Coverage of and compliance to iron supplementation under the National Iron Plus Initiative among reproductive age-group women in urban Puducherry - a cross-sectional study.

Abstract

Anaemia is a global health problem and an important cause of morbidity in all age groups, especially among women and children. Various programmes have been implemented to combat anaemia in India and National Iron Plus Initiative (NIPI) is the latest programme to be implemented. To ascertain the proportion of reproductive age women receiving iron supplementation under the NIPI and assess the compliance and factors hindering the implementation and compliance of the programme. A cross-sectional study was conducted among women of reproductive age (15-49 years) during November 2017. The participants were interviewed at their household using a pre-tested semi-structured questionnaire to obtain information on socio-demographic details, whether they were receiving iron supplements and compliance to the programme. Out of 302 study participants, only 138 (45.7%) were found to be receiving the supplements under the NIPI. The major source of iron supplementation was various health facilities (69.4%). Of those not receiving the tablets, 96.3% were non-pregnant non-lactating women. The proportion of study participants receiving iron supplementation through house visits by auxiliary nurse mid-wives (ANMs) was only 1.45%. Of the 138 women receiving supplementation, 85 (61%) were compliant with their medication. Compliance also tended to be higher among pregnant and lactating women. The most important reasons for non-compliance were adverse effects and forgetfulness. The presence of regular house visits by ANMs had a significant association with reception of tablets [prevalence ratio (PR)-1.43]. Pregnant women had a significant association with both reception (PR-2.19) and compliance (PR-1.8) with iron supplementation. The current NIPI programme needs to be regularly evaluated to ensure its effective implementation. Importance should be given to non-pregnant non-lactating women to increase coverage among them.