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Public Health Nutr. 2008 Jun;11(6):596-605. Epub 2007 Sep 3.

Determinants of compliance with iron supplementation among pregnant women in Senegal.

Author information

  • 1University of Maryland, Department of Nutrition and Food Science, 0112 Skinner Building, College Park, MD 20742, USA. sousso@aol.com

Abstract

BACKGROUND:

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 enrollment through interviews and pill count. Women with low or high compliance (<70% or >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.

PMID:
17764606
[PubMed - indexed for MEDLINE]
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