Rural-Urban Differential of Iron Supplementation Compliance during Pregnancy among Reproductive aged Women in Ethiopia

The global burden of iron deficiency anemia remains substantial, accounting for 41.8% of the population. This study assessed the rural‒urban differential in iron supplementation compliance during pregnancy among reproductive-aged women.

A comparative cross-sectional study was conducted among women aged 15-49 in all parts of Ethiopia. The study was conducted from January 18 to June 27, 2016. After data related to the compliance with iron supplementation were obtained from the demographic survey, a mixed-effects logistic regression model was performed on a weighted sample of 3096 (563 urban and 2533 rural). Significant relationships were determined using multivariable logistic regression analysis. 

The general proportion of iron supplementation compliance was 15.07% (95% CI= 13.8%-16.4%). However, the proportion of adherence to iron among urban and rural women was 17.7% (95% CI=14.8%-21.1%) and 11.2% (95% CI=10.1% -12.5%), respectively. Urban areas were associated with exposure to media (AOR=2.04, 95% CI, 1.07, 3.89) and frequent ANC≥4 (AOR=2.31, 95% CI, 1.10, 4.86). However, those with a high school education level were 65% less likely to adhere to iron supplementation. Additionally, for Rural, the odds of iron supplementation adherence were higher for primary (AOR=1.39, 95% CI, 1.03, 1.89) and secondary education (AOR=1.77, 95% CI, 1.02, 3.08), unemployed women (AOR=1.35, 95% CI, 1.04, 1.76), first ANC registration at 1st 13 months (AOR=3.03, 95% CI, 1.41, 6.54), and 2nd trimester (AOR=2.82, 95% CI, 1.34, 5.95).

The proportion of iron use adherence through gestation is low in both urban and rural Ethiopia compared to the national recommendation.