Low Compliance with Iron-Folate Supplementation Among Postpartum Mothers of Nepal: An Analysis of Nepal Demographic and Health Survey 2011
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One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7 % consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95 % CI (2.268–4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95 % CI (5.552–15.938)]; lived in Far-western development region [aOR 1.822; 95 % CI (1.387–2.395)]; delivered in health facility [aOR 1.335; 95 % CI (1.057–1.687)]; and attended postnatal care [aOR 2.348; 95 % CI (1.859–2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.
KeywordsAnaemia Cross sectional survey Iron deficiency Nepal Postpartum period
- 1.Balarajan, Y., Ramakrishnan, U., Özaltin, E., Shankar, A., & Subramanian, S. (2011). Anaemia in low-income and middle-income countries. Lancet. doi: 10.1016/S0140-6736(10)62304-5.
- 2.Bennett, L., Dahal, D., & Govindasamy, P. (2008). Caste, ethnic and regional identity in Nepal: Further analysis of the 2006 Nepal Demographic and Health Survey. Calverton: Macro International Inc.Google Scholar
- 3.Casey, G., Phuc, T., MacGregor, L., Montresor, A., Mihrshahi, S., Thach, T., & Biggs, B. (2009). A free weekly iron-folic acid supplementation and regular deworming program is associated with improved hemoglobinic and iron status indicators in Vietnamese women. BMC Public Health, 9(26). doi: 10.1186/1471-2458-9-261.
- 5.Child Health Division, and Ministry of Health and Population. (2004). National Nutrition Policy and Strategy. Kathmandu: Child Health Division, and Ministry of Health and Population.Google Scholar
- 6.Christian, P., Stewart, C., LeClerq, S., Wu, L., Katz, J., West, K., & Khatry, S. (2009). Antenatal and postnatal iron supplementation and childhood mortality in rural Nepal: A prospective follow-up in a randomized controlled community trial. American Journal of Epidemiology, 170(90). doi: 10.1093/aje/kwp253.
- 8.Doku, D., Subas Neupane, S., & Doku, P. (2012). Factors associated with reproductive health care utilization among Ghanaian women. BMC International Health and Human Rights, 12(29). doi: 10.1186/1472-698X-12-29.
- 9.Horton, S., & Ross, J. (2003). Food Policy. The economics of iron deficiency, 28(1), 51–75.Google Scholar
- 11.Khanal, V., Adhikari, A., & Karkee, R. (2013). Social determinants of poor knowledge on HIV among Nepalese males: Findings from National Survey 2011. Journal of Community Health, In print. doi: 10.1007/s10900-013-9727-4.
- 12.Khanal, V., & Sauer, K. (2013). Determinants of the introduction of prelatical feeds in rural Nepal: A cross-sectional community-based study. Breastfeed Med, 8(3), 336–339.Google Scholar
- 14.Ministry of Health and Population. (2011). Annual report 2010/2011.Google Scholar
- 15.Ministry of Health and Population (MOHP) [Nepal], New ERA, & ICF International Inc. (2012). Nepal Demographic and Health Survey 2011 Kathmandu, Nepal: Ministry of Health and Population, New ERA, and ICF International. Maryland: Calverton.Google Scholar
- 16.Neupane, S., & Teye Doku, D. (2011). Determinants of time of start of prenatal care and number of prenatal care visits during pregnancy among Nepalese women. Journal of Community Health. doi: 10.1007/s10900-011-9521-0.
- 17.Rutstein, O., & Rojas, G. (2012). Guide to DHS statistics. Maryland: Measure DHS.Google Scholar
- 18.Simkhada, B., Porter, M., & Teijlingen, E. (2010). The role of mothers-in-law in antenatal care decision-making in Nepal: A qualitative study. BMC Pregnancy and Childbirth, 10(34). doi: doi: 10.1186/1471-2393-10-34.
- 19.WHO. (2001). Iron deficiency anemia—assessment, prevention and control. A guide for programme managers WHO/NHD/01.3. Genva.Google Scholar
- 20.WHO. (2006). Iron and folate supplementation integrated management of pregnancy and childbirth. Geneva: WHO.Google Scholar
- 21.Yakoob, M., & Bhutta, Z. (2011). Effect of routine iron supplementation with or without folic acid on anemia during pregnancy. BMC Public Health, 11(Suppl 3). doi: 10.1186/1471-2458-11-S3-S21.