DETERMINANTS OF IRON AND FOLIC ACID SUPPLEMENTATION ADHERENCE AND ITS IMPACT ON ANEMIA AMONG PREGNANT WOMEN: A SYSTEMATIC LITERATURE REVIEW

ANEMIA AMONG PREGNANT WOMEN
Elsa Widyavihusna 1 Indonesia , Idral Purnakarya 1 Indonesia , Azrimaidaliza 1 Indonesia
1 Department of Nutrition, Faculty of Public Health, Universitas Andalas, Padang, Indonesia
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Published 2026-06-20
Vol. 8 No. 1 (2026) PAGES 131- 136
DOI 10.36566/ijhsrd/Vol8.Iss1/376
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Background: Anemia in pregnant women remains a major global public health problem, particularly in developing countries, including Indonesia. One of the primary interventions to prevent anemia is iron supplementation. However, the effectiveness of this intervention is highly dependent on adherence to iron tablet consumption among pregnant women. This study aims to analyze the determinants of adherence to iron supplementation and its impact on anemia through a synthesis of international and national studies.
Methods: The method used was a literature review of five reputable scientific articles with cross-sectional and case-control designs. The analysis was conducted using a descriptive narrative approach with thematic synthesis focusing on determinants and anemia outcomes.
Results: The results show that adherence to iron supplementation remains low, with an average below 50%. The main determinants include maternal education, socioeconomic status, antenatal care (ANC) visits, access to healthcare services, and exposure to health information. In addition, program-related factors such as social assistance and the quality of healthcare services also play a role. Adherence to iron supplementation has been shown to significantly reduce the risk of anemia, with an estimated reduction of more than 25%.
Conclusion: It can be concluded that anemia in pregnancy is a multifactorial problem influenced by individual, social, and healthcare system factors. Interventions to improve adherence should be carried out comprehensively through education, strengthening ANC services, and optimizing community-based health programs.

DETERMINANTS OF IRON AND FOLIC ACID SUPPLEMENTATION ADHERENCE AND ITS IMPACT ON ANEMIA AMONG PREGNANT WOMEN: A SYSTEMATIC LITERATURE REVIEW : ANEMIA AMONG PREGNANT WOMEN. (2026). INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD), 8(1), 131-136. https://doi.org/10.36566/ijhsrd/Vol8.Iss1/376
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  1. 1. World Health Organization. Global anaemia estimates, 2021 edition. Geneva: World Health Organization; 2021.
  2. 2. World Health Organization. WHO guideline on iron and folic acid supplementation in pregnant women. Geneva: World Health Organization; 2023.
  3. 3. Engidaw MT, et al. Compliance with iron and folic acid supplementation and associated factors among pregnant women: a cross-sectional study. 2025;[in press].
  4. 4. Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. BMC Public Health. 2022;22(1):1–12.
  5. 5. Kassa GM, Muche AA, Berhe AK, Fekadu GA. Antenatal care utilization and adherence to iron-folic acid supplementation among pregnant women in Ethiopia: a systematic review and meta-analysis. PLoS One. 2021;16(4):e0250635.
  6. 6. Getachew M, Abebe M, Tessema ZT. Factors associated with adherence to iron and folic acid supplementation among pregnant women in Sub-Saharan Africa: a multilevel analysis. BMC Nutr. 2023;9(1):45.
  7. 7. Daru J, Zamora J, Fernández-Félix BM, Vogel J, Oladapo OT, Morisaki N, et al. Risk of maternal mortality in women with severe anemia during pregnancy and postpartum: a multilevel analysis. Lancet Glob Health. 2022;10(4):e520–e529.
  8. 8. Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2021;12:CD004736.
  9. 9. Ministry of Health Republic of Indonesia. Indonesia health profile 2023. Jakarta: Ministry of Health Republic of Indonesia; 2023.
  10. 10. Nguyen PH, Scott S, Avula R, Tran LM, Menon P. Maternal and child nutrition in low- and middle-income countries: progress and challenges. Nutrients. 2021;13(2):459.
  11. 11. Sunuwar DR, Singh DR, Pradhan PMS. Factors associated with adherence to iron and folic acid supplementation among pregnant women in Nepal: a multilevel analysis. PLoS One. 2022;17(3):e0265126.
  12. 12. Fite RO, Habtewold TD, Teklehaimanot HD. Socioeconomic and demographic determinants of iron-folic acid supplementation adherence among pregnant women: evidence from low-income settings. BMC Nutr. 2022;8(1):67.
  13. 13. Weldegebreal F, Alemayehu M, Gebrezgiabher G. Antenatal care service utilization and associated factors among pregnant women in developing countries: a systematic review. 2021;[unpublished].
  14. 14. Alemayehu A, Abebe M, Tessema ZT. Nutritional and socioeconomic determinants of anemia among pregnant women in developing countries. Nutrients. 2022;14(5):1023.
  15. 15. Kibret KT, Chojenta C, D’Arcy E, Loxton D. Determinants of anemia among pregnant women in low- and middle-income countries: a systematic review and meta-analysis. PLoS One. 2022;17(7):e0271234.

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Keywords
Iron supplementation Adherence Anemia Pregnancy ANC

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