BMC Pregnancy and Childbirth (Apr 2023)

Individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia: a multi-level analysis

  • Melaku Yalew,
  • Shiferaw Getachew,
  • Keriya Mohammed,
  • Hailu Hankarso,
  • Adane Bayile,
  • Shambel Dessale Asmamaw,
  • Mesfin Getahun Assefa,
  • Getaw Walle Bazie,
  • Wondwosen Mebratu,
  • Bereket Kefale,
  • Yitayish Damtie,
  • Mastewal Arefaynie,
  • Tesfaye Birhane,
  • Reta Dewau,
  • Nigus Cherie,
  • Elsabeth Addisu,
  • Kefale Mitiku,
  • Fentaw Tadese,
  • Teklehaimanot Fentie Wendie,
  • Adane Habtie,
  • Tefera Chane Mekonnen,
  • Sisay Eshete Tadesse,
  • Getachew Tadesse Bedane,
  • Yitbarek Wasihun,
  • Tilahun Degu Tsega,
  • Mekuanint Taddele,
  • Zenebe Tefera,
  • Bezawit Adane,
  • Birhanu Wagaye,
  • Fanos Yeshanew Ayele,
  • Aregash Abebayehu Zerga,
  • Abebaw Molla,
  • Biruk Desalegn,
  • Mengesha Birkie,
  • Bekalu Bewket,
  • Belete Kassa Alemu,
  • Segenet Zewdie,
  • Meseret Kefale Tsegaye,
  • Abebayehu Bitew,
  • Kassu Mehari,
  • Lemma Derseh

DOI
https://doi.org/10.1186/s12884-023-05593-7
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 9

Abstract

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Abstract Background Anemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia. Methods A secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05. Results Those primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy. Conclusions Both individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women’s education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.

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