Email this article 
Maternal Knowledge and Adherence to Iron–Folic Acid Supplementation as Factors Associated with Anemia among Pregnant Women
(1) Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Lampung, Indonesia
(2) Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Lampung, Indonesia
(3) Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Lampung, Indonesia
(4) Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Lampung, Indonesia
(5) Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Lampung, Indonesia
(*) Corresponding Author
Abstract
Background: Gestational anemia continues to represent a prominent public health hurdle owing to its harmful impacts on maternal and neonatal health. Even with the regular supply of IFA supplementation during prenatal care, anemia rates remain elevated, showing that maternal awareness and supplement compliance may be important behavioral factors associated with the condition. Objective: This study aimed to evaluate the independent associations of maternal awareness and IFA supplement compliance with anemia status among pregnant women. Methods: An observational cross-sectional investigation was executed involving 66 pregnant women visiting prenatal clinics at Pinang Jaya Primary Health Center, Bandar Lampung, Lampung, Indonesia. Maternal awareness and IFA compliance were gauged through structured surveys, whereas anemia was established via hemoglobin assessment. Data evaluation utilized Chi-square tests alongside multivariable binary logistic regression to compute adjusted odds ratios and 95% confidence intervals. Results: The prevalence of anemia reached 57.6%. Following adjustment for maternal age, parity, pregnancy trimester, and employment, individuals with weak awareness exhibited 4.26 times greater odds of anemia relative to those with proper understanding (AOR = 4.26; 95% CI: 1.31 to 13.81; p = 0.016). Likewise, non-compliant participants experienced 4.29-fold higher odds of anemia compared to compliant peers (AOR = 4.29; 95% CI: 1.31 to 13.99; p = 0.016). Conclusion: Inadequate maternal awareness and non-adherence to IFA supplementation were independently associated with gestational anemia. As this was a cross-sectional study, these findings reflect associations rather than causal relationships. Embedding behavior-focused nutritional instruction along with adherence support into routine prenatal care may help strengthen maternal anemia prevention efforts across primary care environments.
Keywords
Full Text:
PDFReferences
Atmadani, R. N., Akrom, A., Ananda, D., Saputri, L. Y., Puspitasari, A. A., & Urbayatun, S. (2024). Supports and Barriers Regarding The Iron-Folic Acid Supplementation Adherence Level in Anemic Pregnant Women: Indonesian’s Perspective. Media Kesehatan Masyarakat Indonesia, 20(2), 46–56. https://doi.org/10.30597/mkmi.v20i2.32569
Engidaw, M. T., Lee, P., Fekadu, G., Mondal, P., & Ahmed, F. (2025). Effect of nutrition education during pregnancy on iron–folic acid supplementation compliance and anemia in low- and middle-income countries: A systematic review and meta-analysis. Nutrition Reviews, 83(7), e1472–e1487. https://doi.org/10.1093/nutrit/nuae170
Fatriani, R. (2021). Gambaran pengetahuan ibu hamil tentang anemia defisiensi besi dan manfaat suplemen Fe selama kehamilan di wilayah kerja Puskesmas Kemiling Kota Bandar Lampung tahun 2020. Jurnal Ilmu Gizi Indonesia (JIGZI), 2(1). https://doi.org/10.57084/jigzi.v2i1.1071
Fatriani, R., & Daeli, J. H. (2023). Sumber informasi dan tingkat pengetahuan tentang anemia defisiensi besi dan tablet tambah darah pada remaja putri. Jurnal Kesehatan Poltekkes Kemenkes RI Pangkalpinang, 11(2), 201–213. https://doi.org/10.32922/jkp.v11i2.740
Fatriani, R., Widyantari, K. Y., & Herliana, H. (2025). Cegah Anemia Pada Ibu Hamil : Penyuluhan Kesehatan Di Posyandu Cempaka Wilayah Kerja Puskesmas Sukaraja Kota Bandar Lampung. Jurnal Pengabdian Masyarakat Jajama (JPMJ), 4(1), 43–52. https://doi.org/10.47218/jpmj.v4i1.425
Hardido, T. G., Mikamo, A. A., & Legesse, C. T. (2023). Adherence to iron–folic acid among pregnant women attending antenatal care in Southern Ethiopia. Women's Health Reports, 4(1), 431–437. https://doi.org/10.1089/whr.2023.0020
Irawati, D., Madinah, A., Wayanti, S., & Esyuananik. (2024). Health Belief Model theory approach to analyze pregnant women's ability to prevent anemia. Jurnal Kesehatan, 15(1). https://doi.org/10.26630/jk.v15i1.4216
Kementerian Kesehatan Republik Indonesia. (2025). Profil Kesehatan Indonesia 2024. Jakarta, Indonesia: Kementerian Kesehatan Republik Indonesia.
Lencha, B., Mengistu, T., Mekonnen, A., Degno, S., Yohannis, D., & Beressa, G. (2023). Compliance to iron folic acid supplementation and its associated factors among pregnant women attending antenatal clinic in Wondo district: A cross-sectional study. Scientific Reports, 13, 2234. https://doi.org/10.1038/s41598-023-44577-7
Mohamed, A. I., Mohamed, J., Abdillahi, M. M., Abdeeq, B. A., & Lema, T. B. (2024). Magnitude and determinants of adherence to iron–folic acid supplementation among Somaliland pregnant women in Ahmed-dhagah district: A facility-based cross-sectional study. Clinical Epidemiology and Global Health, 26, 101565. https://doi.org/10.1016/j.cegh.2024.101565
Parks, S., Hoffman, M. K., Goudar, S. S., Patel, A., Saleem, S., Ali, S. A., Goldenberg, R. L., et al. (2019). Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan. BJOG: An International Journal of Obstetrics & Gynaecology, 126(6), 737–743. https://doi.org/10.1111/1471-0528.15585
Patel, A., Prakash, A. A., Das, P. K., Gupta, S., Pusdekar, Y. V., & Hibberd, P. L. (2018). Maternal anemia and underweight as determinants of pregnancy outcomes: Cohort study in eastern rural Maharashtra, India. BMJ Open, 8(8), e021623. https://doi.org/10.1136/bmjopen-2018-021623
Peña-Rosas, J. P., De-Regil, L. M., Dowswell, T., & Viteri, F. E. (2015). Daily oral iron supplementation during pregnancy. Cochrane Database of Systematic Reviews, (7), CD004736. https://doi.org/10.1002/14651858.CD004736.pub5
Saragih, I. D., Dimog, E. F., Saragih, I. S., & Lin, C.-J. (2022). Adherence to iron and folic acid supplementation among pregnant women: A systematic review and meta-analysis. Midwifery, 104, 103185. https://doi.org/10.1016/j.midw.2021.103185
Sartika, R. A. D., Wirawan, F., Putri, P. N., & Mohd Shukri, N. H. (2024). Association between Iron-Folic Acid Supplementation during Pregnancy and Maternal and Infant Anemia in West Java, Indonesia: A Mixed-Method Prospective Cohort Study. The American journal of tropical medicine and hygiene, 110(3), 576–587. https://doi.org/10.4269/ajtmh.23-0411
Sendeku, F. W., Azeze, G. G., & Fenta, S. L. (2020). Adherence to iron–folic acid supplementation among pregnant women in Ethiopia: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20, Article 138. https://doi.org/10.1186/s12884-020-2835-0
Temesgen, H., Woyraw, W., Feleke, F. W., Mezgebu, G. S., Taye, K., & Awoke, T. (2024). Iron–folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia: A multilevel analysis of the 2019 Ethiopian Mini Demographic and Health Survey. Frontiers in Nutrition, 11, Article 1348275. https://doi.org/10.3389/fnut.2024.1348275
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization.
World Health Organization. (2024). Anaemia. https://www.who.int/news-room/fact-sheets/detail/anaemia
Yulindar, V., & Siman, P. (2024). PREVALENCE AND PREVENTION OF IRON DEFICIENCY ANEMIA IN PREGNANCY IN INDONESIA: A COMPREHENSIVE SYSTEMATIC REVIEW. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10(3), 141-148. https://doi.org/10.61841/52b7gt72
Article Metrics
Abstract view : 271 timesPDF - 4 times
DOI: https://doi.org/10.26714/jk.15.2.2026.89-96
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Jurnal Kebidanan
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
JURNAL KEBIDANAN
Program Studi Kebidanan
Fakultas Ilmu Keperawatan dan Kesehatan
Universitas Muhammadiyah Semarang, Indonesia
NRC Building, 2nd FLoor
Jl. Kedungmundu Raya No. 18, Semarang
Tlp. +6224-76740288, Fax. +6224-76740287