Prevalence of nonadherence to iron and folic acid supplementation among pregnant women in Bishnupur district of Manipur

Context: Iron and folic acid (IFA) supplementation is an important strategy to reduce the prevalence of iron-deficiency anemia (IDA) during pregnancy. Consequently, it reduces risk of maternal mortality, neonatal mortality, and poor birth outcomes. Nonadherence to IFA supplementation is a challenging factor in combating IDA. Aims: The aim of this study was to determine the prevalence of nonadherence to IFA supplementation among pregnant women and identify the factors associated with it. Subjects and Methods: A cross-sectional study was conducted among pregnant women attending public health facilities of Bishnupur district, Manipur. Pregnant women with ≥20 weeks of period of gestation were recruited consecutively from the antenatal care clinics of the selected public health facilities. Face-to-face interviews were conducted using a pretested semi-structured interview schedule. Association between nonadherence to IFA supplementation and background characteristics and antenatal profile was analyzed using Chi-square test. Results: The mean age of the participants was 28 ± 5.7 years, and 69% were multigravida. Among 396 women who were currently consuming IFA tablets, 25% were nonadherent. Bad taste, side effects, and inadequate supply were cited as the main reasons for irregular intake. The presence of comorbidities (P < 0.001), government supply as source of IFA tablets (P = 0.001), and adequate knowledge about IFA tablets (P = 0.04) were found to be significantly associated with nonadherence. Other associated factors were religion, education, socioeconomic status, and period of gestation. Conclusions: The prevalence of nonadherence was high among pregnant women in Bishnupur district. The importance of IFA supplementation and its adherence should be emphasized to pregnant women.