{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:58:04Z","timestamp":1765828684520,"version":"3.48.0"},"reference-count":33,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,22]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Iron deficiency anaemia and inadequate compliance with iron\u2013folic acid (IFA) supplementation among pregnant and postpartum women pose substantial public health challenges in Nepal. Hence, this study aimed to determine IFA compliance and identify associated factors among postpartum mothers in Bharatpur Metropolitan City, Chitwan, Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An analytical cross-sectional design was employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was conducted in Bharatpur Metropolitan City, Chitwan, Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 286 postpartum mothers were selected using non-probability purposive sampling. Ethical approval was obtained from the Institutional Review Committee of Shree Medical and Technical College, and informed consent was obtained from all participants before data collection. Semi-structured questionnaires were administered through face-to-face interviews to collect data and ensure an in-depth understanding of the participants\u2019 responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 286 participants, 53.5% demonstrated compliance with the IFAs. Multivariable logistic regression showed that compliance was significantly and positively linked to the level of education ((AOR)=3.629; 95% CI: (1.438 to 9.153)) and knowledge regarding IFAs (AOR=3.751; 95% CI: (2.145 to 6.562)). The reasons for non-compliance included the consumption of too many tablets, lack of information provided by healthcare workers, experiencing side effects and forgetting to take the tablets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IFA compliance was observed in more than half of the participants. Compliance was influenced by participants\u2019 education and knowledge. The authors hold a strong conviction that relevant authorities can provide the necessary education in specific areas of concern to enhance the design and improvement of IFA programme strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087459","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:51:44Z","timestamp":1741755104000},"page":"e087459","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["IFA compliance and associated factors among postpartum mothers: a cross-sectional analytical study at public health facilities in Bharatpur metropolitan city, Chitwan Nepal"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3314-232X","authenticated-orcid":false,"given":"Sahera","family":"Khatun","sequence":"first","affiliation":[{"name":"Department of Public Health, Shree Medical and Technical College, Bharatpur, Bagmati, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2451-5060","authenticated-orcid":false,"given":"Jiwan Kumar","family":"Poudyal","sequence":"additional","affiliation":[{"name":"Department of Public Health, Shree Medical and Technical College, Bharatpur, Bagmati, Nepal"},{"name":"Central Department of Population Studies, Tribhuvan University, Kirtipur, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6421-1674","authenticated-orcid":false,"given":"Sumitra","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Department of Nursing, Bharatpur Hospital, Bharatpur, Bagmati, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3993-1614","authenticated-orcid":false,"given":"Govinda Prasad","family":"Dhungana","sequence":"additional","affiliation":[{"name":"Department of Statistics, Tribhuvan University - Birendra Multiple Campus, Bharatpur, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"2025121511531788000_15.3.e087459.1","first-page":"197","article-title":"Determinants of Compliance With Iron and Folate Supplementation Among Pregnant Women in West Iran: A Population Based Cross-Sectional Study","volume":"12","author":"Siabani","year":"2018","journal-title":"J Family Reprod Health"},{"key":"2025121511531788000_15.3.e087459.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0227351","article-title":"Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study","volume":"15","author":"Kamau","year":"2020","journal-title":"PLoS One"},{"key":"2025121511531788000_15.3.e087459.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0232625","article-title":"Adherence to iron and folic acid supplementation and prevalence of anemia among pregnant women attending antenatal care clinic at Tikur Anbessa Specialized Hospital, Ethiopia","volume":"15","author":"Nasir","year":"2020","journal-title":"PLoS One"},{"key":"2025121511531788000_15.3.e087459.4","doi-asserted-by":"crossref","DOI":"10.18332\/ejm\/138595","article-title":"Adherence and associated factors to iron and folic acid supplementation among pregnant women attending antenatal care in public hospitals of Dire Dawa, Eastern Ethiopia","volume":"5","author":"Solomon","year":"2021","journal-title":"Eur J Midwifery"},{"key":"2025121511531788000_15.3.e087459.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0210086","article-title":"Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017","volume":"14","author":"Gebremariam","year":"2017","journal-title":"PLoS ONE"},{"key":"2025121511531788000_15.3.e087459.6","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/608658","article-title":"Evaluation of hematological parameters in partial exchange and packed cell transfusion in treatment of severe anemia in pregnancy","volume":"2012","author":"Salhan","year":"2012","journal-title":"Anemia"},{"key":"2025121511531788000_15.3.e087459.7","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.2015.20.43.4894","article-title":"Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study","volume":"20","author":"Taye","year":"2015","journal-title":"Pan Afr Med J"},{"key":"2025121511531788000_15.3.e087459.8","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/5863737","article-title":"Adherence to Iron and Folic Acid Supplement and Its Associated Factors among Antenatal Care Attendant Mothers in Lay Armachiho Health Centers, Northwest, Ethiopia, 2017","volume":"2019","author":"Agegnehu","year":"2019","journal-title":"Int J Reprod Med"},{"key":"2025121511531788000_15.3.e087459.9","unstructured":"World Health Organization . 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