DETERMINANTS OF THE LEVEL OF ADHERENCE TO IRON AND FOLIC ACID SUPPLEMENTS AMONG ANTENATAL MOTHERS ATTENDING RUIRU LEVEL 4 HOSPITAL, KIAMBU COUNTY, KENYA.

Abstract

This article examines the determinants of adherence to iron and folic acid supplementation (IFAS) among antenatal mothers attending Ruiru Level Four Hospital in Kiambu County, Kenya. Despite global and national recommendations for daily IFAS during pregnancy, adherence rates remain low in many settings, contributing to maternal anaemia and poor pregnancy outcomes. A cross-sectional analytical study was conducted among 241 antenatal mothers systematically selected from the hospital's antenatal clinic. Data were collected using semi-structured, researcher-administered questionnaires. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), which classifies scores as low (<6), moderate (6–7), and high (=8) adherence. The mean MMAS adherence score was 5.95 ± 1.34, indicating moderate adherence. Most participants (55%) had moderate adherence, 39 per cent had low adherence, and 6 per cent had high adherence. The mean age of respondents was 25.74 ± 4.99 years, and the average number of pregnancies was 1.72 ± 0.79. Statistically significant predictors of adherence included level of education (p = 0.005), knowledge of IFAS (p = 0.036), number of antenatal care visits (p = 0.023), and receiving counselling on IFAS (p = 0.011). Age, marital status, and income were not significant predictors. Improving adherence to IFAS requires strengthening maternal education, enhancing counselling during antenatal visits, and promoting regular ANC attendance. These strategies can improve adherence, reduce maternal anaemia, and enhance pregnancy outcomes.