What Makes Bangladeshi Pregnant Women More Compliant to Iron-Folic Acid Supplementation: A Nationally Representative Cross-Sectional Survey Result

Kazi Istiaque Sanin; Mahbubul Alam Shaun; Razia Sultana Rita; Md Khaledul Hasan; Mansura Khanam; Md Ahshanul Haque

doi:10.3390/nu15061512

What Makes Bangladeshi Pregnant Women More Compliant to Iron-Folic Acid Supplementation: A Nationally Representative Cross-Sectional Survey Result

Nutrients. 2023 Mar 21;15(6):1512. doi: 10.3390/nu15061512.

Authors

Kazi Istiaque Sanin¹, Mahbubul Alam Shaun², Razia Sultana Rita¹, Md Khaledul Hasan¹, Mansura Khanam¹, Md Ahshanul Haque¹

Affiliations

¹ Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
² Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, Barisal 8602, Bangladesh.

Abstract

Background: Iron-Folic Acid Supplementation (IFAS) is an effective strategy to prevent iron deficiency anemia during pregnancy. We aimed to explore the key factors associated with compliance to IFA tablets in Bangladesh.

Methods: This study analyzed the 2017-2018 Bangladesh Demographic and Health Survey data of 3828 pregnant women aged 15-49 years. We categorized compliance into two categories; at least 90 days and full 180 days of consumption. We performed multivariable logistic regression to identify the association between key factors and IFAS compliance.

Results: The prevalence of consumption of IFA tablets for at least 90 days was 60.64%, and only 21.72% of women consumed the IFA for the full 180 days. About three-quarters of the women (73.36%) having at least four antenatal care visits (ANC) consumed IFA for at least 90 days, whereas only three in ten women (30.37%) consumed IFA for a minimum of 180 days. For compliance with IFA for at least 90 days, respondent's age of 20-34 years (aOR 1.26, 95% CI 1.03-1.54), respondent's educational qualification of secondary (aOR 1.77, 95% CI 1.16-2.70) or higher (aOR 2.73, 95% CI 1.65-4.53), husband's educational qualification of secondary (aOR 1.33, 95% CI 1.00-1.77) or higher (aOR 1.75, 95% CI 1.22-2.52), and having received at least four antenatal care (ANC) visits from medically skilled providers (aOR 2.53, 95% CI 2.14-3.00) were significantly associated with higher odds of compliance. For compliance with IFA for at least 180 days, respondent's educational qualification of higher (aOR 2.45, 95% CI 1.34-4.48), and having received at least four ANC visits from medically skilled providers (aOR 2.43, 95% CI 1.97-3.00) were significantly associated with higher odds of compliance. Intimate partner violence was negatively associated with compliance with IFA for at least 180 days (aOR 0.62, 95% CI 0.48-0.81).

Conclusions: The full compliance to IFAS is still sub-optimal in Bangladesh. Further precise context-specific intervention strategies must be developed and implemented with fidelity.

Keywords: Bangladesh; IFA compliance; anemia; iron–folic acid supplementation; pregnancy.

MeSH terms

Cross-Sectional Studies
Dietary Supplements
Female
Folic Acid
Humans
Iron*
Pregnancy
Pregnant Women*
Prenatal Care

Substances

Iron
Folic Acid

Grants and funding

The authors received no funding for this research work.