Department of Statistics, Debre Tabor University, Debre Tabor, Ethiopia
BMJ Open. 2022 Sep 6;12(9):e061900. doi: 10.1136/bmjopen-2022-061900.
This study aimed to investigate geographic disparities and determinants of adherence to iron and folate supplementation among pregnant women in Ethiopia.
A secondary data analysis was performed using data from the Ethiopian Mini Demographic and Health Survey 2019. A total of 2235 pregnant women aged 15-49 years were included in the analysis. ArcGIS V.10.8 and SaTScan V.9.6 were used for spatial analysis. Multilevel logistic regression analysis was used to determinants.
Of the total number of participants, 80.3% of pregnant mothers took iron and folate supplements for less than the recommended days. Adherence to iron folate supplementation among pregnant women in Ethiopia was spatially clustered with Moran's global I=0.15868. The SaTScan analysis identified the most likely significant clusters found in the eastern Tigray, northeast Amhara and northwest Afar regions. Multivariable multilevel analysis showed that mothers who were living apart from their partner (adjusted OR (AOR)=10.05, 95% CI 1.84 to 55.04), had antenatal care (ANC) visits at least four times (AOR=0.53, 95% CI 0.41 to 0.69), a higher education level (AOR=0.39, 95% CI 0.25 to 0.63), big distance from health facilities (AOR=1.7, 95% CI 1.51 to 1.97) were significant factors of adherence to iron-folate supplementation. Mothers living in the Amhara and Addis Ababa regions were 0.35 (AOR=0.35, 95% CI 0.19 to 0.621), and 0.29 (AOR=0.29, 95% CI 0.15 to 0.7) times lower iron-folate supplementation intake than mother's in Tigray region.
In this study, 8 out of 10 pregnant women did not take iron and folate supplements during the recommended period. As a result, health education activities were necessary to raise awareness among women and the community about the importance of iron folate supplementation during pregnancy, and public health programmes should increase iron folate supplementation through women's education, ANC visits and mothers living in low-iron areas.
本研究旨在探讨埃塞俄比亚孕妇铁和叶酸补充依从性的地理差异和决定因素。
使用 2019 年埃塞俄比亚微型人口与健康调查的数据进行二次数据分析。共纳入 2235 名 15-49 岁的孕妇。使用 ArcGIS V.10.8 和 SaTScan V.9.6 进行空间分析。采用多水平逻辑回归分析确定决定因素。
在总参与者中，80.3%的孕妇服用铁和叶酸补充剂的天数少于推荐天数。埃塞俄比亚孕妇服用铁叶酸补充剂呈空间聚集，Moran 全局 I=0.15868。SaTScan 分析确定了在提格雷东部、阿姆哈拉东北部和阿法尔西北部地区最有可能出现的显著集群。多变量多层分析显示，与伴侣分居的母亲（调整后的优势比（AOR）=10.05，95%置信区间 1.84 至 55.04）、至少接受四次产前护理（ANC）就诊的母亲（AOR=0.53，95%置信区间 0.41 至 0.69）、受教育程度较高的母亲（AOR=0.39，95%置信区间 0.25 至 0.63）、距离卫生设施较远的母亲（AOR=1.7，95%置信区间 1.51 至 1.97），这些都是服用铁-叶酸补充剂的显著因素。居住在阿姆哈拉和亚的斯亚贝巴地区的母亲服用铁-叶酸补充剂的比例分别为 0.35（AOR=0.35，95%置信区间 0.19 至 0.621）和 0.29（AOR=0.29，95%置信区间 0.15 至 0.7），比提格雷地区的母亲低。
在这项研究中，80%的孕妇在推荐期间没有服用铁和叶酸补充剂。因此，有必要开展健康教育活动，提高妇女和社区对孕期铁叶酸补充剂重要性的认识，公共卫生方案应通过妇女教育、ANC 就诊和居住在缺铁地区的母亲来增加铁叶酸补充剂的摄入。
