Factors Associated with Adherence of Pregnant Women in Consuming Iron Supplementation Tablets

Abstract

Background: Anemia in pregnant women remains a significant public health problem that can increase the risk of pregnancy complications, childbirth complications, and maternal and infant mortality. One of the main strategies to prevent anemia is the consumption of iron supplementation tablets (TTD). However, the level of adherence among pregnant women in consuming TTD is still not optimal, including in North Lampung Regency. Several factors such as socio-demographic characteristics, knowledge, attitude, and social support are believed to influence adherence behavior. This study aimed to determine the factors associated with adherence of pregnant women in consuming iron supplementation tablets in North Lampung Regency in 2025. Methods:  This study employed a quantitative analytic design with a cross-sectional approach. The population consisted of all pregnant women in the working area of the North Lampung District Health Office. A total of 298 respondents were selected using proportional random sampling. Data were collected through structured questionnaires. Data analysis included univariate analysis, bivariate analysis using the Chi-square test, and multivariate analysis using logistic regression with the backward method. Results: The results showed that a majority of respondents were adherent to consuming iron supplementation tablets. Bivariate analysis indicated significant relationships between age, education, knowledge, attitude, health worker support, and husband’s support with adherence (p<0.05). Multivariate analysis revealed that knowledge, attitude, health worker support, and husband’s support were significant predictors of adherence. The most dominant factor influencing adherence was health worker support, indicating its critical role in improving compliance through education, motivation, and continuous assistance. Conclusions: There are significant factors associated with adherence of pregnant women in consuming iron supplementation tablets, particularly knowledge, attitude, health worker support, and husband’s support. Strengthening health education and enhancing the role of health workers, along with involving family support, are essential to improve adherence and prevent anemia during pregnancy.