Determinants of Iron and Folic Acid Supplementation Adherence among Women of Reproductive Age in Kilifi South Sub-County, Kilifi County, Kenya
No Thumbnail Available
Date
2025-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Iron Deficiency Anemia (IDA) among expectant women causes severe consequences
for both productive and reproductive health, resulting in a major public health problem.
Iron Folic Acid supplementation (IFAS) is the foremost approach put in place to curb
pregnancy-related anemia. Despite this implementation, poor adherence remains to be
a big problem. The Kenyan Ministry of Health recommends that pregnant women take
60mgs of iron and 400 μg of folic acid daily from conception till birth. In Kilifi County,
22.2% of pregnant women were reported to adhere to IFAS intake in the year 2017. The
major objective of this research was to find out the determinants of IFAS adherence
among women of reproductive age, with children 0-23 months in Kilifi South SubCounty, Kilifi County, Kenya. The study aimed to establish the proportion of women
who were anemic, the proportion adhering to IFAS intake and how social, economic,
demographic and health system factors influenced IFAS intake. A total of 324 mothers
were recruited. The research was conducted in two purposively selected public
hospitals at the community level, where mothers were selected using cluster sampling.
A cross-sectional study design was used. Qualitative data was collected through Focus
Group Discussions (FGDs) and Key Informant Interviews (KIIs). Quantitative data was
collected using structured questionnaires. Qualitative data was analyzed thematically.
Analysis of Quantitative data was conducted using the Statistical Package for Social
Sciences version 25. A descriptive summary was made before testing relationships.
Association between dependent and independent variables was determined using Chisquare and logistic regression at p<0.05. Odds Ratio was used to test the strength of
association. The Graduate School of Kenyatta University approved the research, ethical
approval was given from the Kenyatta University Ethics and Review Committee,
permit to do the research was given by the National Commission for Science,
Technology and Innovation and permits were also obtained from the county
government of Kilifi, department of health services, both county and sub-county
offices. Adherence to IFAS intake in Kilifi South subcounty was low at 31.2% below
the required 65% but higher than that of the national level. Factors positively associated
with IFAS intake included education level of mother (x2 =16.884; df=4; p=0.002),
age(p=0.03, OR=1.26), monthly income (p=0.044, OR=1.622), Number of ANC visits
(x
2=7.586; df=4; p=0.000), knowledge of IFAS and its importance (x2=7.586; df=2;
p=0.023), knowledge of anemia (x2=8.020; df=1; p=0.005), knowledge of anemia
causes (x2=14.575; df=1; p=0.000), knowledge of effects of anemia in pregnancy
(x2=17.332; df=1; p=0.000), Being anemic during pregnancy (x2=22.877; df=1;
p=0.000; OR=3.35) and challenges faced when taking and acquiring IFAS (x2=4.717;
df=1; p=0.03). Some of the challenges listed were late ANC attendance (57.1%), side
effects (53.4%), forgetfulness (32.4%), long distance to the facility (59.4%) and
stockouts (29.9%). Anemia was found to be high at 69.4%. The study concluded that
mothers who sufficiently took IFAS had improved hemoglobin levels by delivery time.
It recommends that the Kilifi County health department and stakeholders address
knowledge gaps on IFAS and anemia, create awareness on early ANC registration
among pregnant women, ensure enough stock of the supplements and strengthen patient
referral system by community health volunteers
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Monitoring and Evaluation) in the School of Health Sciences of Kenyatta University, November 2025
Supervisors;
1.Anthony Wanyoro