Compliance to iron folic acid supplementation and its associated factors among postpartum mothers of Bharatpur, Nepal: a cross-sectional study.

INTRODUCTION: Anaemia is a major global health issue, affecting pregnant and postpartum women, with 1.92 billion affected in 2021, notably in sub-Saharan Africa and South Asia. Iron deficiency is a key cause, requiring interventions like iron and folic acid supplementation. Despite efforts in Nepal, anaemia prevalence fluctuates with compliance being a concern. This study aims to assess the compliance with iron and folic acid supplementation among postpartum mothers in Bharatpur metropolitan city and explore its associated factors. METHODS: A cross-sectional study was conducted among 303 postpartum mothers with babies aged 45 days-1 year in Bharatpur, Nepal. Data were collected through face-to-face interviews using a pre-tested questionnaire. Descriptive statistics, including frequencies and percentages, were used to summarise participant characteristics and compliance. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with compliance, with OR and 95% CIs reported to determine the strength of associations. Statistical significance was set at p value <0.05. RESULTS: The compliance for iron and folic acid supplementation among postpartum mothers was 48.2%. Among the various sociodemographic factors, religion was significantly associated with compliance (OR 5.367, 95% CI 1.173 to 16.636). Additionally, having more than eight antenatal care (ANC) visits (OR 3.465, 95% CI 1.366 to 8.792), good knowledge about anaemia (OR 5.554, 95% CI 2.485 to 12.415) and good knowledge about iron and folic acid supplementation (OR 2.442, 95% CI 1.064 to 5.60) were also significantly associated with higher compliance. CONCLUSIONS: Our study found that iron and folic acid (IFA) compliance among postpartum mothers was 48.2%, highlighting the need for improved compliance strategies. Compliance was significantly associated with religion, ANC visits and knowledge about anaemia and IFA supplementation. Strengthening ANC services, enhancing maternal education and addressing sociocultural factors through targeted education, counselling and culturally sensitive follow-ups can enhance compliance and reduce maternal anaemia.