Skip to main content
×
Home

Determinants of compliance with iron supplementation among pregnant women in Senegal

  • Binetou C Seck (a1) and Robert T Jackson (a1)
Abstract
AbstractBackground

Community iron supplementation programmes for pregnant women have lacked effectiveness, partly because of low compliance.

Objective

To determine factors that influence compliance among pregnant women in Senegal.

Design

Two hundred and twenty-one pregnant women, recruited from six health centres in Dakar during their first prenatal visit, were randomly assigned to receive either a prescription to purchase iron/folic acid tablets (control, n = 112) to be taken daily, according to official policy, or to receive free tablets (treatment, n = 109). Compliance was assessed 20 weeks after enrolment through interviews and pill count. Women with low or high compliance (<70% or ≥70%) were asked to explain what influenced their adherence to supplementation.

Results

Overall compliance was 69%; it was significantly higher in the treatment than in the control group (86% vs. 48%; P < 0.0001). Women with high compliance (58%) were motivated by: (1) the perception of improved health upon taking the tablets (treatment = 24%, control = 10%); (2) the insistence by midwives that they take the tablets; and (3) the mention that the tablets would improve health. Women with low compliance (42%) reported: (1) the experience of side-effects that they associated with the tablets (treatment = 13%, control = 14%); (2) misunderstanding that they needed to continue taking the tablets throughout pregnancy (treatment = 0%, control = 18%); and (3) forgetfulness.

Conclusion

Compliance with iron/folic acid supplementation in Senegal can be increased by providing women with clear instructions about tablet intake and educating them on the health benefits of the tablets.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Determinants of compliance with iron supplementation among pregnant women in Senegal
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Determinants of compliance with iron supplementation among pregnant women in Senegal
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Determinants of compliance with iron supplementation among pregnant women in Senegal
      Available formats
      ×
Copyright
Corresponding author
Corresponding author: Email sousso@aol.com
References
Hide All
1World Health Organization (WHO). The Prevalence of Anemia in Women: A Tabulation of Available Information, 2nd ed. WHO/MCH/MSM 92.2. Geneva: WHO, 1992.
2United Nations Children’s Fund/World Health Organization (WHO). Prevention and Control of Iron Deficiency Anemia in Women and Children. Geneva: WHO, 1999.
3 Canadian International Development Agency. MICAH Phase 1 Results: 1995–01 [online]. Available at http://www.worldvision.ca/home/articles/International_Programs/MicahReportEnglish.pdf. Accessed July 2004.
4Ndiaye O, Mbaye A, Diouf L, Sow H, Sylla A, Kuakuvin N, Fall M. Risk factors of low birth weight newborn: influence of maternal age, parity, gestation, nutritional status, and maternal pathology. Dakar Medical 1998; 43: 188190.
5 Seck B. Prevalence and determinants of anemia in pregnant women in Dakar, Senegal. Masters thesis, University of Maryland, College Park, MD, 2002.
6Rasmussen KM. Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? Journal of Nutrition 2001; 131 (Suppl.): 590S603S.
7Cogswell ME, Parvanta I, Ickes L, Yip R, Brittenham GM. Iron supplementation during pregnancy, anemia, and birth weight: a randomized controlled trial. American Journal of Clinical Nutrition 2003; 78: 773781.
8Scholl TO. Iron status during pregnancy: setting the stage for mother and infant. American Journal of Clinical Nutrition 2005; 81 (Suppl.): 1218S1222S.
9Yip R. Iron supplementation: country level experiences and lessons learned. Journal of Nutrition 2002; 132 (Suppl.): 859S861S.
10Sloan NL, Jordan E, Winikoff B. Effects of iron supplementation on maternal hematologic status in pregnancy. American Journal of Public Health 2002; 92: 288293.
11Oluwatoyin E. Community attitudes to pregnancy, anemia, iron and folate supplementation in urban and rural Lagos, south-western Nigeria. Midwifery 2000; 16: 8995.
12Galloway R, McGuire J. Determinants of compliance with iron supplementation; supplies, side effects, or psychology? Social Science & Medicine 1994; 39: 381390.
13Galloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, et al. Women’s perceptions of iron deficiency and anemia prevention and control in eight developing countries. Social Science & Medicine 2002; 55: 529544.
14Jackson RT, Jackson LC. Biological and behavioral contributors to anemia during pregnancy in Liberia, West Africa. Human Biology 1987; 59: 585597.
15Macro International Inc. Enquête Démographique et de Santé au Sénégal (EDS-VI). Demographic and Health Surveys. Calverton, MD: Macro International Inc., 2005.
16 Ministere de la Sante Publique et de l’Action Sociale. Plan National de Développement Sanitaire et Social du Senegal (1998–2007) [online], 2007. Available at http://www.sante.gouv.sn/politiquesanitaire.php. Accessed February 2007.
17Stoltzfus R, Dreyfuss ML. Guidelines for the Use of Iron Supplementation to Prevent and Treat Iron Deficiency Anemia. Washington, DC: International Nutritional Anemia Consultative Group/International Life Sciences Institute, 2000.
18Centers for Disease Control and Prevention. CDC criteria for anemia in children and childbearing aged women. Morbidity and Mortality Weekly Report 1989; 38: 400404.
19World Health Organization (WHO). Iron Deficiency Anaemia: Assessment, Prevention, and Control – A Guide for Program Managers. WHO/NHD/01.3. Geneva: WHO, 2001.
20Flowers CH, Kuizon M, Beard JL, Skikne BS, Covell AM, Cook JD. A serum ferritin assay for prevalence studies of iron deficiency. American Journal of Hematology 1986; 23: 141151.
21Dairo MD, Lawovin TO. Demographic factors determining compliance to iron supplementation in pregnancy in Oyo State, Nigeria. Nigerian Journal of Medicine 2006; 15: 241244.
22Carre N, Eono P, Kouakou K, Duponchel JL, Marquis M, Zahui KH. Iron supplementation associated with malaria prevention among pregnant women in Abidjan. Revue d’Épidemiologie et de Santé Publique 2003; 51: 3138.
23Young MW, Lupafva E, Kapenda E, Bobrow EA. The effectiveness of weekly iron supplementation in pregnant women of rural northern Malawi. Tropical Doctor 2000; 30: 8488.
24Ekstrom EC, Kavishe FP, Habitcht JP, Frongillo EA, Rasmussen KM, Hemed L. Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematological consequences. American Journal of Clinical Nutrition 1996; 64: 368374.
25Aguayo VM, Kone D, Bamba SI, Diallo B, Sidibe Y, Traore D, et al. Acceptability of multiple micronutrient supplements by pregnant and lactating women in Mali. Public Health Nutrition 2005; 8: 3337.
26Hyder SM, Persson LA, Chowdhury AMR, Ekstrom EC. Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly-dose regimens in pregnancy. Journal of Health, Population, and Nutrition 2002; 20: 175179.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 28
Total number of PDF views: 381 *
Loading metrics...

Abstract views

Total abstract views: 410 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 18th November 2017. This data will be updated every 24 hours.