Iron and folic acid supplementation and compliance among pregnant women in Nanumba North district of Northern region, Ghana

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September, 2019
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BACKGROUND: Available scientific evidence has shown that routine supplementation with iron and folic acid (IFA) during pregnancy is an effective way of preventing anaemia in pregnant women most especially in areas where its prevalence is high. Anaemia affects an estimated two billion people worldwide, thus 30% of the world‟s population mainly due to iron deficiency. Even though, several studies have been conducted with numerous recommendations, the implementation of iron and folic acid supplementation varies with the geographical and socioeconomic factors at the place of implementation. This research was therefore conducted to assess the compliance and utilization of iron and folic acid supplements in the Nanumba North district of Ghana. METHODS: A cross-sectional study design was used for the study. Quantitative method was used to achieve the set objectives of this study. Data on IFA distribution and utilization was collected among pregnant women using semi-structured questionnaire in addition to the review of maternal child health record booklets. A total number of 290 pregnant women were recruited for the study using convenience sampling technique. RESULTS: From the findings 51.4% the women booked for ANC within the first trimester whilst 43.8% and 4.8% commenced ANC visits in the second and third trimesters respectively. In addition, 67.9% of the respondents received IFA tablets during ANC services whilst 32.1% did not. However, 51.4% of the participants did not know the reason(s) why IFA is giving during pregnancy. The results also revealed that 53.8% had no form of education/counselling on IFAS. The results pointed out that 23.4% have ever defaulted in taking their IFA with reasons such as forgetfulness, fed-up with taking the drug, lack of supplements, and deterred by the inconvenience associated with the drug such as difficulty in swallowing due to the scent of the drug, feeling nauseous and vomiting. It was discovered that 53.5% of clients do not get regular supply of IFA. It was also revealed that women who have attained tertiary education were 8 times likely to adhere to IFA (OR: 7.97; CI: 1.38 - 45.8; p-value: 0.020) whereas women who knew the required number of IFA tablet required every month were 4.8 times likely to adhere to IFA tablets (OR: 4.79; CI: 2.15 - 10.68; p-value: 0.001). CONCLUSION: Generally, the time mothers booked for ANC service is not good enough to be able to obtain the recommended four plus visits. Also the knowledge level of mothers on the importance of taking IFA was equally poor. Gains will be made in IFAS if there is an improvement in SBCC and logistical supply.
A dissertation submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of requirements for the award of Master of Public Health (Mph) degree in Health Promotion and Education.
Food supplements, Folic acid, Iron, Pregnant women, Northern region, Ghana