Factors Influencing Compliance with Iron and Folic Acid Supplements among Pregnant Women at a Tertiary Care Hospital
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Abstract
Background: Iron and folic acid supplementation (IFAS) is an effective intervention for preventing maternal anemia and improving pregnancy outcomes. However, adherence remains suboptimal in low- and middle-income countries due to multiple socio-demographic, obstetric, and behavioral factors. Objective: This study aimed to assess the level of compliance with iron and folic acid supplementation (IFAS) and identify factors influencing compliance among pregnant women attending a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted from January to March 2026 among 264 pregnant women attending the Department of Obstetrics & Gynecology, Liaquat University Hospital, Hyderabad/Jamshoro. Participants were recruited using purposive sampling. Data were collected using a structured questionnaire and analyzed using SPSS version 23. The Chi-square test was used to assess associations, and p < 0.05 was considered statistically significant. Results: Among 264 participants, 61.4% were compliant with IFAS, while 38.6% were non-compliant. Compliance was significantly associated with age, residence, maternal education, husband’s education, monthly income, gravida, parity, gestational age at first antenatal visit, and history of anemia (p < 0.05). The most common reason for non-compliance was unpleasant taste (21.6%), followed by fear of fetal harm (20.1%) and fear of weight gain (19.7%). Vomiting (31.1%) and gastrointestinal discomfort were the most frequently reported side effects. Conclusion: Compliance with IFAS was moderate and influenced by socio-demographic and obstetric factors. Addressing misconceptions, improving counseling, and promoting early antenatal care can enhance adherence and improve maternal outcomes.
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