Determinants of Iron and Folic Acid Supplementation Adherence among Women of Reproductive Age in Kilifi South Sub-County, Kilifi County, Kenya

Background: Iron deficiency anemia among expectant women causes health consequences. Iron Folic Acid supplementation is the foremost strategy established to curb pregnancy-related anemia. Poor adherence is still a problem despite implementation. Pregnant women are recommended to take 60mgs of iron and 400 mcg of folic acid daily from conception till birth.

Objective: The main objective of this study was to find out the determinants of iron and folic acid supplementation adherence among women of reproductive age, with children 0-23 months in Kilifi South Sub-County, Kilifi County, Kenya.

Methodology: A cross-sectional survey was used. Cluster and simple random sampling were used to recruit study participants. Obtained sample size was 324 participants. chi-square and logistic regression were utilized to determine the degree of association between dependent and independent variables. Statistical significance was attained at P<0.05. Odds Ratio was used to test for the strength of association.

Results: Adherence to iron and folic acid supplementation was low at 31.2%. Values for various variables were; education level of the mother (P=0.002), age(P=0.03, OR=1.26), monthly income (P=0.044, OR=1.622), Number of ANC visits(P=0.000), knowledge on IFAS (P=0.023), knowledge on anemia (P=0.005), knowledge of anemia causes (P=0.000), knowledge of effects of anemia in pregnancy (P=0.000), Being anemic during pregnancy (P=0.000; OR=3.35) IFAS accessibility (P= 0.019) and challenges faced when acquiring the supplements (P=0.03). Some of the challenges listed were late ANC attendance 57.1%, side effects 53.4%, forgetfulness 32.4%, long distance to the facility 59.4%, and stockouts 29.9%. Anemia was found to be high at 69.4%.

Conclusions: Iron folic acid supplementation was low. Anemia prevalence was high. Individual factors associated with adherence were education level, antenatal visits, knowledge of the supplements, knowledge of anemia, knowledge of the effects of anemia, and being anemic. Health system factors associated with adherence were the availability of IFAS and experience of challenges during antenatal clinic visits.