Public Health Nutrition

Research Paper

Iron supplementation compliance among pregnant women in Bicol, Philippines

Pamela L Lutseya1 c1, David Dawea2, Ellen Villatea3, Shiela Valenciaa4 and Ofelia Lopeza5

a1 Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA

a2 Food and Agriculture Organization, Regional Office for Asia and the Pacific, Bangkok, Thailand

a3 Helen Keller International, Manila, Philippines

a4 The International Rice Research Institute, Los Banos, Philippines

a5 Sorsogon Provincial Health Office, Sorsogon, Philippines


Objective To quantify factors influencing iron supplementation compliance and haemoglobin (Hb) concentrations among pregnant women participating in an iron supplementation programme under routine field conditions.

Design Cross-sectional interviews and Hb measurements.

Settings Albay and Sorsogon provinces, Bicol, Philippines.

Subjects Three hundred and forty-six pregnant women receiving iron supplements via the Philippine iron supplementation programme.

Results Women had a mean Hb concentration of 10.75 ± 1.43 g dl−1, and 56.4% were anaemic (Hb < 11.0 g dl−1). On average, the first prenatal visit occurred at nearly 4 months (3.80 ± 1.56). The ratio of visits to number of months pregnant was 0.51 ± 0.24. Self-reported consumption of pills received was 85% (0.85 ± 0.23), although pill counts suggested that consumption was 70% (0.70 ± 0.35). Using multiple regression, an earlier first prenatal visit and greater self-reported compliance were positively associated with Hb concentrations. Additionally, perceived health benefits from taking the supplements and higher health programme knowledge were positively associated with pill consumption, while experiencing side-effects and disliking the taste of the supplements were associated with lower pill consumption. A greater number of living children was negatively associated with the frequency of prenatal visits. The number of children was also directly negatively associated with Hb concentrations.

Conclusions Compliance was positively related to Hb concentrations. Several factors associated with greater compliance were identified, including marital status, number of children, health programme knowledge, side-effects, perceived health benefits, and dislike of taste. Some of these factors may serve as avenues for interventions to increase compliance, and ultimately Hb concentrations.

(Received May 04 2006)

(Accepted February 13 2007)


c1 Corresponding author: Email


Former affiliation: The International Rice Research Institute, Los Banos, Philippines.