Adherence to Iron and Folic Acid (IFA) among Women Availing Antenatal Services at a Rural Maternity Hospital in Karnataka

Antenatal Iron and Folic Acid (IFA) supplementation prevents anaemia and improves maternal and child outcomes. We conducted a hospital based cross sectional study in Ramanagara district to assess antenatal IFA adherence and its determinants in rural Karnataka. 200 pregnant women ≥16 weeks of gestation were recruited by consecutive sampling and administered a face validated, structured questionnaire. It included a ten item tool to assess anaemia awareness, Patient Health Questionnaire 2, Generalized Anxiety Disorder 2 item and Multidimensional Scale of Perceived Social Support. Women consuming more than 60% of IFA in a week were considered adherent. Binary logistic regression was done to identify its determinants. We found antenatal IFA adherence to be 89%. Poor anaemia awareness was found among 46.5%, probable depression among 11.0%, probable anxiety among 13.5% and high perceived social support among 78.5% of the women. Adherence counselling by a healthcare worker aOR 4.32 (95% CI: 1.01–18.37) and reminder by family member aOR 10.57 (95% CI: 2.35–47.51) were found to be significant facilitators to IFA adherence. Significantly higher adherence was found among women not experiencing side effects aOR 4.01 (95% CI: 1.10–14.64) or forgetfulness aOR 7.0 (95% CI: 1.73–28.43) and in those consuming a single tablet aOR 3.46 (95% CI: 1.07–11.19) as compared to two or more. We concluded that antenatal IFA adherence in rural Karnataka was high. Significant facilitators were the adherence counselling by a healthcare worker and reminder by a family member. Significant barriers were experiencing side effects, forgetfulness and consumption of two or more tablets.