Factors associated with compliance to recommended micronutrients uptake for prevention of anemia during pregnancy in urban, peri-urban, and rural communities in Southeast Nigeria.
The study investigated the factors associated with compliance to the recommended ≥90-day uptake of micronutrients for prevention of iron-deficiency anemia during pregnancy in Nigeria.



A cross-sectional study of 1500 women who had babies within 6 months prior to the survey, drawn from six urban, peri-urban, and rural local government areas in Enugu and Imo States of Nigeria, was conducted, using a structured questionnaire. A focus group discussion was held with grandmothers and fathers of the new baby. In-depth interviews were held with health workers.



There were six demographic factors in the bivariate analysis: living in an urban center and close to health facility, and being wealthy, with post-secondary education as well as older and engaged in civil service showed significant association with compliance. The urban residents complied more than the peri-urban and rural residents (χ2= 12.749; p = 0.002). Those living close to the health facilities complied more than those living far away (χ2= 24.638; p < 0.001). Those in higher wealth quintile complied more (χ2= 13.216; p < 0.010). Utilization of antenatal clinics during pregnancy showed statistically significant association with compliance. Those who used the ANC services complied more than those that did not (χ2= 6.324; p = 0.010) and the more frequent the use of ANC services the more the compliance (χ2= 14.771; p < 0.001). These results were confirmed when the opinions expressed in the urban, peri-urban, and rural communities are compared. However, the multivariate binary logistic regression highlighted only urban residence, closeness to health facilities, and utilization of ANC services as positively associated with compliance.



These findings could help in targeting health education program to increase compliance to the recommended uptake of micronutrients in prevention of anemia during pregnancy.
Department of Global Health and Population, Takemi Program in International Health, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA. nkechi.onyeneho@unn.edu.ng.|Department of Sociology/Anthropology, University of Nigeria, Nsukka, Enugu State, Nigeria. nkechi.onyeneho@unn.edu.ng.
Nkechi G
NG
Onyeneho
Department of Sociology/Anthropology, University of Nigeria, Nsukka, Enugu State, Nigeria.
Ngozi
N
I'Aronu
Department of Social Work, University of Nigeria, Nsukka, Enugu State, Nigeria.
Ngozi
N
Chukwu
Department of Social Work, University of Nigeria, Nsukka, Enugu State, Nigeria.
Uju Patricia
UP
Agbawodikeizu
Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, USA.
Malgorzata
M
Chalupowski
Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, USA.
S V
SV
Subramanian
D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D000090463:Iron Deficiencies; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D009549:Nigeria; D010349:Patient Compliance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D012111:Residence Characteristics; D012424:Rural Population; D012923:Social Class; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
D018977:Micronutrients; D007501:Iron
Anemia; Compliance; Micronutrients; Pregnancy