Adherence to iron-folic acid supplementation and its associated factors among pregnant women in Kenya: A multilevel data analysis of the 2022 Kenya Demographic and Health Survey

Iron and folic acid deficiency is a global public health issue, particularly in low- and middle-income countries. Adherence to iron-folic acid supplementation (IFAS) remains low in Kenya. Despite several studies on IFAS adherence in Kenya, they do not assess the national scope and clustering effects using advanced analytical models. Therefore, we aimed to assess IFAS adherence and its associated factors among pregnant women in Kenya using data from the 2022 Kenyan Demographic and Health Survey. Nearly two in five pregnant women did not receive IFAS for the recommended periods. Factors such as maternal age, parity, antenatal visits, and education enhanced IFAS adherence, whereas large family size and starting antenatal care in the third trimester of pregnancy reduced adherence. There is need for community, government, and non-governmental organizations to enhance adherence by implementing customized interventions on the factors identified as positive and negative associations.