Compliance with Iron and folic acid supplementation (IFAS) and associated factors among pregnant women: results from a cross-sectional study in Kiambu County, Kenya

Cross-sectional study of 364 pregnant women aged 16-47 years in Kiambu County, Kenya; two-stage cluster sampling identifying one sub-County and five public health facilities; participants attending antenatal clinics and providing consent; data collected via structured interviewer-administered questionnaire assessing socio-demographic data, IFAS knowledge, and current practices; analysis used descriptive statistics and a Poisson regression with a log link to estimate adjusted prevalence ratios, accounting for clustering.

Iron and folic acid supplements; duration: during pregnancy; taken orally; dosage not specified.

IFAS compliance was 32.7%. Higher compliance correlated with higher IFAS knowledge (48.3% vs 21.4%; PR 2.25). Primigravidity associated with higher compliance than multigravidity (37.2% vs 30.4%; PR 0.68). Counseling on management of IFAS side effects was linked to higher compliance (aPR 1.31). Conclusion: Compliance with IFAS is low; improving knowledge, side-effect management counselling, and targeting first-time pregnancies may increase adherence and help reduce anemia risk during pregnancy.

7-day compliance period may not reflect long-term adherence; reliance on self-reported data may introduce recall bias; cross-sectional design precludes causal inferences; conducted in a single sub-county, limiting generalizability; relatively small sample from one site.