ASSOCIATION BETWEEN IRON SUPPLEMENT ADHERENCE AND ANEMIA AMONG PREGNANT WOMEN IN A PRIMARY HEALTHCARE CENTER IN INDONESIA

Abstract

Background: Maternal anemia remains a major public health concern worldwide, particularly in low- and middle-income countries. Despite the implementation of routine iron supplementation programs during pregnancy, anemia continues to affect a substantial proportion of pregnant women. Poor adherence to iron supplementation has been recognized as one of the primary barriers to achieving optimal maternal hemoglobin levels and preventing adverse pregnancy outcomes. Objective: This study aimed to examine the association between adherence to iron supplementation and the occurrence of anemia among pregnant women attending a primary healthcare center in Indonesia. Methods: A quantitative cross-sectional study was conducted among 40 pregnant women receiving antenatal care at Kuwarasan Primary Healthcare Center, Central Java, Indonesia, between May and June 2024. Participants were selected using total sampling. Adherence to iron supplementation was assessed using a structured questionnaire, while anemia status was determined based on documented hemoglobin examination results recorded in maternal health records. Descriptive statistics were used to summarize participant characteristics, and the Chi-square test was employed to examine the association between iron supplement adherence and anemia. Statistical significance was established at p < 0.05. Results: Among the 40 participants, 24 (60.0%) demonstrated good adherence to iron supplementation, whereas 16 (40.0%) had poor adherence. Anemia was identified in 15 (37.5%) pregnant women. The Chi-square analysis revealed a statistically significant association between adherence to iron supplementation and anemia (p = 0.001). Pregnant women with poor adherence were more likely to experience anemia than those who adhered to the recommended iron supplementation regimen. Conclusion: Adherence to iron supplementation was significantly associated with anemia among pregnant women. Strengthening adherence through continuous nursing education, individualized counseling, family involvement, and routine monitoring during antenatal care may contribute to reducing maternal anemia and improving pregnancy outcomes in primary healthcare settings.