Peer-reviewed article
Factors Associated With Uptake of Iron Supplement During Pregnancy Among Women of Reproductive Age in Somaliland: A Cross-Sectional Study.
Awo Mohamed Kahie, Mohamed Said Hassan, Suhaib Mohamed Kahie, Abdikadir Abdillahi Husein, Asma Abdirahman ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined why pregnant women in Somaliland do not take iron supplements, which are important for preventing anemia. Only 37% of pregnant women reported using iron supplements in the survey. The key factors that increased supplement use were attending four or more antenatal care visits, having a wealthier household, and having a husband with paid employment. Women whose husbands had no formal education were less likely to take supplements, and there were large differences between regions.
Key points
- Only 37.08% of women reported using iron supplements during their most recent pregnancy in Somaliland
- Attending four or more antenatal care visits was the strongest predictor of iron supplement uptake (adjusted odds ratio 6.20)
- Household wealth and husband's employment status were significant positive factors, while husband's lack of formal education reduced the odds of uptake
- Significant regional disparities existed, with lower uptake in Sool and Sanaag regions
- The study highlights that socioeconomic inequities and healthcare access barriers are key drivers of low supplement uptake
Limitations
The study is cross-sectional and cannot establish causation, only associations. The data relies on self-reported supplement use during pregnancy, which may be subject to recall bias or social desirability bias.
Abstract
BACKGROUND: Anemia in pregnancy is a severe public health problem in low- and middle-income countries, yet the uptake of recommended iron supplementation remains critically low. In a post-conflict and resource-constrained setting like Somaliland, there is a significant evidence gap regarding the factors that determine whether pregnant women use these essential supplements. This study aimed to identify the individual and community-level factors associated with the uptake of iron supplements during pregnancy in Somaliland. METHODS: We conducted a cross-sectional analysis of data from the 2020 Somaliland Demographic and Health Survey (SLDHS), including a nationally representative weighted sample of 2577 women aged 15-49 years who had a live birth in the 5 years preceding the survey. A multilevel binary logistic regression model was used to identify determinants of iron supplement uptake while accounting for the hierarchical data structure. RESULTS: The uptake of iron supplements was alarmingly low, with only 37.08% of women reporting use during their most recent pregnancy. The strongest predictor was attending four or more antenatal care (ANC) visits (adjusted odds ratio [AOR] = 6.20; 95% confidence interval [CI]: 4.70-8.19). Other significant positive determinants included belonging to a rich household (AOR = 1.93; 95% CI: 1.43-2.60), having a husband in paid employment (AOR = 2.13; 95% CI: 1.71-2.66), and exposure to television. Conversely, women whose husbands had no formal education had significantly lower odds of uptake (AOR = 0.68; 95% CI: 0.51-0.91). Significant regional disparities were observed, with markedly lower uptake in the Sool and Sanaag regions. CONCLUSION: Iron supplement uptake in Somaliland is critically deficient and driven by profound inequities in healthcare access and socioeconomic status. A multipronged strategy is urgently needed, focusing on strengthening ANC services, leveraging mass media and mHealth for targeted health promotion, addressing socioeconomic barriers, and engaging male partners to improve maternal and child health outcomes.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Antenatal care services and health promotion regarding iron supplementation
- Population
- 2,577 women aged 15-49 years in Somaliland who had a live birth in the 5 years before the 2020 survey
Key finding
37.08% of women reported using iron supplements during most recent pregnancy