Knowledge, attitude and factors associated with practice of iron and folic acid supplementation among pregnant women attending antenatal care clinics in Morogoro Municipal Council.

Abstract

ABSTRACT Background: Over 50% of cases of anemia worldwide are caused by iron deficiency, affecting 38.2% pregnant women aged 15 and 49 years; in contrast, the prevalence of anemia in pregnant women in Africa is 46.3%. It is strongly advised that every pregnant mother takes IFA supplements to meet her needs throughout pregnancy to prevent anemia and its potential risks including preterm birth, perinatal mortality, low birth weight, and intellectual disability in children. A few risk factors for developing anemia during pregnancy include grand multiparity, too early pregnancies, short interpregnancy interval, low socioeconomic status, illiteracy, and late ANC initiation which can be reduced if mothers’ attitudes and knowledge of methods of preventing anemia is enhanced. Objective: This study investigated about knowledge, attitude, and factors associated with the practices of IFA supplementation among pregnant women attending ANC clinic follow-ups. Methodology: A quantitative analytical cross-sectional study, involved 358 pregnant women in their second and third trimesters attending antenatal clinics at three health centers in Morogoro municipal council. A structured self-administered Swahili version questionnaire (translated by BAKITA) was used to collect data from the participants. The data were analysed using IBM SPSS version 23. Descriptive statistics was carried out to determine the social-demographic and obstetrics characteristics of participants; and the Chi-square and ordinal logistic regression analysis for the factors associated with the practice of IFA supplementation during pregnancy. Results: Out of 358 studied, the majority showed positive attitudes (94.4%), good practice (52.8%), but poor knowledge (56.7%) regarding IFA supplementation during pregnancy. The odds of having good practice were observed with primary education level aOR = 2.40, 95% CI: 1.11–5.27, p = 0.027; formal and informal employment aOR = 2.72, 95% CI: 1.14–6.77, p = 0.028; gravidity of >2 aOR = 2.28, 95% CI: 1.19–4.41, p = 0.014; and positive attitude towards IFA supplementation aOR = 6.64, 95% CI: 2.70–17.01, p = 0.001. There was no relation between the level of knowledge and good practice (P-value = 0.584). Conclusion: Pregnant women were willing to know much about IFA supplementation and were compliant to the proper recommended IFA practices. Observed good practice is based on their good compliance rather than the level of knowledge. However, good knowledge about IFA supplementation and its importance is crucial to raise the level of good practices. We recommend sustainable and consistent health educations sessions at ANC clinics that accommodates all aspects of practice, introduction of a follow up mechanism for all pregnant women taking IFA supplements through direct intake observation by household caretakers under guidance of community healthcare providers, and further same titled studies be conducted with a sample size not less than a thousand participants (more powered studies).