Study of Maternal Compliance and Associated Factors toward World Health Organization Recommended Iron and Folic Acid Supplementation during Pregnancy

Abstract Introduction: Anemia is a global health issue that predominantly affects women of reproductive age. The World Health Organization has implemented an iron supplementation program that various countries, including India, have adopted. Despite numerous anemia prevention strategies, the incidence of anemia remains high. This study aims to assess pregnant women’s compliance with iron and folic acid supplementation and identify the factors influencing this compliance. Methodology: This cross-sectional study was conducted among pregnant women at a rural medical college. The study utilized a questionnaire based on the Morisky Medication Adherence Scale to categorize the participants into compliant and noncompliant groups. Both groups were interviewed using a standardized questionnaire to gather information on their sociodemographic profiles, obstetric history, anemia awareness, iron supplementation during pregnancy, and healthcare needs. The data were organized in Microsoft Excel and analyzed using appropriate statistical methods. Results: The study sample comprised 460 participants, with 182 women (39.56%) classified as compliant. The compliant group demonstrated significantly better educational and a higher socioeconomic status than the noncompliant group. In terms of obstetric factors, women in the compliant group had substantially more antenatal care visits, earlier registration in the first trimester, longer interconception intervals, and higher contraceptive use rates. Moreover, the compliant group showed greater knowledge and awareness of iron supplementation, anemia prevention, and healthcare needs during pregnancy. Conclusion: This study highlights that compliance with iron and folic acid supplementation among rural pregnant women remains low, with women’s education and awareness being key factors influencing adherence. In addition to ongoing efforts in the Anemia Mukt Bharat Programme, introducing prophylactic parenteral iron supplementation may enhance compliance and reduce anemia.