Adherence to iron prophylactic therapy during pregnancy in an urban regional hospital in South Africa

Background: Iron and folic acid supplementation plays a major role in the prevention and control of iron-deficiency anaemia in pregnancy. Therefore, this study assesses adherence to prophylactic iron supplementation during the antenatal period in South Africa. Methods: An observational study was conducted in a regional hospital from January to December 2016. HIV-uninfected (n？=？100) and HIV-infected (n？=？100)] women were enrolled and subdivided into three groups: (a)？≤？34 weeks (n？=？33), (b) 34–36 weeks (n？=？34) and (c)？≥？37 weeks (n？=？33) gestational age respectively. A structured questionnaire was used for data collection. Data were coded and statistically analysed using SPSS software. Pill count and self-reported data from women (n？=？24) at？≤？34 weeks and 34–36 weeks reflected <？50% adherence and 46% non-adherence, being higher in the HIV-infected women (75%). Nausea was the commonest side effect across all trimesters (79. 2%). Adherence (27.8%) and non-adherence (72.1%) to iron, folic acid and calcium supplementation were found in 88% of women. Conclusion: This study found that adherence to micronutrient supplementation is low in pregnancy, albeit higher in HIV-infected women receiving antenatal care at a regional hospital in Durban, South Africa. Abbreviations: Haemoglobin (Hb), Human Immune Deficiency Virus (HIV), antiretroviral therapy (ARV), zidovudine (ZDV), tuberculosis (TB), low to middle- income countries (LMICs), World Health Organization (WHO), antenatal clinic (ANC)