title: Role of family support and women's knowledge on pregnancy-related risks in adherence to maternal iron-folic acid supplementation in Indonesia.
abstract: To examine whether women's knowledge of pregnancy-related risks and family support received during pregnancy are associated with adherence to maternal iron-folic acid (IFA) supplementation.
  
  
  
  Secondary data analysis of the 2002-03, 2007 and 2012 Indonesia Demographic and Health Survey. Analysis of the association between factors associated with adherence (consuming ≥90 IFA tablets), including the women's knowledge and family support, was performed using multivariate logistic regression.
  
  
  
  National household survey.
  
  
  
  Women (n 19 133) who had given birth within 2 years prior to the interview date.
  
  
  
  Knowledge of pregnancy-related risks was associated with increased adherence to IFA supplementation (adjusted OR=1·8; 95 % CI 1·6, 2·0), as was full family (particularly husband's) support (adjusted OR=1·9; 95 % CI 1·6, 2·3). Adequate antenatal care (ANC) visits (i.e. four or more) was associated with increased adherence (adjusted OR=2·2; 95 % CI 2·0, 2·4). However, ANC providers missed opportunities to distribute tablets and information, as among women with adequate ANC visits, 15 % reported never having received/bought any IFA tablets and 30 % had no knowledge of pregnancy-related risks. A significant interaction was observed between family support and the women's educational level in predicting adherence. Family support significantly increased the adherence among women with <9 years of education.
  
  
  
  Improving women's knowledge of pregnancy-related risks and involving family members, particularly the husband and importantly for less-educated women, improved adherence to IFA supplementation. ANC visit opportunities must be optimized to provide women with sufficient numbers of IFA tablets along with health information (especially on pregnancy-related risks) and partner support counselling.
authors.affiliation: 1SEAMEO Regional Center for Food and Nutrition,Universitas Indonesia,SEAMEO RECFON Building,Kampus Universitas Indonesia,Salemba Raya no. 6,Jakarta Pusat 10430,Indonesia.
authors.forename: Luh Ade Ari
authors.initials: LA
authors.lastname: Wiradnyani
authors.affiliation: 1SEAMEO Regional Center for Food and Nutrition,Universitas Indonesia,SEAMEO RECFON Building,Kampus Universitas Indonesia,Salemba Raya no. 6,Jakarta Pusat 10430,Indonesia.
authors.forename: Helda
authors.initials: H
authors.lastname: Khusun
authors.affiliation: 3Department of Nutrition, Faculty of Public Health,Universitas Indonesia,Jakarta,Indonesia.
authors.forename: Endang L
authors.initials: EL
authors.lastname: Achadi
authors.affiliation: 4Department of Obstetrics and Gynecology, Faculty of Medicine,Universitas Indonesia,Jakarta,Indonesia.
authors.forename: Dwiana
authors.initials: D
authors.lastname: Ocviyanti
authors.affiliation: 5Harvard T.H. Chan School of Public Health,Boston,MA,USA.
authors.forename: Anuraj H
authors.initials: AH
authors.lastname: Shankar
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D005190:Family; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia; D007501:Iron / Q000008:administration & dosage*; D010349:Patient Compliance; D011247:Pregnancy; D011295:Prenatal Care; D064167:Recommended Dietary Allowances; D012944:Social Support
chemical_list: D005492:Folic Acid; D007501:Iron
keywords: Family support; Knowledge; Maternal iron–folic acid supplementation