Abstract
Background The World Health Organization recommended that 80% of communities in all countries should receive the standard dose of iron folic acid. But, in Ethiopia, this target was not yet achieved. The compliance of iron folic acid was also variable across each district. Therefore, the aim of this study was to assess women compliance with iron-folic acid supplementation and its association with a number of antenatal care visits in Ethiopia using systematic review and meta-analysis, 2018. Methods In the current meta-analysis, the target variables were searched from different electronic database system like PubMed, Google Scholar, Science Direct, and Cochrane Library. To predict the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia, all original studies were considered. All necessary data were extracted by using a standardized data extraction format. The data were analyzed by using STATA 14 statistical software. Heterogeneity between the studies was assessed by Cochrane Q and I2 tests. A random effect model was computed to estimate the pooled compliance with iron-folic acid supplementation. Results Twelve full-text studies were included in the meta-analysis. The findings of this meta-analysis revealed that the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia was 43.63% (CI: 28.00, 59.25%). The women from the city administration had a high rate of compliance as compared with other regions of Ethiopia. The odds of having four or more antenatal care visit were the independent pooled predictor of compliance with iron-folic acid supplementation. Conclusion Current compliance with iron-folic supplementation was lower than the World health organization recommendation. Mothers from the city administration who utilized the antenatal care four and above times, had high level compliance with iron-folic acid supplementation. Therefore, we recommended that women should visit the antenatal clinic four times to compliance with the iron folic acid supplementation.
Highlights
Infections, vitamin A, B12, and ribo avin de ciencies as well as blood disorders are the causes for anemia [1]
The World health organization (WHO) guidelines recommend that all women should take the iron and folic acid (IFA) dose for at least 90 days and above during their pregnancy time [12], the present meta-analysis reported that only 43.63% (CI: 28.00, 59.25) of women were in compliance with the iron-folic acid supplementation. e prevalence of IFA supplementation is below the targeted plan of the world health organization
This nding suggested that the prevalence of compliance with IFA supplementation is much higher than the Ethiopia Demographic and Health survey (EDHS) and other sub Saharan countries [46,47,48,49,50,51,52,53,54,55]. e possible explanation for higher rate of compliance with IFA as compared to some sub-Saharan countries could be due to the study site variation in their ndings
Summary
Infections, vitamin A, B12, and ribo avin de ciencies as well as blood disorders are the causes for anemia [1]. E risk factors of iron de ciency anemia are inadequate dietary intake, malabsorption, high demand during pregnancy, and blood loss due to bleeding. De ciencies in iron and folic acid during pregnancy can negatively impact the health of the mother, her pregnancy, as well as fetal development [4]. In this regard, many studies suggested that iron de ciency during pregnancy leads to negative perinatal outcomes, such as low birth weight [5,6,7,8], premature birth [6,7,8,9], and intrauterine growth retardation [6]. E best strategy to prevent anemia related problems is the provision of standard iron and folic acid (IFA) dose at the time of menstruation, pregnancy and adolescent [4, 11]. Weekly provision is indicated when anemia prevalence is at most 20% [11]
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