Prevalence and determinants of uptake of folic acid in peri-conceptional period in a rural lower-middle-income country, Ghana.

Abstract

Folate is a vitamin B-related substance needed by expectant mothers during the period right before and after conception (peri-conceptional period) to help protect foetuses against neural tube defects (NTDs). Despite efforts to promote the peri-conceptional uptake of folic acid (FA), adherence remains low. The aim of this study was to assess the prevalence and determinants of peri-conceptional FA uptake among childbearing women in northern Ghana. In a cross-sectional study, data from 303 women accessing antenatal care services in the Upper East Region of Ghana between February and July 2017 were collected and analysed in Stata (Version 12.1). Chi-square and logistic regression analysis were used to identify the independent determinants of peri-conceptional uptake of FA. The mean age of the study population was 27.4 (±5.73) years. The prevalence of uptake of peri-conceptional FA was 28.7% (95% confidence interval: 26.7%-34.2%); 66% of the women were aware of FA and 52% had acceptable knowledge about FA. Initiating ANC after 3months of pregnancy was associated with 91% less chance of peri-conceptional FA use [adjusted odds ratio (AOR) 0.09; 95% confidence interval (CI) 0.04-0.22; P<.001]. Not knowing the frequency of dosing of FA was associated with a 58% less likelihood of uptake of peri-conceptional FA (AOR 0.42; 95% CI 0.23-0.76; P=.004). There is low uptake of peri-conceptional FA among women of childbearing age accessing antenatal services in Northern Ghana, and this uptake is determined by the time of initiation of ANC visit and knowledge of dosage regimen of FA.