{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:46:50Z","timestamp":1792028810068,"version":"4.4.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Iron deficiency accounts for about half of anemia cases worldwide. Iron and folate supplementation can effectively control and prevent anemia during pregnancy. Despite the efforts to reduce iron deficiency anemia during pregnancy, only a few women took an iron supplement as recommended. The aim of this study is to assess adherence to iron-folic acid supplementation and associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A facility-based cross-sectional study was conducted from April 1 to May 31, 2021, among pregnant women attending the antenatal care clinic at Metema district governmental health institutions. Data was collected through face-to-face interviews with an interviewer-administered questionnaire. Epi info version 7.1 and SPSS 20 were used for data entry and analysis. Binary logistic regression analysis was done to identify factors associated with iron-folic acid supplementation for pregnant women. Significant associations were determined based on the adjusted odds ratio (AOR) and 95% confidence, with a <jats:italic>p<\/jats:italic>-value &amp;lt; 0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of pregnant women adhering to iron-folic acid supplementation was 34.9% (95% CI: 31, 38.8%). Maternal educational status [AOR = 6.09, 95% CI (3.26, 11.4)], time of first antenatal consultation [AOR = 1.95, 95% CI (1.25, 3.06)], having good knowledge of iron with folic acid supplementation [AOR = 2.80, 95% CI (1.83, 4.28)], having a good understanding of anemia [AOR = 1.61, 95% CI (1.06, 2.43)], and a history of anemia during current pregnancy [AOR = 2.31, 95% CI (1.36, 3.94)] were factors affecting iron-folic acid supplementation adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Iron-folic acid supplementation adherence was low in the study area. Increasing maternal awareness, having good knowledge about the benefits of iron-folate supplements, and early registration to antenatal care were positive determinants of iron with folic acid adherence.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.978084","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T07:14:10Z","timestamp":1668755650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Iron-folic acid adherence and associated factors among pregnant women attending antenatal care at Metema District, Northwest Ethiopia"],"prefix":"10.3389","volume":"10","author":[{"given":"Ayenew Engida","family":"Yismaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Bekele","family":"Tulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fisseha Yetwale","family":"Kassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilen Mekonnen","family":"Araya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"B1","article-title":"The global prevalence of anaemia in 2011","year":"2015","journal-title":"Development DoNfHa"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1007\/s10995-016-2252-1","article-title":"Screening and treatment for iron deficiency anemia in women: results of a survey of obstetrician-gynecologists","volume":"21","author":"Marcewicz","year":"2017","journal-title":"Matern Child Health J."},{"key":"B3","year":"2015","journal-title":"WHO The Global Prevalence of Anaemia in 2011"},{"key":"B4","article-title":"Prevention Ca, Atlanta. Worldwide prevalence of anaemia 1993\u20132005","author":"WHO","year":"2008","journal-title":"WHO Global Database on Anaemia"},{"key":"B5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.11648\/j.ijnfs.20150402.16","article-title":"Belachew E. 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","volume":"4","author":"Abel Gebre","year":"2015","journal-title":"Int J Nutr Food Sci"},{"key":"B6","year":"2016","journal-title":"ETHIOPIA Demographic and Health Survey2016."},{"key":"B7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.22270\/jddt.v3i3.520","article-title":"To study compliance of antenatal women in relation to iron supplementation in routine ante-natal clinic at a tertiary health care center","volume":"3","author":"Godara","year":"2013","journal-title":"J Drug Delivery Therapeut"},{"key":"B8","doi-asserted-by":"publisher","first-page":"880","DOI":"10.4314\/ahs.v13i4.3","article-title":"Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India","volume":"13","author":"Mithra","year":"2013","journal-title":"Afr Health Sci Dec."},{"key":"B9","year":"2012","journal-title":"Who Guideline: Daily Iron and Folic Acid Supplementation in Pregnant Women"},{"key":"B10","doi-asserted-by":"publisher","first-page":"43","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":"B11","first-page":"352","article-title":"Determinants of compliance to iron-folic acid supplementation among pregnant women in pastoral communities of Afar region: the cases of Mille and Assaita districts, Afar, Etiopia","volume":"4","author":"Gebre","year":"2015","journal-title":"Med. Res. Chron"},{"key":"B12","doi-asserted-by":"publisher","first-page":"00235","DOI":"10.15406\/jnhfe.2017.07.00235","article-title":"Compliance to prenatal iron and folic acid supplement and associated factors among women during pregnancy in South East Ethiopia: a cross-sectional study","volume":"7","author":"Haile","year":"2017","journal-title":"J Nutr Health Food Eng."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e0120404","DOI":"10.1371\/journal.pone.0120404","article-title":"Individual and facility-level determinants of iron and folic acid receipt and adequate consumption among pregnant women in rural Bihar, India","volume":"10","author":"Wendt","year":"2015","journal-title":"PLoS ONE."},{"key":"B14","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1186\/1471-2458-12-481","article-title":"Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study","volume":"12","author":"Ogundipe","year":"2012","journal-title":"BMC Public Health."},{"key":"B15","article-title":"Factors Associated With Adherence to Iron\/Folate Supplementation Among Pregnant Women Attending Antenatal Clinic","author":"Dinga","year":"2013"},{"key":"B16","first-page":"1","article-title":"Adherence-and-associated-factors-of-prenatal-iron-folic-acid-supplementationamong-pregnant-women-who-attend-ante-natal-care-in-Health Facility at Mizan-Aman Town. Bench Maji Zone, Ethiopia, 2015","volume":"4","author":"Shewasinad","year":"2015","journal-title":"J Pregnancy Child Health"},{"key":"B17","doi-asserted-by":"publisher","first-page":"781973","DOI":"10.1155\/2015\/781973","article-title":"Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha District, South Ethiopia: community based cross-sectional study","volume":"2015","author":"Abinet","year":"2015","journal-title":"J Environ Public Health."},{"key":"B18","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1186\/1471-2458-14-607","article-title":"Coverage, compliance and factors associated with utilization of iron supplementation during pregnancy in eight rural districts of Ethiopia: a cross-sectional study","volume":"14","author":"Gebremedhin","year":"2014","journal-title":"BMC Public Health."},{"key":"B19","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1177\/1010539511403133","article-title":"Determinants of adherence to iron\/folate supplementation during pregnancy in two provinces in Cambodia","volume":"23","author":"Lacerte","year":"2011","journal-title":"Asia-Pacific J Public Health."},{"key":"B20","first-page":"678","article-title":"Factors associated with not using antenatal iron\/folic acid supplements in Indonesia","volume":"23","author":"Dibley","year":"2015","journal-title":"Asia Pacific J Clin Nutr"},{"key":"B21","first-page":"457","article-title":"Compliance to iron supplementation among pregnant women: a cross-sectional study in Urbanslum","volume":"5","author":"Alpanarani","year":"2014","journal-title":"Natl J Commun Med"},{"key":"B22","author":"Fiedler","year":"2014","journal-title":"A Rapid Initial Assessment of the Distribution and Consumption of Iron-Folic Acid Tablets Through Antenatal Care in Ethiopia"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.978084\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T07:14:15Z","timestamp":1668755655000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.978084\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,18]]},"references-count":22,"alternative-id":["10.3389\/fpubh.2022.978084"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.978084","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,18]]},"article-number":"978084"}}