Knowledge of Iron–Folic Acid Supplementation and Associated Factors among Pregnant Women Attending Antenatal Care in Bosaso, Somalia

Abstract Background: Iron–folic acid (IFA) supplementation is an essential intervention for preventing maternal anemia and improving maternal and neonatal outcomes during pregnancy. However, inadequate knowledge remains a major barrier to effective utilization in low-resource settings, including Somalia. This study assessed knowledge and associated factors of IFA supplementation among pregnant women attending antenatal care (ANC) services in Bosaso, Somalia. Methods: A facility-based cross-sectional study was conducted among 400 pregnant women attending ANC services in Bosaso. Data were collected using a structured interviewer-administered questionnaire. Knowledge was categorized using Bloom’s cut-off criteria as poor (<60%), moderate (60–79%), and good (≥80%). Ordinal logistic regression was used to identify factors associated with knowledge. Results: Overall, 56.0% of participants had good knowledge, 32.0% had moderate knowledge, and 12.0% had poor knowledge of IFA supplementation. Higher maternal education, higher household income, and receiving nutrition counseling were significant predictors of higher knowledge. Conclusion: Although more than half of the participants demonstrated good knowledge, important gaps persist. Strengthening structured ANC nutrition counseling and targeting women with lower education are essential to improve maternal knowledge and support appropriate use of IFA supplements. Keywords: Iron–folic acid, antenatal care, maternal nutrition, anemia, pregnancy, Somalia.