Health Program and Nutritional Determinants of Pregnancy Anemia in Boyolali District, Central Java, Indonesia: A Case-Control Study

Background: Pregnancy anemia is a significant issue in Indonesia's public health. The modifiable risk factors of pregnancy anemia were nutritional and health program factors. This research examines the determinants of pregnancy anemia in individual and nutritional health program factors in Boyolali Regency, Central Java Province, Indonesia. Methodology: This facility-based case-control study was conducted in three areas of Primary Healthcare Centers. The case was 60 pregnant women whom health providers diagnosed as having anemia, and the control was 60 who did not. Results: Bivariable analysis showed that the associated factors of pregnancy anemia were parity, family wealth index, maternal health literacy, antenatal care (ANC) compliance (six visits), and Iron-Folic Acid (IFA) consumption. Meanwhile, variables that were not significantly related were birth interval, gravida, monthly expenses, and daily iron intake. Multivariable analysis showed that pregnant mothers who did not followed the recommended ANC were 14.4 times more likely to experience pregnancy anemia than those who did (p-value <0.0001). Irregular IFA consumption, wealth index and parity were also significant determinants of pregnancy anemia. Conclusions: Following health programs, such as attending ANC and IFA consumption, significantly reduces the risk of pregnancy anemia. Health providers should encourage pregnant women to achieve the recommended six ANC visits.