Compliance of iron and folic acid supplementation and status of anaemia during pregnancy in the Eastern Terai of Nepal: findings from hospital based cross sectional study

Hospital-based analytical cross-sectional study conducted between August and February 2016 at three zonal hospitals (Mechi, Koshi, Sagarmatha) and two district hospitals (Sunsari and Siraha) in Eastern Terai, Nepal. Participants were postpartum mothers (within 7 days of delivery); mean age 23 years. Sample size: 328. Data collected via face-to-face interviews and medical records; fixed proportionate sampling to enroll participants; simple random sampling from postpartum registers; binary logistic regression used; ethical approval obtained.

Iron and folic acid supplementation during pregnancy; compliance defined as taking at least 144 of 180 tablets (≥80% of the recommended dose) or an equivalent capsule/liquid dose; duration: during pregnancy.

Results: IFA compliance during pregnancy was 58%; 42% of postpartum mothers were anaemic. Anemia was 24.2 times more likely among IFA noncompliant women (aOR 24.2, 95% CI 10.1–58.3). Anemia was three times less likely among those taking foods rich in heme iron (aOR 3.3, 95% CI 1.4–8.1). Conclusions: To combat anaemia during pregnancy in Eastern Terai, strengthen the IFA supplementation program, promote dietary intake of heme-iron rich foods, and consider broader micronutrient interventions and food fortification to reduce anemia in pregnancy in this region.

Recall bias due to self-reported data; hospital-based sample; findings may not generalize to community or primary health centers.