Folic acid utilization and associated factors among pregnant women who attended public health facilities of illuababor zone, Southwest Ethiopia

BackgroundThe protective period is the ideal time for folic acid supplementation to prevent neural tube defects. It supplements at least one month before conception up to three months after conception. World health organization recommends 0.4 mg daily for women from preconception through the first trimester, yet utilization remains challenged.ObjectiveTo assess protective folic acid utilization and associated factors among women attending antenatal care units in Illuababor Zone public facilities.DesignInstitutional based cross-sectional study was conducted.MethodsThis study was conducted among 714 pregnant women attending antenatal care units in public health facilities of the Illuababor zone, selected through a systematic random sampling technique. The data were collected using a semi-structured interviewer-administered questionnaire. Bi-variate and multivariate logistic regression analyses were undertaken, and the association was declared at 95 CI and p-value less than 0.05.ResultsA total of 714 pregnant women participated in the study, resulting in a 97.4% response rate. Only 119 (17%), [95% CI: (14.0, 19.6)] women had utilized protective folic acid. Residence (AOR: 2.16, 95% CI: 1.38, 3.40), history of family planning utilization (AOR: 2.65, 95% CI: 1.23, 5.71), gravida (AOR: 2.07, 95% CI: 1.17, 3.64), gestational age of antenatal care booking (AOR: 8.77, 95% CI: 5.33, 14.45), and knowledge about folic acid (AOR: 2.99, 95% CI: 1.90, 4.71) were identified as significant predictors of folic acid utilization.ConclusionsFolic acid utilization in the protective period stands at just 17%. Key positive predictors are urban residence, prior family planning use, primigravida status, early first-trimester ANC booking, and strong knowledge of folic acid. Enhancing uptake demands multifaceted strategies addressing knowledge gaps and rural access barriers through targeted education and healthcare services.