Determinants of iron-folic acid supplements use by pregnant women attending antenatal clinics in Rufiji district council.

Abstract

ABSTRACT Background: Folate deficiency has long been found to be associated with severe congenital birth defects such as spina bifida, anencephaly, etc. Pregnant mothers have an increased demand for folic acid to support the growing placenta and fetus and prevent birth defects. However, despite years of promotion, folic acid supplementation in women of reproductive age is still very low in Sub Saharan Africa and Tanzania in particular. Objectives: The study was conducted in order to assess the determinants of Iron- Folic Acid (IFA) supplements uptake among pregnant women attending antenatal clinics in Rufiji district. Materials and Methods: Health facility based cross- sectional study was conducted. A total of 364 pregnant women were selected randomly from 8 facilities to participate in the study. They were interviewed using an interviewer administered questionnaire. They were asked questions from thematic areas that are considered to be potential contributors to the use of IFA supplements such as socio-demographic factors, sexual and reproductive characteristics, socio-cultural, facility based factors and knowledge on benefits and use of IFA supplements. Association between use of IFA supplements and independent variables was assessed using odds ratios through cross tabulations and significance testing was done using Chi square or Fishers’s exact test. Factors with p-value of ≤ 0.2 at bivariate analysis including conventional confounders such as age were entered in multiple logistic regression model to assess significant independent factors associated with use of IFA supplements and to control for potential confounders. The model was considered significant/fit when its p-value ˂ 0.05. All statistical computations were performed on SPSS version 22.0. Results: A total of 363 pregnant women participated in the study. Use of IFA supplements was found to be at 63.1%, access to IFA was found to be 98.9%. Knowledge on benefits of using IFA as nutritional supplements that prevents NTDs was 20.4%. More than three v quarter 238 (86.9%) could also identify green vegetables as a potential natural source of FA. Factors that were significantly associated with IFA supplements use included: having college education, AOR=0.11(95% CI 0.012-0.910; p=0.015), having made 4 or more ANC visits, AOR= 0.18(95% CI 0.050-0.637; p=0.008), as well as having knowledge on beneficial effects of IFA supplements, AOR=3.70(95% CI 1.064-5.538; p=0.003). Conclusion and recommendations About 6 out of 10 women seeking ANC services in Rufiji district use IFA supplements. Predictors of use of IFA include socio-demographic and facility based characteristics. Efforts to increase compliance to IFA supplementation must focus on promoting formal education to women, creating awareness on its benefits and encouraging women to attend ANC at least four times during pregnancy.