Compliance with Iron Supplementation among Women during Postnatal Period at UNRWA Clinics in Gaza Governorates

Najwa Mossleh
نجوى احمد خليل مصلح
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Al-Quds University
deficiency anaemia is one of the most neglected and wide spread nutrition related disorders; it is the most common type of anaemia among women in reproductive age, in spite of all effort to combat it. Iron supplementary is a tool in the battle, struggling against iron deficiency anaemia. UNRWA adopted the WHO strategy for prevention and treatment of iron deficiency anaemia, through providing iron supplementation since the early 90s, however anemia prevalence is still high among target group, and compliance to supplement is suffering from low prevalence rate during pregnancy and post-natal period. The postnatal period is a neglected issue in most of the world countries and in Palestine specially. This study aimed to estimate the prevalence rate of compliance with iron supplementation among women during post natal period at UNRWA clinics in Gaza Governorates, to define the factors affecting the compliance, and to examine the trend of compliance during postnatal and antenatal period. The study was conducted at UNRWA PHC clinics in Gaza Governorates. A quantitative, analytic, cross sectional design was conducted, to collect data from randomly selected three health centers. The sample of 400 subjects was randomly selected and met the inclusion criteria. An exit interviewed questionnaire was used as a tool for data collection with structured closed ended questions, after data collection analysis of data was done using SPSS. The study results showed that the compliance rate of 46.7% was among women during postnatal period, while the compliance rate reached 94.5% among women during antenatal. Factors significantly associated with compliance of post natal women regarding iron supplementation, at p-value ≤ 0.05, were governorates, place of residency and husband education level. From among the obstetric variables of the study; number of visits to the health centers during pregnancy, number of times receiving the iron supplement and Hb level during antenatal and postnatal period showed statistically significant differences in respect to iron compliance. Moreover reasons of noncompliance and the specified side effect reflected statistically significant differences. All counseling variables of this study were found to have statistically significant association with compliance like counseling about anemia and iron supplementation. Regarding the practice variables; Hb level & decision to take iron, receiving iron or not, the number of times receiving the supplements and the regularity of receiving it were significantly associated with compliance. From among the study variables, many have failed to prove statistically significant differences; women age, education level and work status of both women and husband, family income and the household number, marital age, parity, time of registration, breast feeding, and complication during pregnancy and mode of delivery. The results of this study suggest that minimum, consistent and easily understandable information and counseling are key elements to ensure effective programmes for iron supplementation. Health personnel should encourage and provide information and recommendations to women during both of their antenatal and post natal visits, promote benefits of taking iron tablets and perception of susceptibility of women of getting anemia