{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:31:55Z","timestamp":1793694715305,"version":"4.5.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T00:00:00Z","timestamp":1587772800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T00:00:00Z","timestamp":1587772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Effectiveness of prenatal iron supplementation program depends on utilization of the supplement by pregnant women. Nevertheless, in Ethiopia, regardless of increasing efforts, lower proportion of pregnant women use the supplementation for recommended 3 months and above but, the reason is not clear. This study aimed to identify the level and factors associated with utilization of prenatal iron supplementation.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A community based cross-sectional quantitative study complemented with qualitative component was carried out in January, 2016. A total of 411 pregnant women who gave birth 6 months preceding data collection were selected using multi-stage cluster sampling technique. Qualitative data were collected by conducting four focus group discussions (FGDs) of local pregnant mothers and interviewing district maternal and child health (MCH) focal, 3MCH heads of health centers and four health extension workers. Factors associated with appropriate utilization of supplementation were assessed using multivariate logistic regression. The outputs of analyses were presented using Adjusted Odds Ratio (AOR) with 95% confidence intervals (CI).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Result<\/jats:title>\n<jats:p>From the study participants, 11.5% (95% CI\u2009=\u20099.9\u201313.1%) took the supplement for the recommended duration of 3 months or above. Pregnant women who could not read and write had 77% reduced odds of using iron supplementation than their counterparts (AOR\u2009=\u20090.23(95% CI: 0.07\u20130.75)). As compared to women who had four or more antenatal care (ANC), women with 2 and 3 ANC visits had 78% (AOR\u2009=\u20090.22(0.07\u20130.63)) and 66% (AOR\u2009=\u20090.34(0.14\u20130.81)) reduced odds of using the supplementation, respectively. As compared to women who were aware of benefits of taking the supplement for maternal and child health, the counterparts had 90% (AOR\u2009=\u20090.10 (0.10\u20130.63)) reduced odds of using the supplement. Women who were not knowledgeable of anemia had 85% (AOR\u2009=\u20090.15(0.04\u20130.62) reduced odds of using the supplement than those who were knowledgeable. The qualitative study indicated that there was no problem in the supply and logistic system of iron supplement and leading reasons for not taking the supplement were late initiation of Antenatal Care, lack of awareness and occurrence of side effects; unpleasant taste, nausea, vomiting.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In the study area utilization of prenatal iron supplementation is very low. Improving maternal education, ensuring early and frequent ANC, educating pregnant women about the benefits of service and ensuring comprehensive knowledge of anemia expected to improve the utilization of prenatal iron supplementation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12884-020-02883-2","type":"journal-article","created":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T16:02:22Z","timestamp":1587830542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predictors of prenatal iron folic acid supplement utilization in Wolaita, South Ethiopia: a community based cross-sectional study (quantitative and qualitative approach)"],"prefix":"10.1186","volume":"20","author":[{"given":"Ermias Wabeto","family":"Wana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,25]]},"reference":[{"issue":"5","key":"2883_CR1","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1111\/j.1365-2141.2011.09012.x","volume":"156","author":"S Pavord","year":"2012","unstructured":"Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C. UK guidelines on the management of iron deficiency in pregnancy. Br J Hematol. 2012;156(5):588\u2013600.","journal-title":"Br J Hematol"},{"key":"2883_CR2","unstructured":"WHO, UNICEF, United Nations University. Iron deficiency anemia assessment, prevention and control: guide for program managers. Washington: WHO; 2001."},{"key":"2883_CR3","volume-title":"Guideline: daily iron and folic acid supplementation in pregnant women","author":"World Health Organization","year":"2012","unstructured":"World Health Organization. Guideline: daily iron and folic acid supplementation in pregnant women. Geneva: WHO; 2012."},{"issue":"14","key":"2883_CR4","doi-asserted-by":"publisher","first-page":"2607","DOI":"10.1182\/blood-2012-09-453522","volume":"121","author":"S-R Pasricha","year":"2013","unstructured":"Pasricha S-R, Derhsmith H, Black J, Hipgrav D, Biggs B-A. Control of iron deficiency in middle and low income countries. Blood journal. 2013;121(14):2607\u201317.","journal-title":"Blood journal"},{"key":"2883_CR5","unstructured":"Stoltzfus JR, Dreyfuss ML. Guidelines for the use ofiIron supplements to prevent and treat iron deficiency anemia. Washington: International Life Science Institute; 2004."},{"key":"2883_CR6","volume-title":"Trends in maternal health in Ethiopia: in-depth analysis of the EDHS 2000\u20132011","author":"UNFPA","year":"2012","unstructured":"UNFPA. Trends in maternal health in Ethiopia: in-depth analysis of the EDHS 2000\u20132011. Addis Ababa: UNFPA; 2012."},{"key":"2883_CR7","volume-title":"National Nutrition Programme: 2013-2015","author":"Government of the Federal Democratic Republic of Ethiopia (EFDR)","year":"2013","unstructured":"Government of the Federal Democratic Republic of Ethiopia (EFDR). National Nutrition Programme: 2013-2015. Addis Ababa: EFDR; 2013."},{"key":"2883_CR8","first-page":"184","volume-title":"Ethiopian demographic and health survey 2011","author":"Central Stastic Agency (Ethiopia), ICF International","year":"2012","unstructured":"Central Stastic Agency (Ethiopia), ICF International. Ethiopian demographic and health survey 2011. Addis Ababa: Central Stastic Agency, Calverton: ICF International; 2012. p. 184\u20137."},{"key":"2883_CR9","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1186\/1471-2458-14-607","volume":"14","author":"S Gebremedhin","year":"2014","unstructured":"Gebremedhin S, Samuel A, Mamo G, Moges T, Assefa T. Coverage, compliance and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Ethiopia: a cross-sectional study. BMC Public Health. 2014;14:607.","journal-title":"BMC Public Health"},{"issue":"43","key":"2883_CR10","first-page":"7","volume":"20","author":"T Bekele","year":"2015","unstructured":"Bekele T, Gedefew A, Mekonen A. Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study. Pan Afr Med J. 2015;20(43):7.","journal-title":"Pan Afr Med J"},{"key":"2883_CR11","volume-title":"Annual health service plan and performance","author":"Offa Woreda Health Office","year":"2007","unstructured":"Offa Woreda Health Office. Annual health service plan and performance. Gesuba: E.C.; 2007."},{"key":"2883_CR12","first-page":"96","volume-title":"Public and Environmental Health, ed","author":"B Meshesha","year":"2013","unstructured":"Meshesha B. Health promotion handout for graduate (MPH) students. In: Public and Environmental Health, ed. Hawassa: Hawassa University; 2013. p. 96."},{"key":"2883_CR13","volume-title":"National guideline for control and prevention of micronutrient deficiences","author":"Federal Ministery of Health of Ethiopia","year":"2004","unstructured":"Federal Ministery of Health of Ethiopia. National guideline for control and prevention of micronutrient deficiences. Addis Ababa: FMOH; 2004."},{"key":"2883_CR14","volume-title":"Nutrition technical brief: a rapid initial assessment of the distribution and consumption of iron\u2013folic acid tablets through antenatal care in Ethiopia","author":"J Fiedler","year":"2014","unstructured":"Fiedler J, D\u2019Agostino AA, Sununtnasuk C. Nutrition technical brief: a rapid initial assessment of the distribution and consumption of iron\u2013folic acid tablets through antenatal care in Ethiopia. Arlington: USAID\/Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING) Project; 2014."},{"issue":"1","key":"2883_CR15","first-page":"162","volume":"24","author":"CR Titaley","year":"2015","unstructured":"Titaley CR, Dibley MJ. Factors associated with not using antenatal iron\/folic acid supplements in Indonesia: the 2002\/2003 and 2007 Indonesia Demographic and Health Survey. Asia Pac J Clin Nutr. 2015;24(1):162\u201376.","journal-title":"Asia Pac J Clin Nutr"},{"issue":"6","key":"2883_CR16","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1017\/S1368980007000924","volume":"11","author":"BC Seck","year":"2007","unstructured":"Seck BC, Jackson RT. Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr. 2007;11(6):596\u2013605.","journal-title":"Public Health Nutr"},{"key":"2883_CR17","volume-title":"WHO global data base on anemia","author":"World Health Organization","year":"2007","unstructured":"World Health Organization. WHO global data base on anemia; 2007."},{"key":"2883_CR18","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1186\/1756-0500-7-498","volume":"7","author":"H Abdulahi","year":"2014","unstructured":"Abdulahi H, Gasim GI, Saed A, Imam AM, Adam I. Antenatal iron and folic acid supplementation use by pregnant women, Khartoum, Sudan. BMC Res Notes. 2014;7:498.","journal-title":"BMC Res Notes"},{"issue":"5","key":"2883_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/S0102-311X2008000500022","volume":"24","author":"N Lunet","year":"2008","unstructured":"Lunet N, Rodrigues T, Correia S, Barros H. Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy. Cad Saude Publica. 2008;24(5):1\u20137.","journal-title":"Cad Saude Publica"},{"issue":"4","key":"2883_CR20","first-page":"457","volume":"5","author":"AJ Dutta","year":"2014","unstructured":"Dutta AJ, Patel PB, Bansal RK. Compliance to iron supplementation among pregnant women: a cross sectional study in urban slum. Natl J Community Med. 2014;5(4):457\u201362.","journal-title":"Natl J Community Med"},{"issue":"481","key":"2883_CR21","first-page":"1","volume":"12","author":"O Ogundipe","year":"2012","unstructured":"Ogundipe O, Hoyo C, Ostbye T, Oneko O, Manongi R, Terje R, et al. Factors associated with prenatal folic and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional study. BMC. 2012;12(481):1\u201310.","journal-title":"BMC"},{"issue":"3","key":"2883_CR22","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1590\/S1415-790X2013000300016","volume":"16","author":"JA Cesari","year":"2013","unstructured":"Cesari JA, Dumithi SC, Chrestani MAD, Mendoza-Sassi RA. Iron supplementation among pregnant women: results from a population-based survey study. Rev Bras Epidemiol. 2013;16(3):729\u201336.","journal-title":"Rev Bras Epidemiol"},{"issue":"2","key":"2883_CR23","doi-asserted-by":"publisher","first-page":"161","DOI":"10.11648\/j.ijnfs.20150402.16","volume":"4","author":"A Gebre","year":"2015","unstructured":"Gebre A, Mulugeta A, Etana B. Assessment of factors associated with adherence to iron-folic acid supplementation among urban and rural pregnant women in North Western zone of Tigray, Ethiopia: comparative study. Int J Nutr Food Sci. 2015;4(2):161\u20138.","journal-title":"Int J Nutr Food Sci"},{"key":"2883_CR24","volume-title":"Factors sssociated with adherance to iron\/folate supplementation among pregnant women attending antenatal clinic at Thika district hospital [Partial fulfillment of the requirements for the degree of Master]","author":"DA Lynette","year":"2013","unstructured":"Lynette DA. Factors sssociated with adherance to iron\/folate supplementation among pregnant women attending antenatal clinic at Thika district hospital [Partial fulfillment of the requirements for the degree of Master]. Nairobi: Nairobi; 2013."},{"key":"2883_CR25","volume-title":"Factors influencing utilization of iron and folic acid supplementaion services among pregnant women attending ANC clinic at Nyeri provincial Hospital Kenya","author":"LN Gathigi","year":"2011","unstructured":"Gathigi LN. Factors influencing utilization of iron and folic acid supplementaion services among pregnant women attending ANC clinic at Nyeri provincial Hospital Kenya. Nyeri: Jomo Kenyatta; 2011."},{"key":"2883_CR26","doi-asserted-by":"crossref","unstructured":"Ugwu E, Olibe A, Obi S, Ugwu A. Determinants of compliance to iron supplements among pregnant women in Enugu, South Eastern Nigeria. Niger J Clin Pract. 2014;17(5):608\u201312.","DOI":"10.4103\/1119-3077.141427"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-02883-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-020-02883-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-02883-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T23:28:07Z","timestamp":1619306887000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-020-02883-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,25]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2883"],"URL":"https:\/\/doi.org\/10.1186\/s12884-020-02883-2","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,25]]},"assertion":[{"value":"6 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval on study design, participants and data collection method was obtained from the ethical clearance board of Hawassa University with reference number IRB\/030\/08, according to the standardized principles and procedures in line with national and WHO guideline.The participants were informed about the purpose of the study and oral consent was obtained from each study participant before proceeding to the interview and yes option in volunteer to participate in consent section was circled. Parental consent for less than 18 years was planned but none of the study participants was under 18.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable (No identifying images and no personal details in the manuscript).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares that he\/she has no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"243"}}