnant women who were given/prescribed supplements, the average level of compliance was 74.9% and about 25.1% had less than 70% adherence. The leading reported reasons for non-adherence were side-effects (63.3%) and forgetfulness (16.7%).

Conclusion

Promoting early and frequent ANC, enhancing the quality of ANC counseling and promoting the knowledge of women on anemia are essential strategies for improving the utilization of iron supplements.

【 授权许可】

   
2014 Gebremedhin et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Benoist B De, McLean E, Egli I, Cogswell M (Eds): Worldwide prevalence of anemia 1993–2005: WHO global database on anemia. Geneva: WHO, CDC; 2008.
  • [2]Badham J, Zimmermann MB, Kraemer K: (Ed): The guidebook nutritional anemia. Basel: Sight and Life; 2007.
  • [3]Allen LH: Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr 2000, 71(suppl):1280-1284.
  • [4]Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look P: WHO analysis of causes of maternal death: a systematic review. Lancet 2006, 367:1066-1074.
  • [5]Stoltzfus RJ, Mullany L, Black RE: Iron deficiency anemia. In comparative quantification of health risks. Volume Volume 1. Edited by Ezzati M, Lopez AD, Rodgers A, Murray C. Geneva: WHO Press; 2004::163-209.
  • [6]Central Statistical Agency of Ethiopia, Measure DHS: Ethiopia demographic and health survey 2011. Addis Ababa and Calverton: CSA Ethiopia and MEASURE DHS-ICF Macro; 2011.
  • [7]ORC Macro, Central Statistical Agency of Ethiopia: Ethiopia demographic and health survey 2005. Central Statistical Agency and ORC Macro: Addis Ababa and Calverton; 2006.
  • [8]Haidar J, Pobocik R: Iron deficiency anemia is not a rare problem among women of reproductive ages in Ethiopia: a community based cross-sectional study. BMC Blood Disord 2009, 9:7. doi:10.1186/1471-2326-9-7 BioMed Central Full Text
  • [9]Haidar J: Prevalence of anemia, deficiencies of iron and folic acid and their determinants in Ethiopian women. J Health Popul Nutr 2010, 28(4):359-368.
  • [10]Haidar J, Nekatibeb H, Urga K: Iron deficiency anemia in pregnant and lactating mothers in rural Ethiopia. East Afr Med J 1999, 76(11):618-622.
  • [11]WHO: Weekly iron–folic acid supplementation (WIFS) in women of reproductive age: its role in promoting optimal maternal and child health. Position statement. Geneva: WHO Press; 2009.
  • [12]Federal Ministry of Health (FMOH) of Ethiopia: National guideline for control and prevention of micronutrient deficiencies. Addis Ababa: FMOH; 2004.
  • [13]International Food Policy Research Institute: Framework document for a national nutrition strategy for Ethiopia. Addis Ababa: IFPRI; 2005.
  • [14]Campbell MJ, Julious SA, Altman DG: Estimating sample sizes for binary, ordered categorical and continuous outcomes in two group comparisons. BMJ 1995, 311:1145-1148.
  • [15]Lutsey PL, Dawe D, Villate E, Valencia S, Lopez O: Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutr 2007, 11(1):76-82. doi:10.1017/S1368980007000237
  • [16]The International Nutritional Anemia Consultative Group: Adjusting hemoglobin values in program surveys. [http://pdf.usaid.gov/pdf_docs/PNACQ927.pdf webcite]
  • [17]Schultink W, Van der Ree M, Matulessi P, Gross R: Low compliance with an iron-supplementation program: a study among pregnant women in Jakarta, Indonesia. Am J Clin Nutr 1993, 57:135-139.
  • [18]Ibrahim ZM, El-hamid SA, Mikhail H, Khattab MS: Assessment of adherence to iron and folic acid Ssupplementation and prevalence of anemia in pregnant women. Med J Cairo Univ 2011, 79(2):115-121.
  • [19]Ogundipe O, Hoyo1 C, Ostbye T, Oneko O, Manongi R, Lie RT, Daltveit AK: Iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study. BMC Public Health 2012, 12:481. BioMed Central Full Text
  • [20]Lacerte P, Pradipasen M, Temcharoen P, Imamee N, Vorapongsathorn T: Determinants of adherence to Iron/Folate supplementation during pregnancy in two provinces in Cambodia. Asia Pac J Public Health 2011, 23(3):315-323.
  • [21]Knudsen VK, Hansen HS, Ovesen L, Mikkelsen TB, Olsen SF: Iron supplement use among Danish pregnant women. Public Health Nutr 2007, 10(10):1104-1110. doi:10.1017/S136898000769956X
  • [22]Habib F, Alabdin EH, Alenazy M, Nooh R: Compliance to iron supplementation during pregnancy. J Obstet Gynecol 2009, 29(6):487-492.
  • [23]Jasti S, Siega-Riz AM, Cogswell ME, Hartzema AG, Bentley ME: Pill count adherence to prenatal multivitamin/mineral supplement use among low-income women. J Nutr 2005, 135:1093-1101.
  • [24]World Health Organization (WHO: Iron deficiency anemia: assessment, prevention, and control. Geneva: WHO press; 2001.
  • [25]Wulff M, Ekstrom E: Iron supplementation during pregnancy in Sweden: to what extent is the national recommendation followed? Acta Obstet Gynecol Scand 2003, 82(7):628-635.
  • [26]Seck BC, Jackson RT: Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr 2007, 11(6):596-605. doi:10.1017/S1368980007000924
  • [27]Bilimale A, Anjum J, Sangolli HN, Mallapur M, Nehru J: Improving adherence to oral iron supplementation during pregnancy. AMJ 2010, 3(5):281-290.
  • [28]Hyder SMZ, Persson L, Chowdhury AMR, Ekstrom EC: Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly- dose regimens in pregnancy. J Health Popul Nutr 2002, 20(2):175-179.
  • [29]Aikawal R, Jimba M, Nguen KC, Zhao Y, Binns CW, Lee MK: Why do adult women in Vietnam take iron tablets? BMC Public Health 2006, 6:144. doi:10.1186/1471-2458-6-144 BioMed Central Full Text
  • [30]Galloway R, Mcguire J: Determinants of compliance with iron supplementation: Supplies, side-effects or psychology? Soc Sci Med 1994, 39(3):381-390.
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