Maternal Knowledge on Recommended Iron and Folic Acid Supplementation in Pregnancy: A Hospital-based Cross-Sectional Study in Sri Lanka

Background: Anemia during pregnancy is a significant public health concern. Sri Lankan maternal healthcare system adopted free provision of iron and folic acid supplementation to all its pregnant women since several decades, to mitigate the high prevalence of anemia. Despite the dedicated national maternal healthcare services, the prevalence of maternal anemia remains at a moderate level of public health significance for many years. Objective: This study assessed maternal knowledge of anemia and iron and folic acid supplementation in pregnancy (and associated factors), and the content of counselling on iron and folic acid supplementation received by women during pregnancy. Methods: A hospital-based cross-sectional study enrolled 703 women at 0–4 days postpartum. A pretested interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, use of iron and folic acid supplementation, and obstetrics. A self-administered questionnaire was used to assess maternal knowledge with close-ended questions. Results: Of the 703 women, 69.7% scored 9, i.e., the maximum maternal knowledge score. Maternal ethnicity, education level, and monthly family income were significantly associated with maternal knowledge of anemia and iron and folic acid supplementation. However, the majority of women did not receive information on side effects and ways to minimize them during the antenatal counselling sessions. Conclusion: Antenatal counselling on anemia and iron and folic acid supplementation should be improved, and the maternal education level should be considered when providing counselling. It is recommended to standardized antenatal counselling sessions for all community clinics in Sri Lanka, where the content must emphasize anemia prevention and compliance with the recommended iron and folic acid supplementation.