Adherence and barriers of prophylactic iron and folic acid supplementation in children: a community-based mixed method study

Authors

  • Jenny P. Mishra Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • Jayalakshmy Ramakrishnan Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • Premkumar Ramasubramani Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry India
  • Zunatha Banu Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  • Swaroop Kumar Sahoo Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20231693

Keywords:

Adherence, Barriers, Iron deficiency anemia, IFA-iron and folic acid supplement, Prophylactic

Abstract

Background: Anemia is a public health challenge in India among children, adolescents and reproductive age women. Still, 58% of under-five children in India and 43% in Puducherry are anaemic. To determine the proportion of mothers of one-to-nine-year children, aware about iron and folic acid (IFA) supplementation, the proportion of children adherent to the dosage of IFA and the barriers for the adherence to IFA.

Methods: A community-based explanatory sequential mixed methods study consisting survey using a semi-structured questionnaire and followed by focus group discussions (FGD) using an interview guide. The data was collected using EpiCollect5 analysed using SPSS. The results were expressed as proportions with 95% confidence interval (CI) and the qualitative results were expressed as a conceptual framework.

Results: Awareness about IFA supplementation given to children from the public health system was 57% (95% CI: 51.8-62.0) among mothers of one-to-nine-year children. Adherence to IFA supplementation was 34% (28.9.0-38.6). The main reason of the non-adherence reported by the mothers was non-availability of the supplements, nausea and vomiting among children and forgetfulness of the mother. In the FGD, supply side reasons were non-palatability and wrong dose administration, and demand side reasons were lack of awareness and coverage.

Conclusions: Only one out of ten children among under five years were taking IFA syrup and only half of the children ages five-to-nine-years consumed IFA tablets given in their schools. Irregular distribution of IFA tablets, medication side-effects, and non-palatability of the medication were the main reasons quoted by the mother for non-adherence.

References

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Published

2023-05-31

How to Cite

Mishra, J. P., Ramakrishnan, J., Ramasubramani, P., Banu, Z., & Kumar Sahoo, S. (2023). Adherence and barriers of prophylactic iron and folic acid supplementation in children: a community-based mixed method study. International Journal Of Community Medicine And Public Health, 10(6), 2138–2143. https://doi.org/10.18203/2394-6040.ijcmph20231693

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Original Research Articles