Iron-Folate Supplementation Compliance in Maternal Health
Summary
Iron-folate supplementation is a cornerstone of maternal nutrition programmes aimed at preventing iron deficiency anaemia and supporting foetal development. Despite widespread policy adoption and high coverage of antenatal care services in many regions, adherence to the recommended daily regimen remains suboptimal, particularly in low- and middle-income settings. Barriers to compliance include gastrointestinal side effects, limited health literacy, socio-cultural beliefs and inconsistent supply chains. Health-system factors such as timing and frequency of antenatal visits, quality of counselling and community outreach further influence uptake. Improved adherence is associated with higher maternal haemoglobin concentrations, reduced risk of pre-term birth and neural tube defects, and enhanced birthweight outcomes. Strategies to bolster compliance encompass targeted nutrition education, community-based support, digital reminders and integration of supplementation with broader maternal health services. Understanding the interplay of individual, community and systemic determinants is essential to refine interventions, tailor delivery models and ensure that supplementation programmes translate into measurable gains for maternal and neonatal health.
Research from Nature Portfolio
One recent cross-sectional study conducted among antenatal clinic attendees in a district of southern Ethiopia reported a compliance rate of 44.3% to iron-folate supplementation over the recommended period. Maternal age of 25 years or older, higher maternal and partner education levels, and adequate knowledge of anaemia and of the supplementation regimen were all positively associated with adherence. The findings underline the critical role of educational interventions and partner involvement in strengthening compliance.
Iron-Folate Supplementation Compliance in Maternal Health publication trend
The graph below shows the total number of articles in iron-folate supplementation compliance in maternal health across all publications each year (not limited to Nature Index journals).
Technical terms
Compliance: The extent to which pregnant women consume iron-folate tablets according to the prescribed dosage and duration.
Antenatal care (ANC): Clinical and educational services provided to expectant mothers to monitor and support maternal and foetal health.
Iron deficiency anaemia: A condition characterised by reduced haemoglobin concentration due to insufficient iron, leading to fatigue, weakness and increased obstetric risk.
Haemoglobin: The oxygen-transport protein in red blood cells used as a biomarker for anaemia severity and response to supplementation.
Folic acid: A water-soluble B-vitamin essential for DNA synthesis and prevention of neural tube defects, administered concurrently with iron to enhance overall micronutrient status.
References
- Compliance to iron folic acid supplementation and its associated factors among pregnant women attending Antenatal clinic in Wondo district: a cross-sectional study. Scientific Reports (2023).
- Effect of Nutrition Education During Pregnancy on Iron–Folic Acid Supplementation Compliance and Anemia in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. Nutrition Reviews (2024).
- Iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia: a multilevel complex data analysis of 2019 Ethiopian mini demographic and health survey data. Frontiers in Nutrition (2024).
- What Makes Bangladeshi Pregnant Women More Compliant to Iron–Folic Acid Supplementation: A Nationally Representative Cross-Sectional Survey Result. Nutrients (2023).
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