title: High Adherence to Iron/Folic Acid Supplementation during Pregnancy Time among Antenatal and Postnatal Care Attendant Mothers in Governmental Health Centers in Akaki Kality Sub City, Addis Ababa, Ethiopia: Hierarchical Negative Binomial Poisson Regression.
abstract: BACKGROUND
  Iron deficiency during pregnancy is a risk factor for anemia, preterm delivery, and low birth weight. Iron/Folic Acid supplementation with optimal adherence can effectively prevent anemia in pregnancy. However, studies that address this area of adherence are very limited. Therefore, the current study was conducted to assess the adherence and to identify factors associated with a number of Iron/Folic Acid uptake during pregnancy time among mothers attending antenatal and postnatal care follow up in Akaki kality sub city.
  
  
  METHODS
  Institutional based cross-sectional study was conducted on a sample of 557 pregnant women attending antenatal and postnatal care service. Systematic random sampling was used to select study subjects. The mothers were interviewed and the collected data was cleaned and entered into Epi Info 3.5.1 and analyzed by R version 3.2.0. Hierarchical Negative Binomial Poisson Regression Model was fitted to identify the factors associated with a number of Iron/Folic Acid uptake. Adjusted Incidence rate ratio (IRR) with 95% confidence interval (CI) was computed to assess the strength and significance of the association.
  
  
  RESULTS
  More than 90% of the mothers were supplemented with at least one Iron/Folic Acid supplement from pill per week during their pregnancy time. Sixty percent of the mothers adhered (took four or more tablets per week) (95%CI, 56%-64.1%). Higher IRR of Iron/Folic Acid supplementation was observed among women: who received health education; which were privately employed; who achieved secondary education; and who believed that Iron/Folic Acid supplements increase blood, whereas mothers who reported a side effect, who were from families with relatively better monthly income, and who took the supplement when sick were more likely to adhere.
  
  
  CONCLUSIONS
  Adherence to Iron/Folic Acid supplement during their pregnancy time among mothers attending antenatal and postnatal care was found to be high. Activities that would address the above mentioned factors were highly recommended to ensure the sustainability of mothers' adherence to the supplement.
authors.affiliation: Teklaymanot General Hospital, Addis Ababa, Ethiopia.
authors.forename: Bisratemariam
authors.initials: B
authors.lastname: Gebreamlak
authors.affiliation: Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Abel Fekadu
authors.initials: AF
authors.lastname: Dadi
authors.affiliation: Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Azeb
authors.initials: A
authors.lastname: Atnafu
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D019587:Dietary Supplements / Q000009:adverse effects; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007501:Iron / Q000008:administration & dosage / Q000009:adverse effects; D055118:Medication Adherence; D009035:Mothers; D011181:Postnatal Care; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D047928:Premature Birth / Q000139:chemically induced / Q000453:epidemiology; D011295:Prenatal Care
chemical_list: D005492:Folic Acid; D007501:Iron