Socio-demographic and Socio-economic Determinants of Consistent Iron and Folic Acid Supplementation Uptake among Pregnant Women Attending Antenatal Care at Archers Post Sub-County Hospital, Samburu County, Kenya

Purpose: Iron and folic acid supplementation (IFAS) is the principal intervention for preventing anaemia in pregnancy and is provided free of charge at antenatal care (ANC) contacts in Kenya, yet sustained consumption of the supplement remains uncommon. Evidence on the social and economic determinants of uptake among pastoralist populations is scarce, and most Kenyan studies have been conducted in urban and agrarian counties. This study determined the socio-demographic and socio-economic factors associated with consistent IFAS uptake among pregnant women attending ANC at Archers Post Sub-County Hospital, Samburu County, Kenya. Methodology: An analytical cross-sectional study, guided by Andersen's Behavioral Model of Health Services Use, was conducted among pregnant women aged 18 to 49 years who were recruited consecutively at the antenatal clinic. Data were collected using an interviewer-administered questionnaire and abstraction of antenatal records. Consistent uptake was defined as consumption of an IFAS tablet on at least four of the seven days preceding the interview. Associations were assessed using Pearson chi-square tests and multivariable binary logistic regression, with statistical significance set at p < 0.05. Findings: Of the 259 women approached, 210 were interviewed and analysed, representing a response rate of 81.1%. Overall, 58.1% (95% CI 51.3–64.6) of participants met the criterion for consistent uptake. After adjustment, consistent uptake was independently associated with attendance at four or more ANC visits (AOR = 6.56, 95% CI 2.30–18.74), tertiary education (AOR = 6.15, 95% CI 1.82–20.83), secondary education (AOR = 2.41, 95% CI 1.09–5.33), adequate knowledge of IFAS (AOR = 4.88, 95% CI 2.26–10.53), counselling by a health worker (AOR = 3.52, 95% CI 1.65–7.53), a monthly household income of KSh 20,000 or more (AOR = 3.36, 95% CI 1.46–7.76) and partner or family support (AOR = 2.50, 95% CI 1.12–5.58), while reported side effects were associated with lower odds of consistent uptake (AOR = 0.27, 95% CI 0.12–0.58). Marital status, employment status, gravidity and trimester were not associated with uptake, and rural residence and distance to the facility lost significance after adjustment. Consistent IFAS uptake in this pastoralist setting is shaped by education, household income and partner support, acting alongside antenatal contact and the quality of counselling. Unique Contribution to Theory, Practice and Policy: Interventions should prioritise early and repeated ANC attendance, community-based resupply for dispersed households by community health promoters linked to level 1 community health units and the electronic Community Health Information System, engagement of partners, and counselling that prepares women to recognise and manage side effects, delivered alongside deworming and malaria prevention where these are indicated.