Determinants Of Compliance With Iron-Folic Acid Supplementation Among Pregnant Mothers In Bule Hora District, Southern Ethiopia: Unmatched Case-Control Study

BackgroundWorld Health Organization has recommended a daily supplementation of iron folic acid, to avert anemias during pregnancy. However, due to many factors, compliance of pregnant women with this recommendation of iron and folic acid supplementation remains low, both in Africa and Ethiopia. The findings from previous studies show in concurrent finding regarding determinants of iron and folic acid compliance. ObjectiveThis study aimed to assess determinants of iron and folic acid supplementation compliance among antenatal care attendee pregnant women in the Bule Hora district, south Ethiopia, in 2023. MethodsHealth facility -based, unmatched case-control study was conducted in Bule Hora district from November 2023 to December 2023, using pretested interviewer-administered questionnaire. The sample size for the study was calculated using Epi Info version 7.2.6 software. A total of 115 cases and 230 controls were included in the study. The sample size was proportionally allocated to each health facility based on number of pregnant women supplemented with iron-folic acid at least one month before the data collection period; after that, systematic sampling techniques were used to select every 2nd participant from each health facility. Binary and multivariable logistic regression was conducted to identify determinants of iron folic acid compliance; AOR at P-value < 0.05 with 95% CI was used to declare a statistically association after checking absence of multicollinearity (VIF < 1.65, Tolerance >0.6) and Hosmer and Leme-show test of model fitness (p-value =0.08). ResultsA total of 345 pregnant women were included in the study with, a 100% response rate. Prim gravidity [AOR: 4.67, 95% CI (1.60, 13.57)], antenatal care contact 4 or more times [AOR: 7.84, 95% CI (3.34-18.41)], having husband/family support to take iron folic acid [AOR: 4.48, 95% CI (2.19-9.13)] and good knowledge on anemia [AOR: 3.79, 95%CI (1.85-7.75)] shows significant association with iron-folic acid good compliance. ConclusionThe study concluded that prim-gravidity, antenatal care contact 4 or more times, having husband support, and good knowledge of anemias were determinants of good compliance. Promoting husband support and frequency of antenatal care contact and providing information about anemias were needed to enhance compliance with iron folic acid.