Compliance with weekly iron folic acid supplementation and associated factors among secondary school adolescent girls, in Jimma Arjo District, West Ethiopia, 2022: A mixed method cross-sectional Study

Debelo Diriba Daba 1, *, Kassahun Tegegne Bidu 2, Sadat Kasim Heyi 2, Dugasa Garoma 3 and Yirga Bieza Assegu 2

1 Food for the Hungry Ethiopia, Western region, Nekemte, Oromia, Ethiopia.
2 Department of Emergency preparedness and response, World Health Organization, Addis Ababa, Ethiopia.
3 Nekemte Health Science College, Nekemte, Oromia, Ethiopia.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(01), 394–408.
Article DOI: 10.30574/wjbphs.2024.20.1.0800
Publication history: 
Received on 06 September 2024; revised on 15 October 2024; accepted on 17 October 2024
 
Abstract: 
Background: Iron deficiency anemia is a prevalent and major public health problem in low- and middle-income countries among adolescent girls. The risk of Iron deficiency anemia and its consequences are prevented by taking and complying with a weekly iron-folic acid supplement.  However, there was no information regarding compliance and its associated factors in Ethiopia. The study aimed to determine the magnitude of compliance with weekly Iron-folic acid supplementation and associated factors among Jimma Arjo secondary school adolescent girls.
Methods: Institutional-based cross-sectional study was conducted on 417 adolescent girls in three secondary schools of Jimma Arjo, West Ethiopia from March 1st to 31st, 2022 using interviewer-administered structured and semi-structured questionnaires. Bivariable and multivariable logistic regression analyses were used to determine the association of variables.
Results: Compliance with iron-folic acid supplementation was 29.3% with 95% CI (24.9, 33.3). Mother`s secondary level of education (AOR=4.94 (95% CI:2.45,9.94)), awareness of anemia (AOR=4.23 (95% CI:2.35,7.61)), good knowledge about iron-folic acid supplementation (AOR=3.96 (95% CI:2.17,7.22)), lack of iron-folic acid supplementation (AOR=0.42 (95% CI:0.23,0.75)), and iron-folic acid supplementation side effects (AOR=0.17 (95% CI:0.08,0.37)) were factors significantly associated with iron-folic acid supplementation compliance. Misconceptions about iron-folic acid supplementation, forgetfulness of tablet, lack of access to drinking water, and irregularity of school weekly iron-folic acid supplementation days were identified as the main barriers to adolescent girls' compliance with iron-folic acid supplementation in a qualitative study.
Conclusions: Weekly iron-folic acid supplementation compliance was low at 29.3%. Scheduled health education, parental participation in the program, access to drinking water, refresher training for school focal persons, and fixed weekly iron-folic acid supplementation days can improve compliance with iron-folic acid supplementation and are recommended.
 
Keywords: 
Compliance; Weekly iron-folic Acid; Supplementation; School adolescent girls
 
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