Rural-Urban Differential of Iron Supplementation Compliance during Pregnancy among Reproductive aged Women in Ethiopia

Background & aim: The global burden of iron deficiency anemia remains substantial, accounting for ۴۱.۸% of the population. This study assessed the rural‒urban differential in iron supplementation compliance during pregnancy among reproductive-aged women.Methods: A comparative cross-sectional study was conducted among women aged ۱۵-۴۹ in all parts of Ethiopia. The study was conducted from January ۱۸ to June ۲۷, ۲۰۱۶. After data related to the compliance with iron supplementation were obtained from the demographic survey, a mixed-effects logistic regression model was performed on a weighted sample of ۳۰۹۶ (۵۶۳ urban and ۲۵۳۳ rural). Significant relationships were determined using multivariable logistic regression analysis. Results: The general proportion of iron supplementation compliance was ۱۵.۰۷% (۹۵% CI= ۱۳.۸%-۱۶.۴%). However, the proportion of adherence to iron among urban and rural women was ۱۷.۷% (۹۵% CI=۱۴.۸%-۲۱.۱%) and ۱۱.۲% (۹۵% CI=۱۰.۱% -۱۲.۵%), respectively. Urban areas were associated with exposure to media (AOR=۲.۰۴, ۹۵% CI, ۱.۰۷, ۳.۸۹) and frequent ANC≥۴ (AOR=۲.۳۱, ۹۵% CI, ۱.۱۰, ۴.۸۶). However, those with a high school education level were ۶۵% less likely to adhere to iron supplementation. Additionally, for Rural, the odds of iron supplementation adherence were higher for primary (AOR=۱.۳۹, ۹۵% CI, ۱.۰۳, ۱.۸۹) and secondary education (AOR=۱.۷۷, ۹۵% CI, ۱.۰۲, ۳.۰۸), unemployed women (AOR=۱.۳۵, ۹۵% CI, ۱.۰۴, ۱.۷۶), first ANC registration at ۱st ۱۳ months (AOR=۳.۰۳, ۹۵% CI, ۱.۴۱, ۶.۵۴), and ۲nd trimester (AOR=۲.۸۲, ۹۵% CI, ۱.۳۴, ۵.۹۵).Conclusion: The proportion of iron use adherence through gestation is low in both urban and rural Ethiopia compared to the national recommendation.