Factors Influencing Uptake of Iron and Folic Acid Supplements among Women of Child Bearing Age in Mombasa County

Abstract

As per the 2016 estimates, the global prevalence of anaemia among Women of Child Bearing Age (WCBA), 15-49 years was about 32.8%, with more than 30% of the cases being in Sub-Saharan Africa. Approximately 50% of the cases were considered to be due to iron deficiency. According to the World Health Organization, about 20% of perinatal mortality and 10% of maternal mortality in Sub-Saharan Africa is attributed to iron deficiency anaemia. In Kenya, only about 8% pregnant women take Iron and Folic Acid (IFA) supplements for more than 90 days, while over 30% do not take them at all. In Changamwe, only 8.3% of WCBA had received Iron folate supplements at the third trimester of their pregnancy, contrary to the Ministry of Health recommended dose of 60 mg/day of iron and 400µg/day of folic acid respectively for 180 days. This is a clear indication that there is low uptake of IFA supplementation among WCBA in Changamwe. The study assessed factors influencing Iron and Folic Acid (IFA) supplements uptake among WCBA in Mombasa County. This was an analytical cross-sectional survey done between January and March 2015. The target population was 270,982 WCBA from which a sample of 400 was selected using stratified random sampling method. Data was collected using semi-structured questionnaire from 399 WCBA and analyzed using frequencies, percentages, chi-square test and regression analysis. Inferences were drawn at 95% level of confidence and results were presented using tables and figures. Results indicated that 342 (85.7%) of the WCBA had used IFA supplements in the last five years preceding the study; WCBA aged 15-26 years were 78% less likely to uptake IFA supplements compared to those aged 26-36 years; WCBA who had no formal education were 92% less likely to uptake IFA supplements compared to those with secondary level of education; WCBA who did not receive IFA supplements during pregnancy were 93% less likely to uptake IFA supplements compared to those who received; WCBA who did not take IFA drugs as per prescription were 90% less likely to uptake IFA supplements compared to those who did; while WCBA whose source of information on IFA supplements was TV and radio were 87% and 90% respectively less likely to uptake IFA supplements compared to those whose source was hospital. The study concluded that majority of WCBA in Changamwe sub-county had taken IFA supplements in the last five years (between January 2010 and December 2014) preceding the study; socio-demographic and socio-economic conditions of the WCBA including age and education level had significant relationship with uptake of IFAs; practices such as uptake of IFAs during pregnancy and taking IFAs as per prescription had significant relationship with uptake of IFAs; and sources of information on IFAs had significant relationship with uptake of IFAs amongst WCBA in Changamwe sub-county. The study recommends that the ministry of health and county department of health should promote behavior change communications among young WCBA to increase both demand and compliance to IFA supplementation; sensitize the health care workers to provide information on health benefits of IFA supplementation prior to conception and throughout pregnancy; and develop effective strategies to disseminate information on IFA supplementation to complement public health facilities.