THE RELATIONSHIP BETWEEN COMPLIANCE OF IRON-FOLIC ACID SUPPLEMENT TABLET CONSUMPTION WITH ANEMIA STATUS AMONG PREGNANT WOMEN AT KINTAMANI VI PRIMARY HEALTH CARE CENTER

Kadek Bagus Putra Kinandana; Putu Cintya Denny Yuliyatni; I Wayan Weta; Luh Seri Ani

Authors

Kadek Bagus Putra Kinandana Program Studi Sarjana Kedokteran dan Profesi Dokter, Fakultas Kedokteran, Universitas Udayana Author
dr. Putu Cintya Denny Yuliyatni, MPH Department of Public Health, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia Author
Prof. Dr. dr. I Wayan Weta, MS, Sp.GK Departement of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia Author
Dr. Luh Seri Ani, S.KM., M.Kes. Department of Public Health, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia Author

Keywords:

Anemia, pregnant women, compliance, iron–folic acid supplementation

Abstract

Background: Anemia in pregnancy remains a common health problem that contributes to increased maternal and fetal morbidity and mortality. Preventive efforts have been implemented through the supplementation program of iron–folic acid tablets (Tablet Tambah Darah or TTD) recommended throughout pregnancy; however, its effectiveness depends greatly on compliance. Objective: To determine the association between compliance to iron-folic acid tablets consumption and anemia status among pregnant women in the working area of Puskesmas Kintamani VI. Methods: This was an analytical observational study with a cross-sectional design involving 75 third-trimester pregnant women who met the inclusion criteria and sampled using consecutive sampling. Compliance data were collected through interviews using a simplified Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire. Hemoglobin levels were obtained using a POCT (Point of Care Testing) device and medical records. Bivariate analysis was performed using the Chi-square test. Results: The results showed that 52% of respondents were classified as non-compliant. The proportion of pregnant women with anemia was 33.3% in the non-compliant group and 11.1% in compliant group. Bivariate analysis indicated a significant relationship between TTD compliance and anemia status (p-value=0.022; PR=0.33; 95% CI: 0.12–0.93). Other variables, including maternal age, education level, nutritional status, parity, micronutrient intake, sleep quality, hyperemesis gravidarum, income, occupation, and other medical factors, showed no significant association (p-value>0.05). Summary: Compliance to iron-folic acid tablets consumption serves as a protective factor against anemia. It is recommended that healthcare providers strengthen education, follow-up, and support strategies to improve adherence and help reduce anemia prevalence in pregnancy.