Adherence to and predictors of iron-folate acid supplementation among pregnant women in a pastoral population in Ghana: a community-based cross-sectional study.

Background: Iron-Folate Acid Supplementation (IFAS) interventions have been recognized globally as key in reducing the burden of anemia among pregnant women. However, adherence to and determinants of IFAS remain indistinct, as it is the main constraint with supplementation therapy, particularly among minority populations. Hence, this study sought to determine the adherence to and predictors of IFAS among nomadic Fulani pregnant women in the West Gonja Municipality of Ghana.

Methods: A community-based cross-sectional design was employed to involve 130 respondents between February to July, 2022 in the West Gonja Municipality of Ghana. Fulani pregnant women aged 15-49 years, possessing maternal and child health record book and were given iron-folate supplements within 16 weeks and resided within the study area ≥ 6 months before/during the data collection period were included in the study. Multivariable logistic regression was used to determine independent predictors of IFAS using SPSS version 25.0 (p ≤ 0.05 deemed statistically significant across all models). ResultsUptake of and adherence to IFAS was 47.7% and 35.5% respectively. Major barriers to IFAS uptake were forgetfulness (25.7%) and unavailability (20.0%). About 65.4% of the respondents revealed poor knowledge of IFAS. Spousal occupation (AOR = 0.17, p = 0.010), spousal income (AOR = 4.125, p = 0.050) and knowledge on IFAS (AOR = 0.259, p = 0.039) were predictors of IFAS.

Conclusions: Poor adherence to and knowledge on IFAS were noted in the study and highlighted as a grave public health concern. Thus, nutrition and antenatal educational programs should give necessary attention to adherence to IFAS during pregnancy, particularly among nomadic and other vulnerable and minority populations to limit the burden of illnesses.