{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:24:22Z","timestamp":1747196662659,"version":"3.40.5"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>According to World Health Organization, pregnant women should take an oral iron and folic acid every day for at least 3 months to prevent preterm birth, low birth weight, maternal anemia, and puerperal sepsis. In addition to keeping maternal health, it also plays a key role to support the fetus\u2019s healthy growth and development. Therefore, it is very important to know the magnitude of iron supplementation and its determinants in anemia hot spot regions of Ethiopia using an appropriate statistical analysis method.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The aim of this study is to determine the magnitude of iron supplementation and its associated factors in anemia hot spot regions of Ethiopia among pregnant women.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The study was done using the 2019 Ethiopian Mini Demographic and Health surveys data. Before any statistical analysis was done, the data were weighted using sampling weight for probability sampling and non-response. Then, a total weighted sample of 2116 reproductive age group women in anemia hot spot regions of Ethiopia were used for this study. A multilevel binary logistic regression model based on the Bayesian approach was fitted using the <jats:bold><jats:italic>Brms<\/jats:italic><\/jats:bold> R package to identify the determinants of iron supplementation in anemia hotspot regions of Ethiopia. Finally, the 95% credible interval (CrI) of the adjusted odds ratio (AOR) was used to assess statistical significance. If the interval includes 1, the result is considered non-significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>This study showed that in anemia hotspot regions of Ethiopia, the overall magnitude of iron supplementation among pregnant women is 55.5% (95% CrI: 53.4%- 57.6%). Being rural resident (AOR = 0.57; 95% CrI 0.34\u20130.93), having higher education level (AOR = 3.2; 95% CrI 1.80\u20135.7), having secondary education level (AOR = 3.28; 95% CrI 2.13\u20135.1), being wealthy (AOR = 1.80; 95% CrI 1.27\u20132.54), being household headed by female (AOR = 0.55; 95% CrI 0.43\u20130.71) and, have no children (AOR = 0.4;95%CrI 0.17\u20130.98) were significantly associated with iron supplementation among pregnant women in anemia hotspot regions of Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The overall magnitude of iron supplementation among pregnant women in anemia hotspot regions of Ethiopia is notably low when compared to the World Health Organization\u2019s recommended target. Significant factors associated with higher iron supplementation included having secondary or higher education, rich in wealth, and being from a male-headed household. Conversely, being a rural resident, female-headed household, and having no children were associated with lower iron supplementation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313116","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T17:25:08Z","timestamp":1730481908000},"page":"e0313116","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Magnitude and factors associated with iron supplementation among pregnant women in anemia hot spot regions of Ethiopia: Multilevel analysis based on Bayesian approach"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4751-3615","authenticated-orcid":true,"given":"Yilkal","family":"Negesse","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habtamu","family":"Temesgen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wubetu","family":"Woyraw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melsew Setegn","family":"Alie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayenew","family":"Negesse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"pone.0313116.ref001","unstructured":"Organization WH. WHO recommendations on antenatal care for a positive pregnancy experience: World Health Organization; 2016."},{"key":"pone.0313116.ref002","unstructured":"Organization WH. Report: priorities in the assessment of vitamin A and iron status and in populations, Panama City, Panama, 15\u201317 September 2010. 2012."},{"issue":"1","key":"pone.0313116.ref003","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1186\/s13104-017-2834-z","article-title":"Adherence to iron supplements among women receiving antenatal care at Mulago National Referral Hospital, Uganda-cross-sectional study","volume":"10","author":"TS Kiwanuka","year":"2017","journal-title":"BMC Research Notes"},{"issue":"2","key":"pone.0313116.ref004","doi-asserted-by":"crossref","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","article-title":"The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health","volume":"36","author":"NM Abu-Ouf","year":"2015","journal-title":"Saudi medical journal"},{"issue":"9603","key":"pone.0313116.ref005","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1016\/S0140-6736(07)61810-8","article-title":"Nutritional iron deficiency in patients with chronic illnesses","volume":"370","author":"T Thum","year":"2007","journal-title":"The Lancet"},{"key":"pone.0313116.ref006","doi-asserted-by":"crossref","first-page":"132","DOI":"10.5581\/1516-8484.20140030","article-title":"Iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza Strip, Palestine","volume":"36","author":"MM Sirdah","year":"2014","journal-title":"Revista brasileira de hematologia e hemoterapia"},{"key":"pone.0313116.ref007","first-page":"511","article-title":"Nutritional iron deficiency","volume":"350","author":"Z. Mb","year":"2007","journal-title":"Lancet (London, England)"},{"journal-title":"Worldwide prevalence of anaemia 1993\u20132005; WHO Global Database of anaemia","year":"2008","author":"B De Benoist","key":"pone.0313116.ref008"},{"key":"pone.0313116.ref009","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1590\/S0104-11692010000200016","article-title":"Food consumption and iron intake of pregnant and reproductive aged women","volume":"18","author":"APS Sato","year":"2010","journal-title":"Revista latino-americana de enfermagem"},{"issue":"2","key":"pone.0313116.ref010","doi-asserted-by":"crossref","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","article-title":"The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health","volume":"36","author":"NM Abu-Ouf","year":"2015","journal-title":"Saudi medical journal"},{"issue":"1","key":"pone.0313116.ref011","first-page":"103","article-title":"Prevalence of iron-deficiency anaemia among university students in Noakhali region, Bangladesh","volume":"32","author":"KB Shill","year":"2014","journal-title":"Journal of health, population, and nutrition"},{"volume-title":"Guideline: daily iron and folic acid supplementation in pregnant women","year":"2012","author":"WHO W","key":"pone.0313116.ref012"},{"issue":"105","key":"pone.0313116.ref013","first-page":"874","article-title":"Current recommendations for the treatment of iron deficiency anemia","volume":"3","author":"R Schaefer","year":"2007","journal-title":"Revue M\u00e9dicale Suisse"},{"issue":"2","key":"pone.0313116.ref014","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"N Abbaspour","year":"2014","journal-title":"Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences"},{"issue":"12","key":"pone.0313116.ref015","doi-asserted-by":"crossref","first-page":"nzz120","DOI":"10.1093\/cdn\/nzz120","article-title":"Adherence to iron supplementation in 22 sub-Saharan African countries and associated factors among pregnant women: a large population-based study","volume":"3","author":"DM Ba","year":"2019","journal-title":"Current developments in nutrition"},{"key":"pone.0313116.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12878-017-0090-z","article-title":"Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis","volume":"17","author":"GM Kassa","year":"2017","journal-title":"BMC hematology"},{"issue":"4","key":"pone.0313116.ref017","doi-asserted-by":"crossref","first-page":"e0249412","DOI":"10.1371\/journal.pone.0249412","article-title":"Spatial variations and determinants of anemia among under-five children in Ethiopia, EDHS 2005\u20132016","volume":"16","author":"ZA Anteneh","year":"2021","journal-title":"PloS one"},{"key":"pone.0313116.ref018","unstructured":"Rockville M. USA: EPHI Ethiopia Mini demographic and health survey Ethiopian public health institute (EPHI) Ethiopia. USA: EPHI and ICF; 2019."},{"key":"pone.0313116.ref019","unstructured":"CSAEaO M. Ethiopia Demographic and Health Survey 2000. Addis Ababa, Ethiopia and Calverton, Maryland, USA Central Statistical Authority and ORC Macro., 2001 2000."},{"key":"pone.0313116.ref020","unstructured":"CSACEaI. Ethiopia Demographic and Health Survey 2016. AddisAbaba, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2016."},{"key":"pone.0313116.ref021","unstructured":"OM C. Ethiopia demographic and health survey 2005. Addis Ababa,Ethiopia and Calverton, Maryland USA: central statistics agency and ORC Macro; 2005."},{"key":"pone.0313116.ref022","article-title":"Multilevel Analysis of Determinants of Anemia Prevalence among Children Aged 6\u201359 Months in Ethiopia: Classical and Bayesian Approaches","volume":"2018","author":"KN Kawo","year":"2018","journal-title":"Anemia"},{"issue":"1","key":"pone.0313116.ref023","first-page":"1593","article-title":"The No-U-Turn sampler: adaptively setting path lengths in Hamiltonian Monte Carlo","volume":"15","author":"MD Hoffman","year":"2014","journal-title":"Journal of Machine Learning Research"},{"key":"pone.0313116.ref024","unstructured":"Kynn M. Eliciting expert knowledge for Bayesian logistic regression in species habitat modelling: Queensland University of Technology; 2005."},{"key":"pone.0313116.ref025","unstructured":"EDHS E. demographic and health survey 2016: key indicators report. The DHS Program ICF. 2016."},{"key":"pone.0313116.ref026","doi-asserted-by":"crossref","first-page":"604058","DOI":"10.3389\/fpubh.2021.604058","article-title":"Factors Associated With Uptake of Iron Supplement During Pregnancy Among Women of Reproductive Age in Tanzania: an Analysis of Data From the 2015 to 2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey","volume":"9","author":"FV Moshi","year":"2021","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0313116.ref027","doi-asserted-by":"crossref","first-page":"e0000825","DOI":"10.1371\/journal.pgph.0000825","article-title":"Adherence to iron and folate supplementation and associated factors among women attending antenatal care in public health facilities at Covid-19 pandemic in Ethiopia","volume":"3","author":"AA Tefera","year":"2023","journal-title":"PLOS Global Public Health"},{"issue":"5","key":"pone.0313116.ref028","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s10708-024-11151-1","article-title":"Spatial Distribution and Influencing Factors of Zero Consumption of Iron and Folic Acid (IFA) among Pregnant Women in India: Evidence from National Family Health Survey, 2019\u201321","volume":"89","author":"A Verma","year":"2024","journal-title":"GeoJournal"},{"key":"pone.0313116.ref029","doi-asserted-by":"crossref","first-page":"955819","DOI":"10.3389\/fnut.2022.955819","article-title":"Trend of adherence to iron supplementation during pregnancy among Ethiopian women based on Ethiopian demographic and health surveys: A Multivariable decomposition analysis","volume":"9","author":"AM Delie","year":"2022","journal-title":"Frontiers in Nutrition"},{"key":"pone.0313116.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-016-1210-7","article-title":"Differences in spatial distributions of iron supplementation use among pregnant women and associated factors in Ethiopia: evidence from the 2011 national population based survey","volume":"17","author":"D Haile","year":"2017","journal-title":"BMC pregnancy and childbirth"},{"issue":"11","key":"pone.0313116.ref031","first-page":"141","article-title":"Gender relations and the utilization of contraceptives and antenatal care services in Kenya, Namibia and Nigeria","volume":"26","author":"Y Adewoyin","year":"2022","journal-title":"African Journal of Reproductive Health"},{"issue":"1","key":"pone.0313116.ref032","article-title":"Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria","volume":"22","author":"T Dahiru","year":"2015","journal-title":"Pan African medical journal"},{"key":"pone.0313116.ref033","doi-asserted-by":"crossref","first-page":"1348275","DOI":"10.3389\/fnut.2024.1348275","article-title":"Iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia: a multilevel complex data analysis of 2019 Ethiopian mini demographic and health survey data","volume":"11","author":"H Temesgen","year":"2024","journal-title":"Frontiers in Nutrition"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T17:25:18Z","timestamp":1730481918000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313116"}},"subtitle":[],"editor":[{"given":"Alqeer","family":"Aliyo Ali","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":33,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313116","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}