Uptake of iron and folic acid supplements among pregnant women in Dar es Salaam, Tanzania.

Anemia in pregnancy is a public health concern globally with the highest prevalence observed in low and middle-income countries (LMICs). Tanzania is no exception. Iron and folic acid supplements (IFAS) intake is a proven intervention recommended to prevent anemia in pregnancy. Despite interventions in Tanzania, IFAS uptake has remained low due to reasons that are not well documented. This study aimed to assess the uptake and determinants of IFAS during pregnancy in Dar es Salaam, Tanzania. A quantitative cross-sectional study was conducted to assess levels and determinants of IFAS uptake during pregnancy in Dar es Salaam, Tanzania. Data was collected among 428 women post-delivery in postnatal wards of Temeke, Mwananyamala, and Amana regional referral hospitals. Descriptive analyses were conducted to determine levels and characteristics of IFAS uptake, whereas bivariate and multivariate analyses were conducted to examine determinants of uptake using SPSS version 23. Among the study participants, only 136 (31.8%) pregnant women who attended antenatal care (ANC) at referral hospitals had adequate IFAS uptake. Primiparous women were 74% less likely to achieve adequate IFAS uptake compared to multiparous women (aOR=0.26; 95% CI: 0.10 – 0.67). Women who attended five or more ANC visits (aOR=11.7; 95%CI: 1.30 – 63.66) and those from wealthier households (aOR=11.68; 95% CI: 2.91 – 89.57) were about 12 times more likely to achieve adequate IFAS uptake. Similarly, women from food-secure households had a ninefold higher likelihood of adequate uptake compared to those from severely food-insecure households (aOR=9.21; 95% CI: 1.82 – 10.33). Only one in three pregnant women attending regional referral hospitals in Dar es Salaam achieved adequate IFAS uptake to prevent anemia. Targeted interventions are urgently needed, particularly among pregnant women with higher parity, fewer ANC visits, and those facing economic hardship, food insecurity, and challenging family support.

Adherence to Iron and Folic Acid Supplementation (IFAS) intake among pregnant women: A systematic review meta-analysis

BackgroundIron and Folic Acid Supplementation (IFAS) is recommended by World Health Organization as part of antenatal care to prevent anaemia in pregnancy. In 2010, Kenya adopted this recommendation and the current policy is to provide one combined IFAS tablet for daily use throughout pregnancy, free of charge, in all public health facilities. However, adherence remains low over the years though anaemia in pregnancy remains high. Integration of IFAS into community-based interventions has been recommended because of its excellent outcome. Using Community Health Volunteers (CHVs) to distribute IFAS has not been implemented in Kenya before.MethodsFollowing an intervention study implementing a community-based approach for IFAS in five public health facilities in Lari Sub-County, 19 interviews were conducted among CHVs, nurses and pregnant women participating to describe their experiences. Thematic analysis of data was done using NVivo and findings described, with use of quotes.FindingsThe nurses, CHVs and pregnant women were all positive and supportive of community-based approach for IFAS. They reported increased access and utilization of both IFAS and antenatal services leading to perceived reduction in anaemia and better pregnancy outcomes. Counselling provided by CHVs improved IFAS knowledge among pregnant women and consequent adherence. The increased IFAS utilization led to main challenge experienced being IFAS stock-outs. All participants recommended complementing antenatal IFAS distribution approach with community-based approach for IFAS.ConclusionUsing CHVs to implement a community-based approach for IFAS was successful and increased supplement awareness and utilization. However, the role of CHVs in IFAS programme implementation is not clearly defined in current policy and their potential in IFAS education and distribution is not fully utilized. All participants endorsed integration of community-based approach for IFAS into the antenatal approach to enhance IFAS coverage and adherence among pregnant women for better pregnancy outcomes.

BackgroundMacro and micronutrients including iron and folic acid deficiencies are prevalent in Kenya, particularly during pregnancy resulting in anaemia. Despite efforts to control anaemia in pregnancy by adopting Iron and Folic Acid Supplementation (IFAS), this public health problem has persisted contributing to significant morbidity and mortality. The problem notwithstanding, there is poor IFAS compliance, whose reasons remain poorly understood, calling for their investigations. We sought to determine compliance status with IFAS and associated factors among pregnant women.MethodsThis was a cross-sectional study involving 364 pregnant women aged 15–49 years. Using two stage cluster sampling, one Sub-County and five public health facilities in Kiambu County were selected. All pregnant women attending antenatal clinics who met inclusion criteria and consented to participate in the study were recruited. Compliance with IFAS was defined as taking supplements at least 5 out of 7 days per week. A structured interviewer-administered questionnaire consisting of sociodemographic data, IFAS maternal knowledge and compliance practices was pretested and administered. Descriptive and inferential statistics were computed using STATA.ResultsOf the 364 respondents interviewed, 32.7% were IFAS compliant and 40.9% scored high on its knowledge. Of those with high IFAS knowledge, 48.3% were compliant compared to those with low knowledge (21.4%, n = 46, PR = 2.25;95%CI = 1.59–3.17, p < 0.001). Women who were multigravid (30.4%) were less likely to comply compared to primigravid (37.2%, n = 45, PR = 0.68;95%CI = 0.47–0.99, p = 0.004). Multivariate analysis revealed that respondents counselled on management of IFAS side effects (100%, n = 4) were more compliant (76.2%, n = 112, aPR = 1.31;95%CI = 1.19–1.44, p < 0.001).ConclusionFew pregnant women were compliant with IFAS regimen, associated with: knowledgeability on IFAS, primi-gravidity, and IFAS counselling especially on management of its side effects. These underscore the need for approaches to scale up health awareness on the benefits of IFAS, mitigation measures for the side effects, as well as targeted counselling.

Background: The increased demand for iron and folic acid during pregnancy is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: IFAS knowledge, availability, practices, and content of IFAS counselling among pregnant women attending health facilities in Kiambu County, Kenya. Methods: A cross-sectional study involving 364 pregnant women aged 15-49 years. A two stage cluster sampling, including one sub-county and five public health facilities were used. A pre-tested, structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed. Results: Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents. Conclusion: Less than half of the pregnant women had high IFAS knowledge, IFAS documents were scarce in health facilities, IFAS counselling information in different health facilities was limited and varied, and content of counselling was associated with levels of knowledge on IFAS. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women and standardization of counselling messages to improve compliance and pregnancy outcomes.

Background: The increased demand for iron and folic acid during pregnancy is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: IFAS knowledge, availability, practices, and content of IFAS counselling among pregnant women attending health facilities in Kiambu County, Kenya. Methods: A cross-sectional study involving 364 pregnant women aged 15-49 years. A two stage cluster sampling, including one sub-county and five public health facilities were used. A pre-tested, structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed. Results: Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents. Conclusion: Less than half of the pregnant women had high IFAS knowledge, IFAS documents were scarce in health facilities, IFAS counselling information in different health facilities was limited and varied, and content of counselling was associated with levels of knowledge on IFAS. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women and standardization of counselling messages to improve compliance and pregnancy outcomes.

Background: The increased demand for iron and folic acid during pregnancy is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: IFAS knowledge, availability, practices, and content of IFAS counselling among pregnant women attending health facilities in Kiambu County, Kenya. Methods: A cross-sectional study involving 364 pregnant women aged 15-49 years. A two stage cluster sampling, including one sub-county and five public health facilities were used. A pre-tested structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed. Results: Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents. Conclusion: Less than half of the pregnant women had high IFAS knowledge, IFAS documents were scarce in health facilities, IFAS counselling information in different health facilities was limited and varied and content of counselling was associated with levels of knowledge on IFAS. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women and standardization of counselling messages to improve compliance and pregnancy outcomes.

Background: Daily iron and folic acid supplementation (IFAS) during pregnancy reduces the risk of all types of maternal anaemia and iron deficiency anaemia at term; despite the WHO recommendations, pregnant women are still vulnerable because the use of Iron and Folic Acid Supplementation is still low in many countries including Tanzania. Therefore, the study aims to comprehensively understand the prevalence and factors associated with non-adherence to Iron and Folic Acid Supplementation among pregnant women attending Antenatal Care at Mwembeladu Hospital. Achieving this objective will contribute to developing effective strategies to improve IFAS adherence. Methodology: The study was cross-sectional and ANC-based, using questionnaires. Questionnaires were distributed to the 260 pregnant women attending ANC at Mwembeladu Hospital. Data were analyzed using SPSS computer software version 22. Results: Our study showed that 52.7% had more than 4 ANC visits. Based on self-reported adherence, about (61.9%) of pregnant women were taking IFAS supplementation, and (38.1%) were not taking IFAS completely. Among those taking IFAS, (60.2%) out of 161 pregnant women were taking four tablets per week as recommended by WHO, and (39.8%) out of 161 were not following the WHO recommendations. Therefore, out of 260, zero adherence was 38.1%, poor adherence was 24.6%, and good adherence was 37.3%. Hence, 62.7% were non-adherent to IFAS supplementation as recommended by WHO. Also, the result showed that the major factors militating against pregnant women taking IFAS are lack of knowledge of IFAS (22.1%), side effects of IFAS (19%), forgetfulness (18.4%), and lack of understanding of anaemia (12.3%). Conclusion: Overall, the adherence to IFAS among pregnant women was low and did not meet the WHO recommendations for preventing and treating anaemia during pregnancy. Socio-demographic factors, including occupation and education level, maternal characteristics, parity, and gestation age, are not significantly associated with adherence to IFAS. Factors associated with poor adherence to IFAS include side effects, failure to access IFAS, forgetfulness, and knowledge about anaemia and IFAS. Healthcare facilities and providers should strengthen the system to create community awareness of IFAS, its benefits, and side effects, as this will help increase adherence to IFAS among pregnant women.

Background:The demand for iron and folic acid, is greatly increased during pregnancy. The high demand is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: availability, practices, and content of IFAS counselling on knowledge of antenatal mothers attending health facilities in Kiambu County, Kenya.Methods:A cross-sectional study involving 364 pregnant women aged 15-49 years attending antenatal clinic. A two stage cluster sampling, including one sub-county and five public primary health facilities were used. A pre-tested structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed.Results:Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p &lt;0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents.Conclusion:Content of counselling substantially contributed to high level of knowledge on IFAS among pregnant women. Counselling information on the duration of IFAS supplementation, IFAS side effects, and their management are the predictors of IFAS knowledge among pregnant women. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women to improve compliance and pregnancy outcomes.

Background: Anemia is a significant public healthcare challenge. It is prevalent, particularly among pregnant women, and leads to many complications among mothers and newborn children. According to NFHS 5, compliance with consumption of oral iron and folic acid supplementation (IFAS) in Wardha is 50%, hence, there is a need for in-depth exploration of sociocultural factors impacting pregnant women’s adherence to oral iron and folic acid supplementation (IFAS). The proposed research will investigate pregnant women’s oral iron and folic acid supplementation (IFAS) compliance and identify factors affecting the availability, compliance, and intake of oral iron and folic acid supplementation (IFAS) and iron-rich foods. Subject and Methods: The study design will be a community-based mixed-method study conducted in randomly selected primary health centers in the Wardha district. Inferential statistics and regression analysis will be used for quantitative and qualitative data through thematic analysis. R Studio version 4.1.2 shall be used for statistical data analysis. Frequency and proportions of quantitative data must be recorded; thematic analysis of qualitative data must be completed; and inferential statistics such as logistic regression analysis must be performed for conformity evaluation. Results: The expected outcome of the study is the compliance rate of oral iron and folic acid (IFAS) and various determinants affecting the adherence rate and availability and compliance of oral iron and folic acid supplementations. Conclusions: The study will assess compliance in regards to oral iron and folic acid supplementation among pregnant women and participants and stakeholder perceptions of oral iron and folic acid (IFAS) and determinants of compliance through qualitative inquiry, the findings shall help to inform stakeholders for corrective measures and improved MCH outcomes.

Anemia is one of the world's leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was conducted very carefully in order to give up the pooled compliance of Iron and Folic-Acid Supplementation in Sub-Saharan Africa. To conduct this brief systematic review and meta-analysis, a related literature search was done from different sources, PubMed Medline and Google Scholar Journals. Then IFA Supplementation related searching engine was used to make the work more meaningful and intensive. Moreover, we used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to assess the quality of the study in terms of their inclusion. Then, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to carry out the work in a carful manner. Finally, the pooled effect size was computed using the review manager and Compressive Meta-analysis software. Twenty-three studies, which encompassed 24272 pregnant women, were chosen for the analysis. From those an overall prevalence of compliance with Iron and Folic Acid Supplementation (IFAS) in pregnancy in SSA was 39.2%. However, the result from meta-analysis showed that women who were counseled on IFAS in their courses of pregnancy were 1.96 times more likely to adhere to IFAS compared to those who were not counseled [OR:1.96, 95% CI (1.76-,5.93)]. Moreover, it showed that women who had knowledge of IFAS were 2.71 times more likely to have compliance with IFAS as compared to those who had no knowledge of IFAS [OR:2.71, 95% CI (1.33,5.54)]. Also it revealed that those women who had knowledge of anemia were 5.42 times more likely to have compliance with IFAS as compared with those who had no knowledge of anemia [OR5.42, 95% CI (1.52, 19.43)]. Furthermore, women who had received fourth visit for ANC were 1.54 times more likely to have compliance with IFAS as compared to those who had not received for ANC [OR 1.54, 95% CI (0.66, 3.58.43)]. Our finding from this systematic review and meta-analysis shows the low case in prevalence of compliance to IFAS among pregnant women in SSA. Predictors for this includes: knowledge about anemia, knowledge about IFAS, counseling on IFAS and receiving fourth antenatal care visit were statistically correlated positively with compliance to IFAS. This demands careful appraisal of effect of prevention work for functioning policy, programs and plan nutrition intrusions for refining maternal dietary intake in gestation. Also dietary education intrusion requires to be planned to satisfy the needs of pregnant women. So we hope that the result of this study might be essential as a bridging stone for policy makers of Africa; exclusively for maternal and child health care. Finally, we recommended further studies to be conducted in the area of the study for more intensive and detailed suggestions.

BackgroundAnemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was conducted very carefully in order to give up the pooled compliance of Iron and Folic-Acid Supplementation in Sub-Saharan Africa.MethodsTo conduct this brief systematic review and meta-analysis, a related literature search was done from different sources, PubMed Medline and Google Scholar Journals. Then IFA Supplementation related searching engine was used to make the work more meaningful and intensive. Moreover, we used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to assess the quality of the study in terms of their inclusion. Then, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to carry out the work in a carful manner. Finally, the pooled effect size was computed using the review manager and Compressive Meta-analysis software.ResultsTwenty-three studies, which encompassed 24272 pregnant women, were chosen for the analysis. From those an overall prevalence of compliance with Iron and Folic Acid Supplementation (IFAS) in pregnancy in SSA was 39.2%. However, the result from meta-analysis showed that women who were counseled on IFAS in their courses of pregnancy were 1.96 times more likely to adhere to IFAS compared to those who were not counseled [OR:1.96, 95% CI (1.76-,5.93)]. Moreover, it showed that women who had knowledge of IFAS were 2.71 times more likely to have compliance with IFAS as compared to those who had no knowledge of IFAS [OR:2.71, 95% CI (1.33,5.54)]. Also it revealed that those women who had knowledge of anemia were 5.42 times more likely to have compliance with IFAS as compared with those who had no knowledge of anemia [OR5.42, 95% CI (1.52, 19.43)]. Furthermore, women who had received fourth visit for ANC were 1.54 times more likely to have compliance with IFAS as compared to those who had not received for ANC [OR 1.54, 95% CI (0.66, 3.58.43)].ConclusionsOur finding from this systematic review and meta-analysis shows the low case in prevalence of compliance to IFAS among pregnant women in SSA. Predictors for this includes: knowledge about anemia, knowledge about IFAS, counseling on IFAS and receiving fourth antenatal care visit were statistically correlated positively with compliance to IFAS. This demands careful appraisal of effect of prevention work for functioning policy, programs and plan nutrition intrusions for refining maternal dietary intake in gestation. Also dietary education intrusion requires to be planned to satisfy the needs of pregnant women. So we hope that the result of this study might be essential as a bridging stone for policy makers of Africa; exclusively for maternal and child health care. Finally, we recommended further studies to be conducted in the area of the study for more intensive and detailed suggestions.

PurposeThe World Health Organization advocates that all pregnant women in areas where anemia is prevalent receive supplements of iron and folic acid. However, owing to a myriad of factors, the uptake of iron and folic acid supplementation (IFAS) is still low in many countries. Therefore, this study was conducted to assess the prevalence of IFAS and its associated factors among pregnant women.Patients and MethodsA cross-sectional study was conducted at a hospital in Muntinlupa, Philippines, between March and August 2019 among 280 pregnant women. A systematic random sampling technique was used to select participants. Data were collected using interviewer-administered questionnaires. Multivariable logistic regression analyses were employed to identify factors associated with the prevalence of IFAS among pregnant women.ResultsAmong 280 pregnant women, a majority (85.6%, n= 238) took IFAS during pregnancy. Among the respondents, 128 (45.9%) women had knowledge about signs and symptoms of anemia, 126 (45.3%) had knowledge of the benefits associated with IFAS, and 42 (15.4%) had knowledge about side effects associated with IFAS. The main sources of information about IFAS were health care providers (41.8%), followed by community health workers (CHWs) (14.6%). Maternal knowledge concerning IFAS benefits (OR = 2.50, CI = 1.04–5.97, p=0.04) was positively associated with the prevalence of IFAS.ConclusionMaternal knowledge about the benefits of taking IFAS was significantly associated with the prevalence of IFAS among pregnant women in Muntinlupa, Philippines. There is a pressing need to improve health education on the benefits of IFAS among pregnant women to increase its prevalence. This emphasizes the necessity of increased involvement of health care providers and CHWs to increase women’s knowledge of IFAS benefits and support them through pregnancy.

The prevalence of anemia among pregnant women remains high globally, particularly in low-income settings. Iron and folic acid supplementation (IFAS) during pregnancy is the most widely employed strategy to alleviate adverse pregnancy outcomes. This study aimed to explore the determinants of compliance with iron supplementation in the study area. To identify determinants of IFAS compliance among pregnant women attending antenatal care (ANC) in Mettu town, South West Ethiopia, in 2021. A facility-based, unmatched case-control study was conducted from May to July 2021 with a total sample size of 344 (115 cases and 229 controls). Cases and controls were selected using systematic random sampling. Data was collected using a structured, pretested interviewer-administered questionnaire, entered into Epi-data software version 3.1, and exported to SPSS version 23 for analysis. Variables with p < 0.25 during bivariate analyses were entered into a multivariable logistic regression model. Then, variables with a p < 0.05 at 95% confidence interval (CI) were declared to be statistically significant determinants of IFAS. The odds ratio was used to indicate the strength of the association. Having Previous history of anaemia (adjusted odds ratio [AOR] = 5.8, 95% CI [2.5-13.6], p < 0.01), having good knowledge about IFAS (AOR = 3.3, 95% CI [1.7-6.7], p < 0.001), being a government employee (AOR = 5.2 [2.4-11.5], p < 0.01], and receiving counseling service during ANC (2.495% CI [1.3-4.7] p < 0.01) were among determinants of adherence to IFAS. Maternal knowledge about IFAS, counseling about IFAS, occupation, and history of anaemia were found to be significantly associated factors with compliance with iron folate supplementation during pregnancy. This implies that adherence to IFAS can be improved through improving maternal knowledge about importance of IFAS, quality counseling services and strengthening an overall ANC follow-up services.

Objective: To determine the effectiveness of public health education on the uptake of iron and folic acid supplements (IFAS) among pregnant women. Design: A stepped wedge cluster randomized trial. Setting: 12 antenatal care clinics (ANC) in Embu County - Kenya. The clinics are outpatient departments in health facilities dedicated to providing care for pregnant women. Participants: Pregnant women receiving antenatal care services in the study sites. Intervention: After a baseline observational phase, a multifaceted intervention bundle was implemented. The intervention included a 60-minute IFAS information session for health workers at the start of intervention. Health workers then provided daily IFAS literacy sessions to all the pregnant women and issued them with IFAS related information materials (a pill reminder card, and a personalized calendar). The study team conducted biweekly facility audits for quality assurance. The total duration of the study was 8 months, starting June 2022. Primary outcome: The primary outcome was the proportion of pregnant women taking IFAS daily in the intervention phase compared with control phase. This was measured through IFAS residual pill count during every ANC visit. Results: A total of 4,749 ANC visits were monitored for 2,132 women receiving antenatal care in the 12 clinics. Participant characteristics were similar across control and intervention phases. The uptake of IFAS significantly improved from 44.8% (95% CI 34.7 to 55.0) in control phase to 83.3% (95% CI 75.9 to 90.9) during the intervention. This translates to a 38.5 (95% CI 26.0 to 51.1) percentage points improvement. The number needed to treat (NNT) for this intervention was 3 patients (95% CI 2 to 4). Conclusion: IFAS uptake significantly improved following the intervention. The findings support public health education as an effective strategy for improving the uptake of IFAS in ANC settings.