Department of Community Medicine, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania.
Department of Public Health and Community Nursing, The University of Dodoma, P. O. Box 395, Dodoma, Tanzania.
BMC Pregnancy Childbirth. 2024 Oct 14;24(1):673. doi: 10.1186/s12884-024-06871-8.
The physiological requirements for iron and folic acid in pregnancy are a significant challenge to achieve through normal dietary intake, especially in low resource settings. The World Health Organization recommends daily oral iron and folic acid supplementation (IFAS) to prevent maternal anaemia and related adverse effects in community settings where the prevalence of anaemia during pregnancy is > 40%. The objective of this study was to assess the routine uptake of prenatal iron-folic acid supplementation and associated factors among pregnant women at peri-urban areas of Dodoma City, Tanzania.
A cross-sectional study was conducted in peri-urban areas. Data was collected through face-to-face interviews and review of records from maternal clinic card (RCH 4 card). Routine uptake of iron-folic acid supplementation was defined as pregnant woman who reported taking iron-folic acid supplements at least once within the past seven days prior to data collection. Frequency and percentage were used to report respondents' characteristics and uptake of prenatal iron-folic acid supplementation. Chi-square test and logistic regression were conducted to determine the relationship and association of routine uptake of iron-folic acid supplementation with respondents' characteristics.
The total respondents were 452. Overall routine uptake of iron-folic acid supplementation was 35.6% (161). The majority of the respondents (66.5%) initiated iron-folic acid supplementation during the second trimester of pregnancy. Most of the respondents (86.3%) obtained IFA supplements at the health centers where they were receiving antenatal care. The prevalence of routine uptake of iron-folic acid supplementation was significantly higher among women in the third trimester of pregnancy (54.9%), those with more than a five-year interval since last pregnancy (40.6%), those with at least four antenatal care (ANC) visits (73.7%) and women who had undergone haemoglobin testing in the current pregnancy (63.0%). Factors associated with routine uptake of iron-folic acid supplementation were; frequency of ANC visits (AOR = 1.69) and haemoglobin testing (AOR = 3.02).
Approximately one third of the pregnant women took iron-folic acid supplementation at least once a week. The current frequency for intake of iron-folic acid supplementation can be described as intermittent. This practise is unacceptable for prevention of maternal anaemia and associated adverse pregnant outcomes. Frequency of ANC visits and haemoglobin testing during pregnancy were found to be associated with routine uptake of iron-folic acid supplements. Stakeholders are urged to consider novel systems for provision of prenatal IFAS in community settings with limited access to health-care professionals to ensure a timely and continuous supply of supplements.
妊娠期间对铁和叶酸的生理需求通过正常饮食摄入难以满足，尤其是在资源匮乏的环境下。世界卫生组织建议在贫血患病率大于 40%的社区环境中，每日口服铁和叶酸补充剂（IFAS）以预防孕产妇贫血及相关不良后果。本研究旨在评估达累斯萨拉姆市城郊孕妇铁叶酸补充的常规服用情况及其相关因素。
在城郊地区进行了一项横断面研究。通过面对面访谈和孕产妇病历（RCH4 卡）记录回顾收集数据。铁叶酸补充的常规服用被定义为在数据收集前的过去七天内至少服用过一次铁叶酸补充剂的孕妇。频率和百分比用于报告受访者的特征和产前铁叶酸补充的服用情况。卡方检验和逻辑回归用于确定铁叶酸补充常规服用与受访者特征的关系和关联。
总共有 452 名受访者。总体铁叶酸补充常规服用率为 35.6%（161 人）。大多数受访者（66.5%）在妊娠第二个三个月开始服用铁叶酸补充剂。大多数受访者（86.3%）在接受产前护理的卫生中心获得 IFA 补充剂。妊娠第三个三个月的铁叶酸补充常规服用率显著较高（54.9%），上次妊娠间隔五年以上的妇女（40.6%），至少接受过四次产前护理（ANC）就诊的妇女（73.7%）和当前妊娠期间进行过血红蛋白检测的妇女（63.0%）。与铁叶酸补充常规服用相关的因素包括：ANC 就诊频率（AOR=1.69）和血红蛋白检测（AOR=3.02）。
约有三分之一的孕妇每周至少服用一次铁叶酸补充剂。目前铁叶酸补充的摄入频率可以描述为间歇性。这种做法对于预防孕产妇贫血和相关不良妊娠结局是不可接受的。妊娠期间 ANC 就诊频率和血红蛋白检测与铁叶酸补充常规服用相关。敦促利益相关者考虑在医疗服务专业人员有限的社区环境中提供产前 IFAS 的新系统，以确保及时和持续供应补充剂。
