TY - JOUR
T1 - Pregnant women’s decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries
AU - ZEGEYE, Betregiorgis
AU - ADJEI, Nicholas Kofi
AU - OLORUNSAIYE, Comfort Z.
AU - AHINKORAH, Bright Opoku
AU - AMEYAW, Edward Kwabena
AU - SEIDU, Abdul Aziz
AU - YAYA, Sanni
PY - 2021/12/13
Y1 - 2021/12/13
N2 - BackgroundAnaemia and related complications during
pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA).
Women’s decision-making power has significantly been linked with maternal
health service utilization but there is inadequate evidence about adherence to
iron supplementation. This study therefore assessed the association between
household decision-making power and iron supplementation adherence among
pregnant married women in 25 sub-Saharan African countries.MethodsWe used data from the Demographic and
Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010
and 2019. Women's decision-making power was measured by three parameters; own
health care, making large household purchases and visits to her family or
relatives. The association between women’s decision-making power and iron
supplementation adherence was assessed using logistic regressions, adjusting
for confounders. The results were presented as adjusted odds ratio (AOR) with
95% confidence intervals (CIs).ResultsApproximately 65.4% of pregnant married
women had made decisions either alone or with husband in all three decisions
making parameters (i.e., own health care, making large household purchases,
visits to her family or relatives). The rate of adherence to iron medication
during pregnancy was 51.7% (95% CI; 48.5–54.9%). Adherence to iron
supplementation was found to be higher among pregnant married women who had
decision-making power (AOR = 1.46, 95% CI; 1.16–1.83), secondary education
(AOR = 1.45, 95% CI; 1.05–2.00) and antenatal care visit (AOR = 2.77, 95% CI;
2.19–3.51). Wealth quintiles and religion were significantly associated with
adherence to iron supplementation.Conclusions
Adherence to iron supplementation is high
among pregnant women in SSA. Decision making power, educational status and
antenatal care visit were found to be significantly associated with adherence
to these supplements. These findings highlight that there is a need to design
interventions that enhance women’s decision-making capacities, and empowering
them through education to improve the coverage of antenatal iron
supplementation.
AB - BackgroundAnaemia and related complications during
pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA).
Women’s decision-making power has significantly been linked with maternal
health service utilization but there is inadequate evidence about adherence to
iron supplementation. This study therefore assessed the association between
household decision-making power and iron supplementation adherence among
pregnant married women in 25 sub-Saharan African countries.MethodsWe used data from the Demographic and
Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010
and 2019. Women's decision-making power was measured by three parameters; own
health care, making large household purchases and visits to her family or
relatives. The association between women’s decision-making power and iron
supplementation adherence was assessed using logistic regressions, adjusting
for confounders. The results were presented as adjusted odds ratio (AOR) with
95% confidence intervals (CIs).ResultsApproximately 65.4% of pregnant married
women had made decisions either alone or with husband in all three decisions
making parameters (i.e., own health care, making large household purchases,
visits to her family or relatives). The rate of adherence to iron medication
during pregnancy was 51.7% (95% CI; 48.5–54.9%). Adherence to iron
supplementation was found to be higher among pregnant married women who had
decision-making power (AOR = 1.46, 95% CI; 1.16–1.83), secondary education
(AOR = 1.45, 95% CI; 1.05–2.00) and antenatal care visit (AOR = 2.77, 95% CI;
2.19–3.51). Wealth quintiles and religion were significantly associated with
adherence to iron supplementation.Conclusions
Adherence to iron supplementation is high
among pregnant women in SSA. Decision making power, educational status and
antenatal care visit were found to be significantly associated with adherence
to these supplements. These findings highlight that there is a need to design
interventions that enhance women’s decision-making capacities, and empowering
them through education to improve the coverage of antenatal iron
supplementation.
KW - DHS
KW - Global health
KW - iron adherence, sub-Sahara Africa
KW - Women autonomy
UR - http://www.scopus.com/inward/record.url?scp=85121326827&partnerID=8YFLogxK
U2 - 10.1186/s12884-021-04258-7
DO - 10.1186/s12884-021-04258-7
M3 - Journal Article (refereed)
C2 - 34903198
AN - SCOPUS:85121326827
SN - 1471-2393
VL - 21
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
M1 - 822
ER -