Could Self-report a valid method to measure adherence to iron folic acid supplementation among pregnant women attending antenatal care service in Addis Ababa, Ethiopia
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Date
2019-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Iron folic acid supplementation during pregnancy is one of the major
intervention given for pregnant women to alleviate the risk of anemia. According to WHO
2012 report anemia prevalence among pregnant women is highest in Africa including
Ethiopia. The major problem with increased prevalence of anemia during pregnancy is
noncompliance as the women fails to take their pills properly.
Objective: Aimed to validate self report to measure adherence to iron folic acid
supplementation among ante-natal care attending pregnant women in Addis Ababa Ethiopia.
Methods: Longitudinal was employed among 361 pregnant women in Addis Ababa from
March to July 2019. A multi-stage random sampling procedure was employed. The study
participants was prospectively observed over three months using pill count and self report
methods. Data were entered using Epi-Info version 7 and analyzed using STATA SE Version
14.1. Estimation of the prevalence of adherence was done using both methods. Sensitivity,
specificity and positive predictive value was computed to check the validity on the
performance of self report in estimating Adherence. McNemar test was done to assess if
there was significant difference in adherence rate between the methods. P-value of <0.05 was
considered to indicate a significant difference in prevalence.
Result: The prevalence of iron folic acid supplementation of 82.8% (at 95% CI, 78.5 – 86.6)
was obtained by self report where as adherence rate of 58.2% (95% CI of 52.9 - 63.3) was
observed using pill count method. Descripance of 24.6 % difference was observed between
both methods of adherence measurement. The sensitivity, specificity and RUC curve of selfreport
was
showed
97.7%,
37.7%
and
0.68%
respectively
at
a
P-Vvalue
of
<
0.05.
Conclusion: Valid measurment is extremely important in assessing adherence rate. Self
report adherence estimation to IFA supplementation continues to be problematic and difficult
in determining how pregnant women are using their supplement.
Self-report adherence measurement had poor validity in measuring those who were correctly
adhered as compared to pill count. There was a statistically significant difference in
estimation of adherence between the self report and pill count methods.
Description
Keywords
Iron folic acid ,pregnant women ,Antenatal care