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 41.8% 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 15-49 in all parts of ethiopia. the study was conducted from january 18 to june 27, 2016. 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 3096 (563 urban and 2533 rural). significant relationships were determined using multivariable logistic regression analysis. results: the general proportion of iron supplementation compliance was 15.07% (95% ci= 13.8%-16.4%). however, the proportion of adherence to iron among urban and rural women was 17.7% (95% ci=14.8%-21.1%) and 11.2% (95% ci=10.1% -12.5%), respectively. urban areas were associated with exposure to media (aor=2.04, 95% ci, 1.07, 3.89) and frequent anc≥4 (aor=2.31, 95% ci, 1.10, 4.86). however, those with a high school education level were 65% less likely to adhere to iron supplementation. additionally, for rural, the odds of iron supplementation adherence were higher for primary (aor=1.39, 95% ci, 1.03, 1.89) and secondary education (aor=1.77, 95% ci, 1.02, 3.08), unemployed women (aor=1.35, 95% ci, 1.04, 1.76), first anc registration at 1st 13 months (aor=3.03, 95% ci, 1.41, 6.54), and 2nd trimester (aor=2.82, 95% ci, 1.34, 5.95). conclusion: the proportion of iron use adherence through gestation is low in both urban and rural ethiopia compared to the national recommendation.