Effect of a Community-based Approach of Iron and Folic Acid Supplementation on Compliance by Pregnant Women in Kiambu County, Kenya: a Quasi-experimental Study

Background: Consumption of iron and folic acid supplements (IFAS) during pregnancy is an essential intervention that prevents anemia. IFAS are provided for free in Kenya to women during ANC. Compliance to IFAS remains low. The study aimed to evaluate the effect of a community-based approach to IFAS distribution on compliance, assess side effects, and their mitigation by pregnant women.

Methods: The study used a pretest-posttest quasi-experimental study design. Intervention and control groups of 340 pregnant women between the ages of 15-49 years from 5 health facilities in Kiambu County were enrolled. Community health volunteers provided IFAS, counselling, and weekly follow-ups to women in the intervention group. The control group received standard care from health facilities. Difference-In-Difference regression was used to analyze data.

Results: Compliance levels increased by 8% in the intervention group and 6% in the control group. Women in the intervention group reported less side-effects and were better equipped to manage side effects compared to the women in the control group.

Conclusions: A community-based approach improved maternal compliance with IFAS, awareness of IFAS side effects and management. Integrating a community-based approach with antenatal distribution of IFAS is needed.