Determinants of Factors Affecting Adherence to Iron and Folic Acid Supplementation among Pregnant Women in Ogbomoso, South West, Nigeria

Background: Iron-folic acid (IFA) deficiency anemia is a public health concern worldwide, especially in low and middle-income countries. IFA supplementation during pregnancy is a vital intervention aimed at preventing maternal anemia and adverse pregnancy outcomes. However, adherence remains a challenge in many settings, including Nigeria. Methodology: A cross-sectional study was conducted among consented 400 pregnant women attending antenatal clinics in Ogbomoso, Nigeria, enrolled by multistage sampling technique. Data were collected using a structured interviewer-administered questionnaire assessing socio-demographic characteristics, knowledge, attitude, and practices regarding IFA supplementation. Chi-square tests and logistic regression were used to identify factors associated with adherence. Results: The mean age of respondents was 28.78 ± 5.57 years; 84.8% were married and 54.0% had tertiary education. While 91.3% of participants were aware of the need for IFA supplements, only 70.5% adhered to daily use, and 68.3% commenced supplementation in the first trimester. Knowledge gaps were identified, particularly regarding correct dosage and full benefits of IFA. Adherence was significantly associated with the number of antenatal visits (p = 0.007), correct knowledge of dosage (p < 0.001), and awareness of timing for initiation and discontinuation (p < 0.001). Logistic regression revealed that women attending 3-6 ANC, those with correct knowledge of dosage and timing had higher odds of good adherence. Conclusion: While general awareness of IFA supplementation was high among pregnant women in Ogbomoso, adherence was moderate and influenced by knowledge, ANC attendance, and source of information. Strengthening antenatal education and addressing identified barriers could improve adherence and maternal outcomes.