Prevalence and factors associated with compliance to iron and folic acid supplementation in pregnancy in Tamale Metropolis, Ghana

Background Supplementation with iron and folic acid (IFA) is recommended to prevent anaemia in pregnancy. However, the effectiveness of the supplementation in improving haemoglobin level depends on the degree of compliance. It is therefore necessary to periodically assess level of compliance with IFA supplementation. The aim of this study was to assess the prevalence and factors associated with compliance to IFA supplementation in pregnancy in Tamale Metropolis, Ghana. Methods A health facility–based cross-sectional study was conducted among 403 pregnant women who accessed antenatal clinic (ANC) services in three health facilities in Tamale Metropolis, Ghana. Simple random sampling was used to select study health facilities and participants. Compliance to IFA was defined as use of IFA supplement in 4 of the last 7 days. Logistic regression analysis was used to identify the determinants of IFA supplementation compliance. Results The mean age of the study population was 26.7 (± 4.18) years. The prevalence of compliance to IFA supplementation was 58.8% (215/403) and the main reason the women gave for non-compliance was forgetting to take the supplements (40.9%). Following multivariate analysis, factors that were significantly associated with compliance were pregnancy trimester at interview, educational level, IFA knowledge, sex of household head and household wealth index. Conclusion About 3 out of 5 women seeking ANC services in Tamale Metropolis are compliant with IFA supplementation with some of their socio-demographic and household characteristics predicting compliance. Efforts to increase compliance to IFA supplementation must focus on education on its benefits and improvement of socio-economic status of women.