Socio-Economic Determinants of Adherence to Iron and Folic Acid Tablets Among Rural Ante-Natal Mothers in Lucknow, India

Authors

  • Manas P Roy CSMMU UP, Lucknow
  • Uday Mohan CSMMU UP, Lucknow
  • Shivendra Kumar Singh CSMMU UP, Lucknow
  • Vijay Kumar Singh CSMMU UP, Lucknow
  • Anand Kumar Srivastava CSMMU UP, Lucknow

Keywords:

Ante natal care, Iron and folic acid, Maternal health

Abstract

Introduction: Anemia is a great challenge for maternal health in India, affecting more than half of the pregnant mothers. For combating this, iron supplementation during pregnancy has long been recognized as a way. Recent document indicates that only 23% women consumed iron tablets for at least 90 days during pregnancy. In this perspective, the present study aimed to find out the socio-economic determinants of 100 iron and folic acid tablets consumption in rural Lucknow, India.

Methods: The cross-sectional study, conducted in 2009-10, used a structured questionnaire to collect data from 352 recently delivered women, following systematic random sampling. Variables of interest included age, religion, education, socio economic status, family type, parity, timing of ante-natal registration and number of ante-natal care visits. Predictors were found out using univariate and multivariate logistic regressions.

Results: Overall, 83.5% of the women received 100 iron and folic acid tablets during their pregnancy but, only 36.9% consumed them. Factors significantly associated with consumption of 100 tablets, after simple logistic regression, were education, parity, timing of ante-natal registration and number of ante-natal care visits to any facility. On multiple logistic regression, applying enter method and considering all variables, only primiparity (OR= 2.212, 95% CI= 1.186 – 4.125) and elder age (OR= 1.836, 95% CI= 1.020 – 3.305) were found to be the predictors for 100 iron and folic acid tablet consumption.

Conclusion: Consumption of sufficient number of iron and folic acid tablets was very low. Primipara and elderly mothers were more likely to consume 100 iron tablets. This poor status of iron tablets consumption warrants specific approach to improvise maternal health outcome.

References

WHO/World Bank/UNICEF/UNFPA. Trends in maternal Mortality: 1990 to 2008. World Health Or-ganization. Geneva. 2010. (http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf Accessed on 22nd Nov, 2011)

Govt. of India. Millennium development goals – India country report 2009. Mid-term statistical appraisal. Central Statistical Organization, Ministry of Statistics and Programme Implementation, Govt. of India.

Ronsmans C, Graham WJ; Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where and why. Lancet 2006;368:1168-200.

WHO/ CDC. Worldwide prevalence of anemia 1993-05: WHO global database on anemia. World Health Organization. Geneva. 2008. (http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf Accessed on 22nd Nov, 2011)

UNICEF. Tracking progress in maternal, newborn and child survival: The 2008 report. The United Nations Children’s Fund. New York. 2008. (http://www.who.int/pmnch/Countdownto2015FINALREPORT-apr7.pdf Accessed on 22nd Nov, 2011)

International Institute for Population Sciences (IIPS) and Macro International. National Family Health Sur-vey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS. 2007.

Ali AA, Rayis DA, Abdallah TM, Elbashir MI, Adam I: Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan. BMC Research Notes 2011;4:311.

Bhat IA. Assessment of antenatal and postnatal care in Budgam district. Population Research Centre, Sri-nagar. 2003.

Lacerte P, Pradipasen M, Temcharoen P, Imamee N, Vorapongsathorn T. Determinants of Adherence to Iron/Folate Supplementation During Pregnancy in Two Provinces in Cambodia. Asia Pac J Public Health 2011;23(3):315-23.

Khan DA, Fatima S, Imran R, Khan FA. Iron, folate and cobalamin deficiency in anemic pregnant females in tertiary care centre at Rawalpindi. J Ayub Med Coll Abbottabad 2010;22(1):17-21.

WHO. Iron deficiency anemia: assessment, prevention and control – a guide for programme managers. Ge-neva: World Health Organization; 2001.

Hyder SMZ, Persson LA, Chowdhury AMR, Ekstrom EC. Do side-effects reduce compliance to iron sup-plementation? A study of daily- and weekly-dose reg-imens in pregnancy. J Health Popul Nutr 2002;20(2):175-9.

International Institute for Population Science. District Level Household and Facility Survey (DLHS 3), 2007-08. District Fact Sheet. Uttar Pradesh. Lucknow. Mumbai: IIPS. 2010.

International Institute for Population Sciences (IIPS) and Macro International. National Family Health Sur-vey (NFHS-3), India, 2005–06: Uttar Pradesh. Mum-bai: IIPS. 2008.

NIHFW. Survey instruments for collection of infor-mation from house hold developed by NIHFW for collaborative activity of the National consortium of public health. New Delhi: NIHFW;2003.

Patel VD, Puwar BT, Sheth JK. Utilization of antena-tal care services in the Gandhinagar (rural) district, Gujarat. National J Community Med 2013,4(1):104-8.

Govt. of U.P. Baseline Facts-Uttar Pradesh (2005-07): Concurrent Assessment and Technical Assistance to districts. Family Welfare Directorate, Govt. of U.P.

Singh MK. A Study on Utilization of ASHA under NRHM in Maternal and Neonatal Health Services in Rural Lucknow. [MD thesis] CSM Medical University UP, Lucknow. 2008.

Kotecha PV. Maternal health services – quality of care: Uttar Pradesh scenario anemia control as a context. Solution exchange for MCH community, News Letter Safe Motherhood special, April 2009.

Sohail R, Zainab S, Zainab F. Prevalence of anemia in obstetrical population. Ann King Edward Med Coll 2004;10(2):146-8.

Gholamreza V. Anemia in north of Iran (south-east Asia of Caspian Sea). Pakistan J Biological Sci 2007;10(10):1703-7.

Ogundipe O, Hoyo C, Østbye T, Oneko O, Manongi R, Lie RT, et al. factors associated with prenatal folic acid and iron supplementation among 21,889 preg-nant women in Northern Tanzania: a cross-sectional hospital-based study. BMC Public Health 2012;12:481.

Knudsen VK, Hansen HS, Ovesen L, Mikkelsen TB, Olsen SF. Iron supplement use among Danish preg-nant women. Public Health Nutr 2007;10:1104–10.

Albsoul-Younes AM, Al-Ramahi RJ, Al-Safi SA. Fre-quency of anemia in pregnancy in northern Jordan. Soudi Med J 2004;25(10):1525-7.

Amarin Z, Khader Y, Okour A, Jaddou H, Al-Qutob R. National maternal mortality ratio for Jordan, 2007-08. Int J Gynecol Obstr 2010;111(2):152-6.

Das NP, Mishra VK, Saha PK. Does community ac-cess affect the use of health and family welfare ser-vices in rural India? NFHS subject report No.18. Mumbai, India and Honolulu, USA. International In-stitute of Population Sciences, Mumbai and East-West Center, Honolulu 2001.

Nielsen BB, Liljestrand J, Thilsted SH et al. Character-istics of antenatal care attenders in a rural population in Tamil Nadu, South India; a community based cross-sectional study. Health Soc Care Community 2001;9:327-33.

WHO. The World Health Report: 2005: Make every mother and child count. Geneva: World Health Or-ganization; 2005.

Nilsen RM, Vollset SE, Gjessing HK, Magnus P, Meltzer HM, Haugen M, et al. Patterns and predic-tors of folic acid supplement use among pregnant women: the Norwegian Mother and Child Cohort Study. Am J Clin Nutr 2006;84(5):1134-41.

Elder LK. Issues in programming for maternal anae-mia. Center for Population, Health and Nutrition. Bu-reau for Global Programs, Field Support and Re-search, U.S; Sept 2000.

Bilimale A, Anjum J, Sangolli HN, Mallapur M. Im-proving Adherence to Oral Iron Supplementation dur-ing pregnancy. AMJ 2010;3(5):281-90.

Sharma JB, Jain S, Mallika V, Singh T, Kumar A, Aro-ra R, et al. A prospective, partially randomized study of pregnancy outcomes and hematologic responses to oral and intramuscular iron treatment in moderately anemic pregnant women. Am J Clin Nutr 2004;79:116–22.

Downloads

Published

2013-09-30

How to Cite

1.
Roy MP, Mohan U, Singh SK, Singh VK, Srivastava AK. Socio-Economic Determinants of Adherence to Iron and Folic Acid Tablets Among Rural Ante-Natal Mothers in Lucknow, India. Natl J Community Med [Internet]. 2013 Sep. 30 [cited 2024 Apr. 19];4(03):386-91. Available from: https://njcmindia.com/index.php/file/article/view/1540

Issue

Section

Original Research Articles