Background and Aim
Maternal morbidity and mortality statistics remain unacceptably high in Malawi. Prominent among the risk factors in the
country is anaemia in pregnancy, which generally results from nutritional inadequacy (particularly iron deficiency) and malaria,
among other factors. This warrants concerted efforts to increase iron intake among reproductive-age women.
This study, among women in Malawi, examined factors determining intake of supplemental iron for at least 90 days during
pregnancy.
Methods
A weighted sample of 10,750 women (46.7%), from the 23,020 respondents of the 2010 Malawi Demographic and Health
Survey (MDHS), were utilized for the study. Univariate, bivariate, and regression techniques were employed. While univariate
analysis revealed the percent distributions of all variables, bivariate analysis was used to examine the relationships between
individual independent variables and adherence to iron supplementation. Chi-square tests of independence were conducted
for categorical variables, with the significance level set at P < 0.05. Two binary logistic regression models were used to
evaluate the net effect of independent variables on iron supplementation adherence.
Results
Thirty-seven percent of the women adhered to the iron supplementation recommendations during pregnancy. Multivariate
analysis indicated that younger age, urban residence, higher education, higher wealth status, and attending antenatal care
during the first trimester were significantly associated with increased odds of taking iron supplementation for 90 days or
more during pregnancy (P < 0.01).
Conclusions
The results indicate low adherence to the World Health Organization’s iron supplementation recommendations among
pregnant women in Malawi, and this contributes to negative health outcomes for both mothers and children. Focusing on
education interventions that target populations with low rates of iron supplement intake, including campaigns to increase
the number of women who attend antenatal care clinics in the first trimester, are recommended to increase adherence to iron
supplementation recommendations.