A Cross-Sectional Study on Consumption of Iron and Folic Acid Supplements and its Determinants among Women During Pregnancy in Rural Punjab, India
DOI:
https://doi.org/10.51957/Healthline_760_2025Keywords:
Determinants, IFA supplementation, Maternal Anaemia, PunjabAbstract
Introduction: Anaemia in pregnancy remains a public health problem and is an important indirect cause of maternal mortality. Iron deficiency is regarded as the most common cause of anaemia during pregnancy. World Health Organization recommends daily oral iron and folic acid (IFA) supplementation as part of antenatal care. Despite this recommendation, the use of IFA supplements is still very low in several developing countries. Objectives: To determine the prevalence of consumption of IFA supplements and to identify its determinants among women while pregnant. Methods: It was a population based cross sectional study done in rural field practice area of community medicine. Total of 370 mothers of two months to two years old children were selected by PPS sampling. Data so collected was analysed by SPSS using descriptive inferential and chi square test. Results: Prevalence of IFA consumption for 180 days or more was 56.7%. Factors like caste, socioeconomic status of family, education of respondent as well as husband, parity and knowledge about antenatal care, anaemia and IFA consumption were significantly associated with consumption of IFA supplements. Side effects, forgetfulness and lack of knowledge about duration of intake were main reasons for discontinuation. Conclusion: There is a need to generate awareness regarding importance and correct duration of IFA consumption during pregnancy and constant mobilisation and support by health workers is required to increase the compliance
References
1. World Health Organization. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011. p.1 6.
2. World Health Organisation(WHO). WHO Global Database on Anaemia, Nutrition Landscappe Information System. Geneva, Switzerland: World Health Organisation (WHO).
3. Ministry of Health and Family Welfare. National Family Health Survey-4, India Fact Sheet [Internet], International Institute of Population Sciences. Government of India. 2021-22:4 [Cited 2025 Apr 15]. Available at: https://www.data.gov.in/catalog/national-family-health-survey-5-nfhs-5-india-districts-factsheet-data
4. Ministry of Health and Family Welfare. National Family Health Survey-4 State fact sheet Punjab. Mumbai: International institute for population sciences, Mumbai; 2021-22:4. [Cited 2025 Apr 15]. Available at: https://im4change.in/docs/NFHS-5%20Punjab.pdf
5. Ministry of Home affairs. Sample Registration System, Maternal Mortality in India: 1 pdf 997-2003, Trends causes and risk factors. New Delhi: Govt. of India; 2003:17
6. World Health Organization. Attending to 136 million births every year. In: Make every mother and child count WHO Report 2005. Geneva: WHO Publications; 2005: 61-77
7. Centre for Reproductive Rights. Maternal Mortality in India – Using International and Constitutional Law to Promote Accountability and Change. New York: 2008: Centre for Reproductive Rights; 13-14 [Cited 2024 August 5]. Available from:https://reproductiverights.org/sites/default/files/documents/MM_report_FINAL.pdf
8. World Health Organization. Great expectations: making pregnancy safer. In: Make every mother and child count WHO Report 2005. Geneva: WHO Publications; 2005: 41-58
9. Lal S, Adarsh, Pankaj. Population Stabilization: High fertility – Mortality. In: Text Book of Community Medicine. 3rd ed. New Delhi: CBS Publishers; 2011: 87-9
10. Suryanarayana R, Chandrappa M, Santhuram AN, Prathima S, Sheela SR. Prospective study on prevalence of anemia of pregnant women and its outcome: A community based study. J Family Med Prim Care 2017 Oct;6(4):739-43 DOI: https://doi.org/10.4103/jfmpc.jfmpc_33_17
11. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–74.
12. WHO. Daily iron and folic acid supplementation in pregnant women. Geneva, World Health Organization, 2012. [Cited 2024 Dec 27]. Available at: https://www.who.int/publications/i/item/9789241501996
13. Park K. Community nutrition programmes. In: Park's Text book of Preventive and Social Medicine. 25th ed. Jabalpur: M/s Banarsidas Bhanot Publishers; 2019: 717.
14. Gautam CS, Saha L, Sekhri K, Saha PK. Iron deficiency in pregnancy and rationality of iron supplements prescribed during pregnancy. Medscape J Med 2008 Dec;10(12):283.
15. Ministry of Health and Family Welfare. Guidelines for Control of Anaemia- Intensified National Iron Plus Initiative. New Delhi, MoFHW [ Cited 2024 September 15] Availableat: http://nhm.gov.in/images/pdf/programmes/wifs/guidelines/GuidelinesforControlofIronDeficiencyAnaemia.pdf
16. Nivedita K et al. knowledge attitude and practices of pregnant women regarding anaemia, iron rich diet and iron supplements and its impact on their haemoglobin levels. Int J Reprod Contracept Obstet Gynaecol 2016 Feb;5(2:425-31 DOI: https://doi.org/10.18203/2320-1770.ijrcog20160383
17. Debbarma B, Konjengbam S, Elangbam V, Christina S, Akoijam BS. Prevalence of nonadherence to iron and folic acid supplementation among pregnant women in Bishanpur district of Manipur. J Med Soc 2022;36:43-7 DOI: https://doi.org/10.4103/jms.jms_82_21
18. Saputri GZ, Candradewi SF, Hidayati A, Winarti D. The Correlation Between Pregnant Women Knowledge Level, Perception, and Compliance with Ferrous Fumarate Tablet Consumption in a Primary Health Care Institution. Advances in health sciences research. 2021;33:402-7 DOI: https://doi.org/10.2991/ahsr.k.210115.080
19. Vashisht BM, Bhadwaj H, Chauhan M, Anvesha, Jaiprakash, Sociodemographic determinants of iron and folic acid consumption(IFA) by females during their antenatal period delivering in a tertiary care hospital of Haryana. Public Health Rev Int J Public Health Res. 2020 April;7(2):19-25. DOI: https://doi.org/10.17511/ijphr.2020.i02.01
20. Saimaa P, Prakash M, Pandiamunian J, Sabita P, Sivagami K, Basu M. A Mixed-Method Study on Iron-Folic Acid Adherence and its Determinants among Pregnant Women in Puducherry, India. Healthline.2024;15(3): 190-200 DOI: https://doi.org/10.51957/Healthline6462024
21. Singh G, Lal M, Singh S. Utilization of iron folic acid tablets among pregnant women in rural Punjab: an interventional study. Int J Community Med Public Health. 2020 April;7(4):1307-12. DOI: https://doi.org/10.18203/2394-6040.ijcmph20201033
22. Mishra RK, Tiwari K. Knowledge and compliance of Iron and folic acid supplementation among pregnant and postnatal women in a hospital of Kathmandu. Journal of advanced academic research. 2020 June;7(1):63-9. DOI: https://doi.org/10.3126/jaar.v7i1.35468
23. Godara S, Hooda R, Nanda S, Mann S. To study compliance of antenatal women in relation to iron supplementation in routine ante-natal clinic at a Tertiary health care centre. J Drug Deliv Ther 2013 May;3(3):71-5. DOI: https://doi.org/10.22270/jddt.v3i3.520
24. Deori TJ, Ramaswamy G, Jaiswal A, Loganathan V, Kumar R, Mahey R, et al. Compliance with iron folic acid (IFA) tablets and associated factors among pregnant women attending ante‑natal care clinic at Sub District Hospital, Ballabgarh. J Family Med Prim Care 2021 May;10(5):2006-11 DOI: https://doi.org/10.4103/jfmpc.jfmpc_1742_20
25. Asres AW, Hunegnaw WA, Ferede AG, Azene TW. Compliance levels and factors associated with iron folic acid consumption among pregnant women in Dangila, Northern Ethopia: A cross sectional study. SAGE Open Medicine. 2022 July;10:1-8. DOI: https://doi.org/10.1177/20503121221118989
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