ASSOCIATION BETWEEN KNOWLEDGE AND COMPLIANCE OF TAKING IRON/FOLIC ACID SUPPLEMENTS DURING PREGNANCY
DOI:
https://doi.org/10.22159/ajpcr.2017.v10s5.23126Keywords:
Ironfolic acid supplementation, Knowledge, Compliance, IndonesiaAbstract
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Objective: In Indonesia, pregnant women are recommended to take a minimum of 90 tablets of iron/folic acid (IFA), to prevent iron deficiency anemia. Our analysis aimed at examining the extent to which improved knowledge on IFA supplementation is associated with women's compliance with taking a minimum of 90 IFA tablets during their last pregnancy in four districts in Indonesia.
Methods: Data were derived from a cross-sectional study conducted in four districts, that is, Lebak and Pandeglang District (Banten Province) as well as Purwakarta and Subang District of West Java Province, Indonesia on June 2014. We used information from 436 mothers who delivered their baby in the last 6 months from the time of the survey and received at least 90 IFA tablets during her last pregnancy. Logistic regression analysis was used to examine the role of knowledge after controlling for confounders and other significant predictor on compliance with taking a minimum of 90 IFA tablets during pregnancy.
Result: Significant association was found between knowledge of IFA supplements and compliance. Compared to women with poor knowledge of IFA supplementation, the odds of taking a minimum of 90 IFA tables increased by almost 100% in women with moderate knowledge (adjusted odd ratio [aOR]=1.96, 95% confidence interval [CI]: 1.17-3.30, p=0.011); and by more than four times (aOR=5.42, 95% CI: 1.76-16.68, p=0.003) in women with good knowledge of IFA supplementation. Other factors associated with compliance was attendance in at least four antenatal services (aOR=5.71, 95% CI: 1.28-25.53, p=0.023) and pregnant women experience of no side effects resulting from taking IFA tablets during pregnancy (aOR=2.70, 95% CI: 1.63-4.46, p<0.001).
Conclusions: Efforts to increase women's knowledge on IFA supplementation through community-based education will increase women's compliance of taking IFA supplements. Strengthening counseling services on potential side effects of IFA supplementation and ways to manage them will also help to improve compliance.
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References
Stoltzfus RJ, Dreyfuss ML. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anaemia. Washington, DC: ILSI Press, International Anaemia Consultative Group (INCAG); 1998.
Stoltzfus RJ, Mullany L, Black RE. Iron deficiency anaemia. In: Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Vol. 1. Ch. 3. Geneva: World Health Organization; 2004.
de Benoist B, McLean E, Egli I, Cogswell M, editors. Worldwide Prevalence of Anaemia 1993-2005: WHO Global Database on Anaemia. Geneva: World Health Organization; 2008.
Rasmussen KM. Is there a causal relationship between iron deficiency or iron-deficiency anaemia and weight at birth, length of gestation and perinatal mortality? J Nutr 2001;131(2S-2):590S-601.
Scholl TO. Iron status during pregnancy: Setting the stage for mother and infant. Am J Clin Nutr 2005;81(5):1218S-22.
Titaley CR, Dibley MJ, Roberts CL, Hall J, Agho K. Iron and folic acid supplements and reduced early neonatal deaths in Indonesia. Bull World Health Organ 2010;88:500-8.
Statistics Indonesia, National Family Planning Coordinating Board, Ministry of Health, ORC Macro. Indonesia Demographic and Health Survey 2012. Calverton, Maryland: BPS and ORC Macro; 2013.
National Institute of Health Research and Development MOH, Republic of Indonesia. Basic Health Research 2013: National Report 2013. Jakarta: National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia; 2013.
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: An application to educational enrollments in States of India. Demography 2001;38(1):115-32.
Bener A, Al Maadid MG, Al-Bast DA, Al-Marri S. Maternal knowledge, attitude and practice on folic acid intake among Arabian Qatari women. Reprod Toxicol 2006;21(1):21-5.
Ren A, Zhang L, Li Z, Hao L, Tian Y, Li Z. Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China - An area with a high prevalence of neural tube defects. Reprod Toxicol 2006;22(3):431-6.
Gebremedhin S, Samuel A, Mamo G, Moges T, Assefa T. Coverage, compliance and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Ethiopia: A cross-sectional study. BMC Public Health 2014;14:607.
Robbins JM, Cleves MA, Collins HB, Andrews N, Smith LN, Hobbs CA. Randomized trial of a physician-based intervention to increase the use of folic acid supplements among women. Am J Obstet Gynecol 2005;192(4):1126-32.
Girard AW, Olude O. Nutrition education and counselling provided during pregnancy: Effects on maternal, neonatal and child health outcomes. Paediatr Perinat Epidemiol 2012;26 Suppl 1:191-204.
Galloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, et al. Women’s perceptions of iron deficiency and anemia prevention and control in eight developing countries. Soc Sci Med 2002;55(4):529-44.
Lutsey PL, Dawe D, Villate E, Valencia S, Lopez O. Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutr 2008;11(1):76-82.
Seck BC, Jackson RT. Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr 2008;11(6):596-605.
Joshi H, Joshi M, Ranjan P, Misra S, Verma P, Rana M, et al. Refresher training on maternal and child health for urban community health volunteers: Assessing knowledge and skills. Internet J Med Update 2006;1(2)18-24.
Sistiarani C, Dardjito E, Nurhayati S. Educational leaflet to improve mothers knowledge about utilization. In: Maternal and Child Health
Book. Vol. 1. Kalibagor, Indonesia. Management in Health; 2015. p. XIX.
Adawiyani R. Pengaruh pemberian booklet anaemia terhadap pengetahuan, kepatuhan minum tablet tambah darah dan kadar hemoglobin ibu hamil. J Ilmiah Mahasiswa Univ Surabaya 2013;2(12):50-4.
Lunet N, Rodrigues T, Correia S, Barros H. Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy. Cad Saude Publica 2008;24(5):1151-7.
Kalimbira AA, Mtimuni BM, Chilima DM. Maternal knowledge and practices related to anaemia and iron supplementation in rural malawi: A crosssectional study. Afr J Food Agric Nutr Dev 2009;9(1):550.
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