Abstract:
Iron deficiency is the most common nutritional cause of anaemia and has been associated
with poor pregnancy outcome. On the other hand, lack of adequate folate intake prior to
conception and during the early weeks of pregnancy increases the risk of the
development of neural tube defects. In Kenya all pregnant women are targeted for free
folic acid and iron supplementation. However, information about whether folic acid and
iron supplements are actually used by the women is not available, and there is concern
that women would not take them because of perceived side effects, particularly of iron
supplements. This study aimed at determining factors associated with utilization of iron
and folic acid supplementation services and the prevalence of anaemia among pregnant
women attending antenatal clinic at Nyeri Provincial General Hospital. A cross sectional
study was conducted among pregnant women selected through systematic random
sampling. A semi-structured questionnaire was administered to collect information on
receipt and use of supplements where high compliance to supplementation was defined
as using each of the supplements for more than four days in a week. After administration
of the questionnaire, haemoglobin level was determined directly from capillary blood via
finger pricks and measured using a portable HemoCue B-Hb photometer. Of the 381
women interviewed, 51.2% and 69.3% reported being given iron and folic acid
supplements respectively. Less than half 44.6 % and 58% reported receiving information
on iron and folic acid respectively. Of the women who received supplements, 67.7%
reported being initiated on iron supplements after 16 weeks gestation while 80.7%
reported being initiated on folic acid supplements after 12 weeks. The most frequently
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cited reason by the women for not taking the supplements was not receiving supplies of
iron (89.4%) and folic acid (81.3%) supplements during ANC visits. Among those who
reported receiving iron and folic acid supplements, 80.5% and 82.2% reported high
compliance respectively.The prevalence of anaemia was 7.8%. The mean haemoglobin
level was 12.6±1.2 g/dl. In multivariate analysis the only factor that was significantly
associated with compliance to iron supplements (p=0.05) was to protect oneself from
anaemia (OR=12.20). While factors significantly associated with compliance to folic
acid supplementation (P=0.05) were: in order to improve general health (OR=20.82),
because the health worker advised to take folic acid supplements (OR=56.02) and to
protect oneself from anaemia (OR=14.10). Improvement in supplies of the supplements,
sensitization and training of health workers to give information while delivering
supplementation services and sensitization of community members
