Factors Associated with Non-use of Antenatal Iron and Folic Acid Supplements among Pakistani Women: A Cross Sectional Household Survey

Abstract

Objectives: To determine the prevalence of use of antenatal iron-folic acid (IFA) supplements, and to identify socio-demographic risk factors for non-use of antenatal IFA supplements. Methods: A cross sectional household cluster sample survey was conducted in 14 districts in Pakistan. Trained female fieldworkers conducted interviews with married women of reproductive age from December 2011 to March 2012. Women with live births in the preceding five years of the survey were selected for this study. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate logistic regression models were constructed to identify the independent factors for non-use of antenatal IFA supplements. Results: Out of 6,266, 2,400 (38.3%, 95% CI: 36.6%, 40.1%) women took antenatal IFA supplements during their last pregnancy. Common sources of supplements were doctors (49.4%) and community health workers (40.3%). The mean (±SD) month of pregnancy at initiation of supplementation was 5.3 (±1.7) months. Living in Dera Ghazi Khan district (Adj OR=1.72), maternal age ≥45 years (Adj OR=2.01), no maternal education (Adj OR=2.33), no paternal education (Adj OR=1.58), belonging to the lowest household wealth index quartile (Adj OR=1.47), and no antenatal care services used (Adj OR=13.44) were risk factors for non-use of antenatal IFA supplements. Conclusions: The coverage of antenatal IFA supplements is low in the surveyed districts of Pakistan, and the lack of parental education, older aged women, belonging to poorest households, residence in Dera Ghazi Khan district and no antenatal care services used were risk factors for non-use of IFA supplements.