Determinants of Non-Compliance to Iron Folic Acid Supplementation during Pregnancy. A Case Study of Nyeri County, Kenya

Abstract

In the World, a deficiency of iron is the most common nutrition disorder affecting more than 30% of the global populace more so children and women. Countries in the developing world are working in programs on implementing the Iron and folic acid supplementation although the effectiveness of curbing anemia is usually affected by non-compliance to iron and folic acid supplements by women who are pregnant. In Nyeri County, anemia among pregnant women has continued to rise. The purpose of the study was to determine the determinants of non-compliance to iron folic acid supplementation during pregnancy in Nyeri County. This was a mixed methods study. The study targeted pregnant women. A sample of 385 pregnant women were calculated using the modified formulae by Fisher. The study employed the use of a structured researcher administered questionnaire. Themes and patterns were derived from the qualitative data, categorized through content analysis and then tabulated. SPSS version 20 for windows was employed for data analysis. Descriptive statistics and chi-square tests were used to analyze the data which was presented in form of frequency and percentage tables, bar graphs and pie charts. The study found that Majority (56%) of the participants in the study indicated that they had at one time forgotten to take iron folic acid supplement (IFAS). The results showed that the bulk of the respondents (55%) had acceptable levels of hemoglobin (121 g/l and 150 g/l). Chi-square tests showed a significant relationship (p=0.018) between compliance to IFAS and prevalence of Anemia. About 53% of the respondents indicated that they were not aware of the benefits of IFAS. About 56% of the respondents indicated that they had not been counselled on the dietary sources of iron and folic acid. All respondents agreed that IFAS supplements were available at their health facility when they needed them. A greater number of respondents 80% indicated that the waiting time when getting IFAS supplements was high. Results showed that 66% of respondents indicated that they were informed about IFA Supplements and where to get them. In Nyeri County, the study found out that the prevalence of non-compliance in women who were pregnant was high. However, IFAS non-compliance did not contribute to child mortality. Mothers understanding on the benefits of IFAS was poor and generally, current health care support system for the IFAS program is good. The study recommends that pregnant women should be sensitized about the importance of complying to IFAS.