Association between knowledge and compliance of taking iron/folic acid supplements during pregnancy

Objective: In Indonesia, pregnant women are recommended to take a minimum of 90 tablets of iron/folic acid (IFA), to prevent iron deficiency anemia. Our analysis aimed at examining the extent to which improved knowledge on IFA supplementation is associated with women’s compliance with taking a minimum of 90 IFA tablets during their last pregnancy in four districts in Indonesia. Methods: Data were derived from a cross-sectional study conducted in four districts, that is, Lebak and Pandeglang District (Banten Province) as well as Purwakarta and Subang District of West Java Province, Indonesia on June 2014. We used information from 436 mothers who delivered their baby in the last 6 months from the time of the survey and received at least 90 IFA tablets during her last pregnancy. Logistic regression analysis was used to examine the role of knowledge after controlling for confounders and other significant predictor on compliance with taking a minimum of 90 IFA tablets during pregnancy. Result: Significant association was found between knowledge of IFA supplements and compliance. Compared to women with poor knowledge of IFA supplementation, the odds of taking a minimum of 90 IFA tables increased by almost 100% in women with moderate knowledge (adjusted odd ratio [aOR]=1.96, 95% confidence interval [CI]: 1.17-3.30, p=0.011); and by more than four times (aOR=5.42, 95% CI: 1.76-16.68, p=0.003) in women with good knowledge of IFA supplementation. Other factors associated with compliance was attendance in at least four antenatal services (aOR=5.71, 95% CI: 1.28-25.53, p=0.023) and pregnant women experience of no side effects resulting from taking IFA tablets during pregnancy (aOR=2.70, 95% CI: 1.63-4.46, p<0.001). Conclusions: Efforts to increase women’s knowledge on IFA supplementation through community-based education will increase women’s compliance of taking IFA supplements. Strengthening counseling services on potential side effects of IFA supplementation and ways to manage them will also help to improve compliance.