Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21)

Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21) Angan Sengupta, Meghna Prakash, Tina Dutta This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4587207/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background: Iron and Folic Acid (IFA) supplementation is one of the highly recommended strategies to tackle anemia. Under the backdrop of high anemia prevalence, this study examines the level of non- compliance with IFA supplementation among pregnant women in India. Methods: The analysis is conducted on a sample of 151171 women, who bought or received IFA tablets/syrup during pregnancy, and was surveyed during the National Family Health Survey-5 (2019-21). Descriptive statistics and conditional probabilities are calculated to examine the initiation and attainment of different levels of IFA consumption across selected background variables. Binary logistic regressions are employed to understand the influence of socio-economic factors on non-compliance of IFA supplementation for minimum 100 days and 180 days. Results: While the probability of initiation of IFA tablets is fairly high among pregnant women in India, the probability of consuming at least 100 tablets declines drastically for pregnant women irrespective of their socio-economic profile. The chances of not taking IFA for at least 100 days and at least 180 days are lesser by 21% and 15% for urban with respect to rural women. Age is not a significant parameter. When compared to the richest, the poorest face 1.6 times higher odds for not consuming IFA for at least 100 days, and 1.96 times higher in case of non-compliance for minimum 180 days. Women with no education shows 1.73 and 1.46-times higher likelihood do be non-compliant with both criteria as compared to those with higher education. Those who have received less than four ANCs are at least two times more likely to be non-compliant. Risk of non-compliance is lesser among women with lower birth order as compared to pregnancies of third and higher birth order. Conclusion: Involvement of community health workers in awareness generation and close monitoring of IFA consumption behaviour ensuring compliance for a minimum of 180 days, might improve the scenario. Iron and Folic Acid Antenatal Care Non-compliance Pregnancy Anemia India Figures Figure 1 Figure 2 Figure 3 Figure 4 Background The prevalence of anemia among pregnant women has been a critical concern for the health of expectant mothers in Indian society; an issue that continues to persist despite concerted efforts. The deficiency of folic acid can cause numerous maternal and foetal health conditions such as spontaneous abortion, megaloblastic anemia in foetus, pre-eclampsia, abruption placenta, adverse birth outcomes and neural tube defects [ 1 ]. In order to address anemia and to improve maternal and foetal health, World Health Organization (WHO) recommends IFA supplementation for all pregnant women, at least for 90 days [ 2 , 3 ]. A cross-sectional study conducted in the eastern terai of Nepal found that IFA compliance rate was 58% during pregnancy and 42% were anemic and the likelihood of being anemic was 24 times more in IFA non-compliant women during pregnancy than their counterparts [ 4 ]. A study conducted involving pregnant women attending Antenatal Care (ANC) in a Sub District Hospital in National Capital Region, found that the non-anemic women (greater than 11gm/dl hemoglobin level) (82%) had better compliance with IFA tablets, as against the compliance rate of 73.6% among anemic pregnant women [ 5 ] Another study based on pregnant women receiving antenatal services from the Agartala Government Medical College- PMC validates that the non- compliance to iron and folic acid supplementation has a high role in the prevalence of anemia among the pregnant women [ 6 ]. Kumar et al. (2019) finds that utilization of “full ANC” 1 , which includes consumption of IFA tablets/syrup for at least 100 days as one of the components, has been only one fifth among the pregnant women in India. The lower likelihood of full ANC utilization among Indian pregnant women are found to be linked with higher birth order, teenage and unplanned pregnancies, father’s absence during antenatal visits, lower mother education, and lower wealth quintile(s). The National Family Health Survey (NFHS)-5 (2019-21) data shows that 57% of women in India are anemic (with almost 32% women being moderately to severely anemic), when compared to 53% in NFHS-4. The pervasiveness of anemia is 93% in Ladakh, whereas it is more than 60% in union territories and states such as Jammu & Kashmir, Dadra & Nagar Haveli and Daman & Diu, Chandigarh, Chhattisgarh, Bihar, Odisha, Gujarat, Jharkhand, Assam, Tripura, West Bengal [ 8 ]. Even if NFHS-5 states that half of the pregnant women are anemic, empirical studies have observed that nearly three-fourth of the pregnant women in India was found to be anemic [ 9 ]; yet their adherence to IFA supplementation has been extremely low. According the NFHS-5, eighty-eight percent of women who gave birth in last five years since the survey, purchased or were given IFA tablets during pregnancy. During last few decades there has been efforts to contain the prevalence of anemia through Iron Folic Acid supplementation. Yet, its impact in curbing anemia has not been very encouraging, mainly due to poor compliance rate. Studies from various low- and middle-income countries have observed that the compliance to IFA supplementation has remained sub-optimal, registering lower than 80% [ 3 , 4 , 10 , 11 ]. A systematic review conducted among pregnant women in Sub-Saharan Africa shows an extremely low prevalence (39.2%) of compliance to IFA supplementation [ 12 ]. In Nepal, three-fourth of women were compliant with the IFA tablets [ 10 ]. In India, a number of previous research show varied rate of IFA compliance. Report of the national level NFHS-5 survey also states that more than 85% of women who delivered a child during the last five years were given or bought IFA tablets during their pregnancy. However, less than half of all pregnant women took supplementation for at least 100 days [ 8 ]. A study conducted among pregnant women in urban areas of South India (Karnataka) observed that 58.1% of its respondents consumed all the IFA tablets provided to them [ 13 ], while studies conducted in Kolkata and Delhi observed more than 77% of women attending ANC services were compliant to the IFA supplementation [ 5 , 14 ]. However, a study conducted in a smaller city found that only 52.5% were compliant to IFA supplementation [ 6 ]. A number of factors can be attributed to non- compliance with IFA supplementation. Multiple studies evaluating factors influencing IFA supplementation found that knowledge of IFA supplementation, number of antenatal care visits, birth order, economic status, educational level and age of pregnant women play important roles in compliance to IFA supplementation in India [ 13 , 15 ]. Hence, it is important to monitor and evaluate the compliance status of IFA consumption in any country where there is high prevalence of anemia among women, especially among pregnant women. The present study attempts to assess the level of compliance to IFA supplementation among pregnant women aged 15–49 years in India during 2019-21. The specific objectives are: 1) to study the percentage distribution of respondents failing to comply with the consumption of IFA supplementation for at least 100 days and at least 180 days across their socio-economic backgrounds, 2) to study the pattern of progression of a woman’s beginning of IFA tablets consumption to her continuation for a minimum of 100 + days and then from 100 + to 180 + days, and 3) to investigate how different socio-economic and demographic covariates influence a woman’s propensity to consume IFA tablets/syrup for at least 100 and at least 180 days. Methods The data for the analysis are obtained from the “Children’s Recode” (IAKR file) of National Family Health Survey (NFHS)-5 conducted during 2019-21. The NFHS is conducted on a regular interval across all states of India. NFHS-5 collects data on several socio-demographic and public health parameters at both individual and household level, claiming to cover a representative sample of more than 95% of the Indian population. During the survey, women who have given a birth in the last five years were interviewed to understand the percentage of women who were given or who purchased IFA tablets during the pregnancy for their recent birth. From a sample of 664,972 selected households, 747,176 eligible women are identified for individual interviews, and this study analyses a sample size of 151171 women, those who bought or received IFA tablets or syrup during pregnancy. The first part of analyses consists of descriptive analysis to understand the percentage distribution of women complying to consumption of 100 and 180 IFA tablets across various socio- economic characteristics. The second part entails computation of probabilities of i) IFA initiation, ii) IFA continuation till 100 + tablets and iii) continuation from 100 + to 180 + IFA tablets for the sampled women with different background characteristics. The third and final part of analyses involves causal analysis to investigate how different socio-economic and demographic covariates influence a woman’s propensity to fail to consume 100 IFA tablets and 180 IFA tablets. For the second part of analyses, the probabilities are calculated as follows: Let, T: number of IFA tablets consumed by a woman from a particular socio − economic background n(T = t): number of women consuming t number of tablets $$P(T=t): Probability of a woman consuming t number of tablets$$ Then, \(\left(i\right) P\left(consuming at least one IFA tablet\right)is given by:\) $$P(T\ge 1)= \frac{n(T\ge 1)}{n(T\ge 1)+n(T=0)}$$ $$\left(ii\right)P\left(consuming at least100 IFA tablets|the woman initiated IFA consumption\right)$$ $$P(T\ge 100|T\ge 1)=\frac{n(T\ge 100)}{n(T\ge 1)}$$ $$\left(iii\right)P\left(consuming at least 180 IFA tablets|the woman consumed at least 100 tablets\right)$$ $$P(T\ge 180|T\ge 100)=\frac{n(T\ge 180)}{n(T\ge 100)}$$ For the third part of analyses, two separate binary logit regression are run, delineated as follows: Model-1 Dependent variable: Y = 1: if a woman fails to consume at least 100 IFA tablets; (Y = 0, otherwise) Model-2 Dependent variable: Y = 1: if a woman fails to consume at least 180 IFA tablets; (Y = 0, otherwise) The general form of binary logit regression model is given by: $$ln\left(\frac{p(Y=1)}{1-p(Y=1)}\right)={\beta }_{0}+{\beta }_{1}{X}_{1}+{\beta }_{2}{X}_{2}+....+{\beta }_{k}{X}_{k}+{ϵ}_{i}$$ $$where,the ratio \frac{p(Y=1)}{1-p(Y=1)} is called the odds ratio$$ $$the odds ratio implies the likelihood of ocurrence of Y=1 as compared to Y=0$$ $${X}_{1}{X}_{2},....,{X}_{k} are the independent variables$$ $${\beta }_{1}, {\beta }_{2},\dots .,{\beta }_{k} are the changes in the log-natural of odds ratios given as:$$ $${\beta }_{i}=ln\left(\frac{\frac{p(Y=1|{X}_{i}=1)}{1-p(Y=1|{X}_{i}=1)}}{\frac{p(Y=1|{X}_{i}=0)}{1-p(Y=1|{X}_{i}=0)}}\right)$$ $$Alternatively, {e}^{{\beta }_{i}} is the change in the odds ratios, given as:$$ $${e}^{{\beta }_{i}}=\left(\frac{\frac{p(Y=1|{X}_{i}=1)}{1-p(Y=1|{X}_{i}=1)}}{\frac{p(Y=1|{X}_{i}=0)}{1-p(Y=1|{X}_{i}=0)}}\right)$$ The list of independent variables for both the models includes place of residence (‘rural’ reference category), age grouped into five categories (’40–49’ reference category), wealth index (‘richest’ reference category), highest education level of women (‘higher’ reference category), caste groups (‘none of them’ reference category), religion (‘Hindu’ reference category), antenatal care visits (‘yes’ reference category), partner’s education level (‘higher’ reference category), working status of women (‘no’ reference category), husband or partner’s presence during ANC visits (‘yes’ reference category), and birth order of child (‘three and above’ reference category). Results Compliance Pattern of IFA Tablets among Indian Women Compliance to IFA tablets is measured as whether a woman actually consumes the tablets after receiving/purchasing them. In 2019-21, there are more than 60% of women in Uttar Pradesh, Bihar, Jharkhand and Ladakh along with a few north-eastern states such as Arunachal Pradesh, Nagaland, Tripura (Fig. 1), who received IFA tablets/syrup but did not consume for more than 100 days. The non- compliance percentage further increases in case of consumption of IFA supplementation for at least 180 days, with Rajasthan accounting for more than 80% non-compliance (Fig. 2 ). Non-compliance for 100 IFA tablets is lesser than 20% in the southern states of India, including, Kerala, Tamil Nadu and Goa (Fig. 1). The same set of states has been performing better as compared to the rest of the country with respect to non-compliance for minimum 180 days, portraying a non-compliance percentage of less than 40% (Fig. 2 ). Table 1 presents the non-compliance in terms of consumption of IFA for at least 100 days and for at least 180 days by women’s socio-economic and demographic characteristics. It is observed that 45.6% of rural women do not consume IFA tablets for 100 days, even after receiving or buying the tablets/syrup. At the same time, 63.1% of rural women do not consume IFA tablets for 180 days. The non-compliance even after receiving IFA tablets significantly decreases with rise in age; for both the categories (100 days’ consumption and 180 days’ consumption). The non-compliance to IFA tablet consumption is highest among the poorest wealth quintile (50.9% and 66.6% for 100 days and 180 days respectively), which significantly drops with the advancement of economic profile. On the other hand, approximately 32% of richest women do not consume IFA tablets even after receiving it for 100 days; the percentage is higher (51.4%) when the reference period is 180 days. Education of women being an important factor; those respondents with no education show the highest non-compliance for both the criteria; 50.5% and 64.4% for 100 days and 180 respectively. It is noteworthy that one out of three women with higher education do not consume the tablets even for 100 days, while more than half of them could not meet the consumption criteria for 180 days. There is a significantly higher percentage of scheduled caste women who did not consume IFA tablets for 100 days (45%) and 180 days (62.3%). More than 40% of Hindus and Muslims demonstrate non-compliance to 100 days of IFA consumption, while the figures surge by another twenty percentage points in case of 180 days’ reference period. Christian women and women belonging to other religions show much better compliance rate. Those who have more than four ANC visits happen to demonstrate better consumption practices as compared to those who received less than four ANC visits. Even though the gap still remains statistically significant, it reduces considering 180 days’ compliance pattern. Working status does not impact the criteria of meeting 100 days or 180 days IFA supplements consumption landmarks very strongly. Higher is the education level of husband or partner, the rate of non-compliance to IFA tablets statistically significantly declines among their spouses/partners. Half of the women whose partners has no education is found to be non-compliant to IFA tablet for at least 100 days. However, among those whose partners have achieved higher education, percentage of women not consuming at least 100 IFA tablets fall to 36%. Non-compliance to consumption of at least 180 IFA tablets increases drastically irrespective of education levels of the women’s partners. NFHS-5 data also finds that husband or partner’s presence during pregnancy is significantly associated with the distribution of IFA non-compliance, as 48.3% of those whose husbands were not present for ANC checkup are found to be non-compliant with IFA tablets for at least 100 days, as compared to 41.5% among those whose husbands/partners were present. In case of non-compliance for at least 180 days, 63.2% of those whose husbands did not accompany for ANC visits are non-compliant with IFA supplementation. Yet another significant variable is the birth order of the child, as the birth order increases the non-compliance to IFA consumption also increases. When the birth order is three and above, approximately 60% and 78% women are non-compliant for 100 days and 180 days respectively. Table 1 Percent distribution of women showing non-compliance to IFA supplementation for at least 100 days and at least 180 days different background characteristics of women even after receiving/ purchasing IFA tablets/ syrup Determinants Categories Not consuming IFA tablets for at least 100 days Chi-squared Sig Not consuming IFA tablets for at least 180 days Chi-squared Sig Type of place of residence Urban 34.0% 0.000 53.6% 0.000 Rural 45.6% 63.1% Age 15–19 43.0% 0.000 62.0% 0.000 20–24 43.6% 62.1% 25–29 42.8% 60.6% 30–39 40.5% 58.4% 40–49 39.3% 56.2% Wealth index Poorest 50.9% 0.000 66.6% 0.000 Poorer 47.3% 64.5% Middle 41.8% 60.5% Richer 36.9% 56.5% Richest 31.9% 51.4% Highest educational level No education 50.5% 0.000 64.4% 0.000 Primary 46.6% 64.2% Secondary 41.2% 60.2% Higher 33.8% 53.8% Caste/Tribe Schedule caste 45.0% 0.000 62.3% 0.000 Schedule tribe 41.8% 61.8% OBC 43.4% 59.9% None of them 38.1% 58.1% Religion Hindu 43.0% 0.000 60.8% 0.000 Muslim 42.1% 61.1% Christian 28.6% 48.5% Others 35.5% 51.9% ANC Visit four and above No 51.9% 0.000 65.3% 0.000 Yes 36.0% 57.3% working status No 41.5% 0.012 60.8% 0.362 Yes 42.5% 60.3% Husband/partner's education No education 50.4% 0.000 65.9% 0.000 Primary 44.2% 62.6% Secondary 40.9% 60.8% Higher 36.0% 56.2% Husband/partner’s presence during ANC No 48.3% 0.000 63.2% 0.000 Yes 41.5% 60.8% Birth order One 43.5% 0.000 65.3% 0.000 Two 46.5% 68.3% Three and above 59.5% 77.9% Total 42.3% 60.4% Progression and Dropouts in IFA Consumption Table-2 presents the following probabilities: 1) the probability of consuming IFA supplementation for at least one day 2) the conditional probability of consuming IFA supplementation for at least one day provided they were given/bought iron tablets/syrup, 3) the conditional probability of consuming IFA supplementation for at least 100 days given the woman consumed for at least one day, and 4) the conditional probability of consuming IFA supplementation for at least 180 days given the woman consumed for at least 100 days. The idea is to study the pattern of progression of a woman’s initiation of consumption of IFA tablets to her continuation till 100 + days and then from 100 + to 180 + days. As observed from Table-2, for each background variable, the likelihood of a woman’s initiation of consumption of IFA tablets is substantially high ranging from 0.75 to 0.89. Even for women with no education, their chance of taking IFA tablet is considerably high at 0.752. Provided a woman has obtained IFA tablets or syrup, the probability of initiating the consumption increases considerably (at least 95%) irrespective of her socioeconomic background. However, for women of all backgrounds, the likelihood of continuing to consume IFA tablets for at least 100 days decreases significantly. Women with no education and women with lesser than four ANC visit have only 36% and 36.5% chance respectively of continuing the IFA consumption for at least 100 days. High dropout rate in consumption of IFA tablets is observed among women with no or primary education, poorest or poorer wealth index, no ANC visit, rural background, and women from scheduled caste social group, where the dropout percentage from initiation to 100 + days is more than 50%. Even for women with urban background, and women from higher to richest wealth index have 0.625 to 0.66 probability of continuing IFA tablets up to 100 + days. Likelihood to initiate consumption of IFA supplementation is considerably high among women who are currently working, or who husbands are highly educated. One noteworthy finding from Table-2 is that once a woman consumes IFA tablets at least 100 days, her likelihood to continue the consumption to at least 180 days increases for all background variables (except for Christians, it is slightly lower). For e.g. while the probability to reach consumption of IFA tablets to 100 days mark is only 0.361 for women having no education, the probability for consumption of tablets for 180 + days once they finish consuming tablets for at least 100 days is 0.49. For the poorest and richest groups, these proportions are respectively 0.49 and 0.67. Among religious groups, Christian women showcase a higher probability to comply to the IFA targets as compared to women from Hindu and Muslim communities. While women with at least four ANC visits exhibit better initiation (0.895) and continuation to 100 days IFA consumption mark (0.615), their continuation to 180 + days (0.612) is just slightly higher than those having less than four ANC visits (0.525). Table 2 Probability of initiation and Conditional Probabilities of continuation of IFA tablets Probability of consuming IFA supplementation for at least one day (1) Conditional Probability of consuming IFA supplementation for at least one day provided they were given/bought iron tablets/syrup (2) Conditional Probability of consuming IFA supplementation for at least 100 days given the woman consumed for at least one day (3) Conditional Probability of consuming IFA supplementation for at least 180 days given the woman consumed for at least 100 days (4) Place of residence Urban 0.864 0.966 0.625 0.637 Rural 0.835 0.961 0.481 0.566 Age groups 15–19 0.856 0.968 0.520 0.573 20–24 0.849 0.965 0.510 0.573 25–29 0.846 0.962 0.520 0.596 30–39 0.838 0.960 0.541 0.605 40–49 0.760 0.954 0.505 0.561 Wealth index Poorest 0.794 0.960 0.388 0.490 Poorer 0.830 0.961 0.458 0.546 Middle 0.852 0.963 0.535 0.590 Richer 0.871 0.965 0.597 0.621 Richest 0.884 0.963 0.660 0.665 Highest educational level No education 0.752 0.956 0.361 0.489 Primary 0.820 0.961 0.459 0.531 Secondary 0.865 0.965 0.547 0.597 Higher 0.896 0.962 0.645 0.654 Caste/ tribe Schedule caste 0.837 0.960 0.491 0.578 Schedule tribe 0.854 0.967 0.528 0.556 OBC 0.838 0.962 0.508 0.613 None of them 0.848 0.962 0.575 0.59 Religion Hindu 0.847 0.963 0.518 0.593 Muslim 0.820 0.965 0.508 0.546 Christian 0.856 0.938 0.679 0.656 Others 0.856 0.957 0.609 0.684 ANC Visit four and above No 0.772 0.952 0.365 0.525 Yes 0.895 0.972 0.615 0.612 working status No 0.635 0.962 0.533 0.573 Yes 0.640 0.962 0.521 0.593 Husband/partner's education No education 0.539 0.962 0.383 0.485 Primary 0.599 0.968 0.488 0.544 Secondary 0.660 0.964 0.549 0.581 Higher 0.719 0.961 0.613 0.623 Husband/partner’s presence during ANC No 0.767 0.945 0.423 0.551 Yes 0.842 0.966 0.545 0.594 Birth order One 0.581 0.967 0.577 0.614 Two 0.702 0.963 0.548 0.593 Three and above 0.644 0.956 0.418 0.545 Total 0.843 0.962 0.573 0.522 Factors influencing non-compliance to IFA tablet consumption The logistic regression presented in Table 3 shows that the chance of not taking IFA tablets for at least 100 days and at least 180 days are lesser by approximately 21% and 15% for urban with respect to rural women. Wealth index exhibits a significant impact on the compliance to consumption of IFA tablets. When compared to the richest, the poorest face nearly 1.6 times higher odds of failure to consume IFA for least 100 days, and nearly 1.962 times higher odds of failure for consuming IFA for at least 180 days. An increase in level of education among pregnant women and among their partners significantly decreases the odds for non-compliance with IFA consumption. When compared to those with higher education, women with no education show increased odds of failure to consume IFA by 1.72 times for minimum 100 days and 1.46 times for minimum 180 days. The chances of non-compliance are significantly lower for scheduled tribes (STs) women; around 21% lesser with reference to ‘none of them’ (general) castes women. However, those belonging to scheduled castes (SCs) do not show any significant difference as compared to general category. Christian women, when compared to women belonging to other religions have significantly much lower likelihood to not consume the tablet for at least 100 days (OR = 0.585) and a minimum of 180 days (OR = 0.569). Those who have not received at least four Antenatal Care (ANC) check-up have at least two times higher likelihood to not consume the tablet for at least 100 or 180 days. Those who are economically engaged show a significantly higher chance (OR = 0.879), at 5% level of significance, of failing to comply with minimum 180 days criterion. Also, as compared to those women with birth order three and above, women with one and two birth order showed around 35% and 25% lower odds to not comply with IFA supplementation for 100 days and 180 days respectively. Table 3 Binary logistic regression on non-compliance with IFA supplementation for at least 100 days and at least 180 days even after receiving or purchasing IFA supplementation Determinants Categories IFA 100 IFA 180 Sig. Exp(β) 95% C.I. for Exp(B) 95% C.I. for Exp(B) Lower Upper Sig. Exp(β) Lower Upper Place of residence Rural 1.00 1.00 Urban .000 .791 .735 .851 .000 .852 .790 .918 Age 40–49 15–19 .052 1.330 .997 1.775 .846 1.032 .750 1.421 20–24 .000 1.521 1.205 1.921 .543 1.085 .834 1.411 25–29 .042 1.267 1.009 1.591 .404 .896 .693 1.159 30–39 .185 1.167 .929 1.466 .247 .859 .664 1.111 Wealth index Richest 1.00 1.00 Poorest .000 1.607 1.421 1.816 .000 1.962 1.717 2.243 Poorer .000 1.370 1.225 1.530 .000 1.605 1.428 1.804 Middle .011 1.144 1.031 1.270 .000 1.291 1.161 1.434 Richer .675 .979 .888 1.080 .000 1.199 1.089 1.321 Education level Higher 1.00 1.00 No education .000 1.726 1.520 1.959 .000 1.457 1.266 1.675 Primary .000 1.521 1.337 1.729 .000 1.394 1.212 1.604 Secondary .000 1.217 1.110 1.335 .936 .996 .908 1.092 Caste None of them 1.00 1.00 Schedule caste .952 .997 .908 1.095 .988 .999 .905 1.104 Schedule tribe .000 .785 .695 .885 .000 .760 .668 .864 OBC .019 1.100 1.016 1.192 .441 .968 .891 1.052 Religion Hindu 1.00 1.00 Muslim .932 1.004 .917 1.099 .964 1.002 .908 1.106 Christian .000 .585 .472 .725 .000 .569 .467 .693 Other religion .834 .981 .816 1.179 .058 .836 .694 1.006 ANC Visits: four and above Yes 1.00 1.00 No .000 2.254 2.119 2.397 .000 2.093 1.948 2.248 Education level of partner Higher 1.00 1.00 No education .150 .907 .794 1.036 .372 1.071 .921 1.245 Primary .001 1.17 1.091 1.259 .083 .889 .778 1.016 Secondary .001 1.16 1.078 1.243 .161 .938 .858 1.026 Working status No 1.00 1.00 Yes .004 .901 .840 .967 .001 .879 .815 .947 Husband/partner’s presence during ANC Yes 1.00 1.00 No .000 1.352 1.241 1.473 .000 1.199 1.087 1.322 Birth order Three and above 1.00 1.00 One .000 .640 .585 .700 .000 .670 .608 .739 Two .000 .745 .688 .806 .000 .758 .694 .828 Figure 3 demonstrates the scatter plot between anemia and IFA non-compliance for 100 days in India. The analysis shows a positive correlation (correlation coefficient = 0.320) between anemia and IFA non- compliance. The outlying state or union territory in this case is Ladakh, with more than 90% prevalence of ‘any anemia’ (< 11.0 g/dl) in women. More than 50% women in Ladakh are not consuming IFA tablets for 100 days. Figure 4 exhibits a similar pattern in the case of non-compliance for 180 days. The correlation coefficient is 0.258, representing a weak, yet positive association between state-wise prevalence of anemia and IFA non-compliance for 180 days and above across states. As in the previous case, 64% women in Ladakh are not consuming the tablet for 180 days with an extremely high prevalence of anemia. Discussion Under the backdrop of an unwavering anemia prevalence, this study highlights a considerable gap in compliance to IFA consumption for a minimum of 100 days among Indian pregnant women. The probability of consuming IFA supplementation among pregnant women for at least one day is more than eighty percent. Even if ensuring the availability of IFA supplementation has almost made it certain that a woman will at least start taking IFA tablets/syrup, the probability of consuming those tablets or syrup for 100 days and above given that they have consumed at least one IFA tablet decreases tremendously. At the same time, if a woman consumes IFA tablets/ syrup at least for 100 days, that individual has a higher likelihood to consume at least 180 tablets irrespective of her socio-economic conditions. The probability of consuming more than 100 IFA tablets has remained very low, while that of 180 + tablets is appalling across all socioeconomic groups. However, there is a prominent regional variation in this regard. Southern states are doing better than the northern region, and urban population showing more compliance than their rural counterparts. Wealth index and education profile plays a significant role in determining compliance with intake of IFA tablet supplementation. Higher frequency of ANC visits certainly improves the compliance. Our study findings support the observations of Chourasia et al (2017)’s study which found that the women from highest socioeconomic stratum have significantly higher (two-times) odds for consumption of IFA tablets for at least 90 days. On the contrary, Deori et al. (2021) showed that the compliance was lower among well-off women (67.6%), while it was higher among women from lower socioeconomic status (82.1%) [ 5 ]. A study conducted in Philippines observed that rural poor was more compliant as compared to the urban poor women [ 3 ]. Even though our study does not find any significant association between age and IFA non- compliance, earlier studies in India showed that IFA compliance increases with age [ 5 , 13 ]. Chourasia et al. (2017) showed that women aged 30 years and above has 1.5 times higher chance to consume 90 + IFA tablets as compared to 15-19-year-old respondents [ 16 ]. However, a survey conducted in Ethiopia found that women in the higher age group (more than 35 years) showed less adherence when compared to women in the age group between 25 and 29 years [ 17 ]. Previous research showed IFA compliance is lower with teenage pregnancy [ 14 ]. Similar to our findings, earlier studies have also found that education of pregnant women is positively associated with IFA compliance [ 5 , 14 , 18 ]. Chourasia et al. (2017) showed that well educated women are four times likely to adhere to the recommended dose of IFA supplementation [ 16 ]. A study shows that women with higher level of education along with knowledge of hemoglobin status and iron pill dose has shown higher compliance to iron pills [ 19 ]. Studies from other developing countries also demonstrate a similar pattern [ 3 , 10 ]. Our results bolster the fact that ANC visits of women significantly influence IFA consumption. In sub-Saharan Africa it was found that IFA supplementation scenario could be improved by escalating the awareness among women about anemia and IFA supplementation, and more than four antenatal care visits [ 12 ]. A study based on urban slums in India found that increase in the number of ANC visits increases the compliance to iron pills [ 19 ]. Similar to our observations, other studies also have highlighted that there is a positive significance of the presence of partner during antenatal care visits on women consuming IFA tablets for at least 90 days [ 16 ]. Beside higher frequency of prenatal care visits, registering pregnancy during first trimester and being attended by any healthcare provider increases the probability of consuming IFA for at least 100 days [ 18 ]. Some of the most common cited reasons for non-compliance to IFA tablets are forgetfulness [ 13 , 14 , 19 , 20 ], women’s tendency to ignore personal health issues, or even the size of the tablets [ 19 ], side effects of the tablets [ 6 , 13 , 20 ], and so on. The reasons such as forgetfulness, size and taste of the tablets, unawareness about the consumption pattern etc. can be mitigated by the proper involvement of the community health workers. Earlier studies conducted in developing countries such as India [ 21 ], and Brazil [ 22 ] found the primary reason for non-compliance was the gap in the information provided by the healthcare workers. The other factors which resulted in a gap in the consumption of IFA tablets were inadequate counselling and distribution of tablets, poor utilization of healthcare services provided by the facilities and the prevalence of misconceptions around consuming medicines during pregnancy [ 13 , 20 ]. A study conducted on tribal adolescent girls in India observed that several qualitative factors influence the compliance and feasibility of IFA supplementation, that include creating awareness by active involvement of anganwadi workers, ensuring quality of tablets and its timely supply [ 23 ]. A study conducted in Uttar Pradesh noted that even if the women are given 100 pills of IFA supplements by the ASHA (Accredited Social Health Activists) workers for a period of three months, they only visit the villages once or twice per month, except attending emergency cases [ 24 ]. Informative posters about taking iron supplements, patient centric therapeutic approaches in case of side-effects, providing calendar based reminders can significantly improve the compliance [ 25 ]. In the high focus states of India, birth order (below 2) and mass media exposure showed a significance to women consuming IFA tablets for at least 90 days [ 16 ]. Our study supports the findings of Chourasia et al., (2017) that consumption of IFA supplementation decreases with rise in birth order [ 16 ]. However, Mithra et al. (2014) found that the compliance increases with birth order [ 13 ]. Studies on backward districts in Gujarat, observed that the external factors constraining the compliance with IFA supplementation are inaccessibility to healthcare facilities, and the economic cost to avail ANC services including IFA supplementation [ 26 ]. Prevalence of anemia among post-natal women in Indian states varies between 26.5–96.4% across Indian states [ 27 ]. Smitha et al. (2024) observed that only one-fifth of post-natal women were compliant with IFA supplementation, while more than half of them consumed IFA tablets during pregnancy [ 26 ]. Although Government of India has launched a weekly iron-folic acid supplementation program (WIFS) for adolescents in 2012, adolescent girls demonstrate high prevalence rate of anemia in India with a poor IFA consumption pattern [ 28 , 29 ]. Studies have shown that higher compliance to IFA tablets supplementation reduces prevalence of anemia substantially [ 23 ]. Therefore, this is important that the policymakers take the issue of IFA consumption seriously also for the women under post-natal care as well as those who are adolescents and non- pregnant women. Involving community health workers in providing ANC services can improve quantity and quality of ANC [ 30 ] and subsequent improvement in compliance to IFA consumption. Conclusion Even though the availability of IFA supplementation and the proportion of women initiating with the supplementation have been considerably high among pregnant women in India, the non-compliance with consuming minimum 100 and minimum 180 IFA tablets, even after receiving them is highly prevalent among pregnant women in India. This study has helped to understand the dynamics around the progression of likelihood of consuming IFA supplementation for a desired number of days. This is important to emphasize the need of educating and communicating about the importance of iron and folic acid consumption among adolescent girls and women of reproductive age. The IFA supplementation is one of several important tools or measures to control anemia [ 31 ]. The Government of India has launched Anemia Mukt Bharat in 2018 as part of intensified National Iron Plus Initiative (NIPI), targeting children and adolescents of both gender, women of reproductive age, pregnant women and lactating mothers. It aims at reducing the prevalence rate of anemia at a rate of 3% points per annum. Studies have suggested that health workers play a significant role in achieving the national policy goals by effectively mobilizing the community to consume IFA supplementation properly (Debi et al., 2020). The Pradhan Mantri Surakshit Matritva Abhiyan, launched by the Government of India, aims to provide comprehensive antenatal care at free of cost for each and every pregnant woman, on the ninth day of every month, besides diagnostic and counselling services for the women as a part of the strategy focusing on Reproductive Maternal Neonatal Child and Adolescent Health. Yet, uniform health care programs may not help in India, a country which is socio-culturally extremely diverse. Therefore, policies and strategies need to tailor-fit specific groups. A systemic approach is required to make a sustainable change in the ecosystem, involving people, frontline health workers, processes, public and private healthcare providers and the state. These findings wish to draw attention of the researchers studying maternal health issues, not only in India but in other low- and middle-income countries as well where anemia among pregnant women is a bothering public health concern. Limitations The approach of this study and its findings are not completely void of limitations. The analysis is based on secondary data and the information on gap between receiving and consuming IFA tablets are neither exhaustive nor explicit. A few of the reasons are obtained through literature review, could not be examined given the paucity of data in NFHS dataset. Many indicators related to perceptions about IFA supplementation among women could not be captured in this study. More primary researches understanding the roles of community health workers in social mobilization and motivating women reaching a higher IFA consumption level is required. Declarations Ethics approval and consent to participate: The protocol and the content of all the data collection tools for the National Family Health Survey (NFHS)-5, was reviewed and approved by the Institutional Review Board of International Institute for Population Sciences (IIPS) and the ICF Institutional Review Board, alongside the U.S. Centers for Disease Control and Prevention (CDC). Consent for publication: We state that all three authors have seen and approved the final version of the manuscript being submitted. All the authors have given their consent to submit this manuscript at BMC Pregnancy and Childbirth for a potential publication. Availability of data and materials: National Family Health Survey data is publicly available at free of cost, and can be downloaded from the Demographic Health Survey website (https://www.dhsprogram.com/) Competing interests: The authors do not have any conflict of interest to disclose. Funding: Since this manuscript is an outcome of a student’s dissertation work, this study has not received any financial support from any individual or organization. Authors' contributions: AS: Conceptualization, Methodology, Writing- Original draft preparation, Supervision, Validation MP: Conceptualization, Data curation, Analysis, Writing- Original draft preparation TD: Writing- Reviewing and Editing, Analysis, Validation Acknowledgements: The authors would like to thank the editorial team and the reviewers for their time and efforts References Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin b12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr. Bull. 2008;29:S101-S111. https://doi.org/10.1177/15648265080292S114 World Health Organization (WHO). Guideline: daily iron and folic acid supplementation in pregnant women. 2012. World Health Organization. Felipe-Dimog EB, Yu C-H, Ho C-H, Liang F-W. Factors influencing the compliance of pregnant women with iron and folic acid supplementation in the Philippines: 2017 Philippine Demographic and Health Survey Analysis. Nutrients. 2021;13:3060. https://doi.org/10.3390/nu13093060 Yadav KD, Yadav UN, Wagle RR, Thakur DN, Dhakal S. Compliance of iron and folic acid supplementation and status of anaemia during pregnancy in the Eastern Terai of Nepal: findings from hospital based cross sectional study. BMC Res. Notes. 2019;12:1-6. https://doi.org/10.1186/s13104-019-4167-6 Deori TJ, Ramaswamy G, Jaiswal A, Loganathan V, Kumar R, Mahey R, Yadav K, Kant S. Compliance with iron folic acid (IFA) tablets and associated factors among pregnant women attending ante-natal care clinic at Sub District Hospital, Ballabgarh. J Family Med Prim Care. 2021;10(5):2006-2011. 10.4103/jfmpc.jfmpc_1742_20 Choudhuri P, Debbarma A, Debbarma S, Reang T. Compliance to iron and folic acid tablets among pregnant women attending antenatal clinic in Agartala Government Medical College. J Family Med Prim Care. 2022;11(6):2763-2767. 10.4103/jfmpc.jfmpc_1914_21 Kumar G, Choudhary TS, Srivastava A, Upadhyay RP, Taneja S, Bahl R. et al. Utilisation, equity and determinants of full antenatal care in India: analysis from the National Family Health Survey 4. BMC Pregnancy Childbirth. 2019;19:327. https://doi.org/10.1186/s12884-019-2473-6 International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS)-5. 2022;IIPS, Mumbai Saha S, Pandya AK, Raval D, Wanjari MB, Saxena D. A study of maternal anemia and utilization of antenatal and postnatal care services in Devbhumi Dwarka, Gujarat. Cureus. 2022;14(10). 10.7759/cureus.30427 Rai SS’ Ratanasiri T, Koju R, Arkaravichien T. Effect of knowledge and perception on adherence to iron and folate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thai. 2014;97(10):S67-74. Workineh Y, Semachew A, Ayalew E, Temesgen WA. Compliance to iron-folic acid supplementation and its association with the number of ANC visits in Ethiopia: systematic review and meta-analysis. Adv Prev Med. 2019;3602585. https://doi.org/10.1155/2019/3602585 Fite MB, Roba KT, Olijira L, Tura AK, Yadeta TA. Compliance with Iron and Folic Acid Supplementation (IFAS) and associated factors among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis. PLOS ONE. 2021;16(4):e0249789. https://doi.org/10.1371/journal.pone.0249789 Mithra P, Unnikrishnan B, Rekha T, Nithin K, Mohan K, Kulkarni V, Holla R, Agarwal D. Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India. Afr Health Sci. 2014;14(1):255-260. http://dx.doi.org/10.4314/ahs.v14i1.39 Debi S, Basu G, Mondal R, Chakrabarti S, Roy SK, Ghosh S. Compliance to iron-folic-acid supplementation and associated factors among pregnant women: A cross-sectional survey in a district of West Bengal, India. J Family Med Prim Care. 2020;9(7):3613-3618. 10.4103/jfmpc.jfmpc_392_20 Khanam A, Vohra K, Achary MG T, Ranjith A, Bharti H, Rupam, Kaur R. Yadav K. A systematic review of factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Indian J Community Health. 2022;34(4):456-463. https://doi.org/10.47203/IJCH.2022.v34i04.002 Chourasia A, Pandey CM, Awasthi A. Factors influencing the consumption of iron and folic acid supplementations in high focus states of India. Clin Epidemiol Glob Health. 2017;5(4):180-184. https://doi.org/10.1016/j.cegh.2017.04.004 Sendeku FW, Azeze GG. Fenta SL. Adherence to iron-folic acid supplementation among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC pregnancy childbirth. 2020;20:138. https://doi.org/10.1186/s12884-020-2835-0 Singh PK, Dubey R, Singh L, Kumar C, Rai RK, Singh S. Public health interventions to improve maternal nutrition during pregnancy: a nationally representative study of iron and folic acid consumption and food supplements in India. 2020; Public Health Nutr. 2020;23(15):2671-2686. 10.1017/S1368980020001007 Dutta AJ, Patel P, Bansal RK. Compliance to iron supplementation among pregnant women: a cross sectional study in urban slum. Nat J Community Med. 2014;5(04), 457-462. Galloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, et al. Women’s perceptions of iron deficiency and anemia prevention and control in eight developing countries. Soc Sci Med. 2002;55(4):529-44. 10.1016/s0277-9536(01)00185-x Manasa K, Chandrakumar SG, Prashantha B. Assessment of compliance with iron-folic acid therapy during pregnancy among postnatal mothers in a tertiary care centre, Mysuru. Int J Community Med Public Health. 2019;6(4):1665-1669. https://doi.org/10.18203/2394-6040.ijcmph20191402 Niquini RP, Bittencourt SDDA, Lacerda EMDA, Saunders C, Leal MDC. Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro. Rev Bras Saude Mater Infant. 2016;16:189-199. https://doi.org/10.1590/1806-93042016000200007 Chakma T, Rao PV, Meshram PK. Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India. Public Health Nutr. 2012;16(2):377-380. https://doi.org/10.1017/S1368980012002704 Sharma J, Devanathan S, Sengupta A, Rajeshwari PN. Assessing the prevalence of iron deficiency anemia and risk factors among children and women: A case study of rural Uttar Pradesh. Clin Epidemiol Glob Health. 2024;101545. https://doi.org/10.1016/j.cegh.2024.101545 Galloway R, McGuire J. Determinants of compliance with iron supplementation: Supplies, side effects, or psychology?. Soc Sci Med. 1994;39(3):381-390. https://doi.org/10.1016/0277-9536(94)90135-X Smitha MV, Indumathi P, Parichha S, Kullu S, Roy S, Gurjar S, Meena S. Compliance with Iron-Folic Acid supplementation, associated factors, and barriers among postpartum women in Eastern India. Hum Nutr Metab. 2024;35:200237. https://doi.org/10.1016/j.hnm.2023.200237 Selvaraj R, Ramakrishnan J, Sahu SK, Kar SS, Laksham KB, Premarajan KC, Roy G. High prevalence of anemia among postnatal mothers in Urban Puducherry: A community-based study. J Family Med Prim Care. 2019;8(8):2703-2707. 10.4103/jfmpc.jfmpc_386_19 Rathi N, Kansal S, Raj A, Pedapanga N, Joshua I, Worsley A. Indian adolescents’ perceptions of anaemia and its preventive measures: Aqualitative study. J Nutr Sci. 2024;13:e9. 10.1017/jns.2024.4 Wangaskar SA, Sahu SK, Majella MG, Rajaa S. Prevalence of anaemia and compliance to weekly iron-folic acid supplementation programme amongst adolescents in selected schools of urban Puducherry, India. Niger Postgrad Med J. 2021;28(1):44-50. 10.4103/npmj.npmj_336_20 Nadella P, Subramanian SV, Roman-Urrestarazu A. The impact of community health workers on antenatal and infant health in India: a cross-sectional study. SSM Population Health. 2021;15:100872. https://doi.org/10.1016/j.ssmph.2021.100872 Taner CE, Ekin A, Solmaz U, Gezer C, Cetin B, Kelesoglu M, et al. Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery. J Turk Ger Gynecol Assoc. 2015;16(4):231-236. 10.5152/jtgga.2015.15071 Footnote 1 Full ANC is defined as at least antenatal visits, one or more tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) tablets/syrup for at least of 100 days Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 Jun, 2024 Editor assigned by journal 21 Jun, 2024 Submission checks completed at journal 21 Jun, 2024 First submitted to journal 15 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4587207","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":318426511,"identity":"72b21bfa-bb83-4be5-8dd8-6944859a318a","order_by":0,"name":"Angan Sengupta","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYFCD4w1AwsCCFC1nDoC0SJCi5UYCiCRCC//s9oufCxjs8vhuPr+64UeBBAN/e3cCXi0Sd84US89gSC6WvJ1TdrMH6DCJM2c3EHBPToI0DwNz4obbOWk3eIBaDCRy8WuRv5GT/JuHoT5xw80zaTf/EKPF4Eb6MaAthxM33GA/dpsoWwxv5LBZ8xgcT5x5JofttoyBBA9Bv8jdSH98m6eiOrHv+PFnN9/8sZHjb+8l4H0GHgOg82AMIElAOQiwP0BnjIJRMApGwShABQDxr0nTVx42aQAAAABJRU5ErkJggg==","orcid":"","institution":"Amrita School of Business, Amrita Vishwa Vidyapeetham","correspondingAuthor":true,"prefix":"","firstName":"Angan","middleName":"","lastName":"Sengupta","suffix":""},{"id":318426512,"identity":"c8d25dd5-f8f4-4865-84f4-f5f9e1087bfa","order_by":1,"name":"Meghna Prakash","email":"","orcid":"","institution":"Amrita School of Business, Amrita Vishwa Vidyapeetham","correspondingAuthor":false,"prefix":"","firstName":"Meghna","middleName":"","lastName":"Prakash","suffix":""},{"id":318426513,"identity":"0f69e29a-6919-4ec0-ba46-1a018edfe8d6","order_by":2,"name":"Tina Dutta","email":"","orcid":"","institution":"Birla Institute of Technology, Mesra","correspondingAuthor":false,"prefix":"","firstName":"Tina","middleName":"","lastName":"Dutta","suffix":""}],"badges":[],"createdAt":"2024-06-15 15:54:01","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4587207/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4587207/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60615502,"identity":"bc5a86bf-135f-4d40-b00e-7d3f48991ea5","added_by":"auto","created_at":"2024-07-18 20:12:41","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70598,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eState wise distribution of percentage of pregnant women consuming IFA supplementation for at least 100 days\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4587207/v1/2d7427db0acf0d9f6b0b92b4.jpg"},{"id":60615504,"identity":"64d5527d-292e-42d5-a6d0-c7cffc54f85e","added_by":"auto","created_at":"2024-07-18 20:12:41","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":75337,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eState wise distribution of percentage of pregnant women consuming IFA supplementation for at least 180 days\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4587207/v1/39ccec23a4aea009415ecd8b.jpg"},{"id":60615503,"identity":"4d9ab496-4813-4cd2-8865-bd3a21a8d575","added_by":"auto","created_at":"2024-07-18 20:12:41","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":54707,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eScatter plots between state-wise prevalence of anemia and IFA non-compliance for at least 100 days and for at least 180 days\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4587207/v1/d474b6427f9dd987b10efa5b.jpg"},{"id":60615501,"identity":"830ffe00-0ae5-4eef-ba33-b12922064663","added_by":"auto","created_at":"2024-07-18 20:12:41","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":55050,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eScatter plots between state-wise prevalence of anemia and IFA non-compliance for at least 100 days and for at least 180 days\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4587207/v1/13f9aacae38a28368d0ebfd4.jpg"},{"id":60616430,"identity":"6d20fd2a-7805-4dfc-9189-fef5e2d0b9d5","added_by":"auto","created_at":"2024-07-18 20:20:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1456347,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4587207/v1/e201c4ed-6e70-48fa-be1e-9ab2828e6140.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21)","fulltext":[{"header":"Background","content":"\u003cp\u003eThe prevalence of anemia among pregnant women has been a critical concern for the health of expectant mothers in Indian society; an issue that continues to persist despite concerted efforts. The deficiency of folic acid can cause numerous maternal and foetal health conditions such as spontaneous abortion, megaloblastic anemia in foetus, pre-eclampsia, abruption placenta, adverse birth outcomes and neural tube defects [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In order to address anemia and to improve maternal and foetal health, World Health Organization (WHO) recommends IFA supplementation for all pregnant women, at least for 90 days [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. A cross-sectional study conducted in the eastern terai of Nepal found that IFA compliance rate was 58% during pregnancy and 42% were anemic and the likelihood of being anemic was 24 times more in IFA non-compliant women during pregnancy than their counterparts [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. A study conducted involving pregnant women attending Antenatal Care (ANC) in a Sub District Hospital in National Capital Region, found that the non-anemic women (greater than 11gm/dl hemoglobin level) (82%) had better compliance with IFA tablets, as against the compliance rate of 73.6% among anemic pregnant women [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Another study based on pregnant women receiving antenatal services from the Agartala Government Medical College- PMC validates that the non- compliance to iron and folic acid supplementation has a high role in the prevalence of anemia among the pregnant women [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Kumar et al. (2019) finds that utilization of \u0026ldquo;full ANC\u0026rdquo;\u003csup\u003e1\u003c/sup\u003e, which includes consumption of IFA tablets/syrup for at least 100 days as one of the components, has been only one fifth among the pregnant women in India. The lower likelihood of full ANC utilization among Indian pregnant women are found to be linked with higher birth order, teenage and unplanned pregnancies, father\u0026rsquo;s absence during antenatal visits, lower mother education, and lower wealth quintile(s).\u003c/p\u003e \u003cp\u003eThe National Family Health Survey (NFHS)-5 (2019-21) data shows that 57% of women in India are anemic (with almost 32% women being moderately to severely anemic), when compared to 53% in NFHS-4. The pervasiveness of anemia is 93% in Ladakh, whereas it is more than 60% in union territories and states such as Jammu \u0026amp; Kashmir, Dadra \u0026amp; Nagar Haveli and Daman \u0026amp; Diu, Chandigarh, Chhattisgarh, Bihar, Odisha, Gujarat, Jharkhand, Assam, Tripura, West Bengal [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Even if NFHS-5 states that half of the pregnant women are anemic, empirical studies have observed that nearly three-fourth of the pregnant women in India was found to be anemic [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]; yet their adherence to IFA supplementation has been extremely low. According the NFHS-5, eighty-eight percent of women who gave birth in last five years since the survey, purchased or were given IFA tablets during pregnancy. During last few decades there has been efforts to contain the prevalence of anemia through Iron Folic Acid supplementation. Yet, its impact in curbing anemia has not been very encouraging, mainly due to poor compliance rate.\u003c/p\u003e \u003cp\u003eStudies from various low- and middle-income countries have observed that the compliance to IFA supplementation has remained sub-optimal, registering lower than 80% [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. A systematic review conducted among pregnant women in Sub-Saharan Africa shows an extremely low prevalence (39.2%) of compliance to IFA supplementation [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In Nepal, three-fourth of women were compliant with the IFA tablets [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn India, a number of previous research show varied rate of IFA compliance. Report of the national level NFHS-5 survey also states that more than 85% of women who delivered a child during the last five years were given or bought IFA tablets during their pregnancy. However, less than half of all pregnant women took supplementation for at least 100 days [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A study conducted among pregnant women in urban areas of South India (Karnataka) observed that 58.1% of its respondents consumed all the IFA tablets provided to them [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], while studies conducted in Kolkata and Delhi observed more than 77% of women attending ANC services were compliant to the IFA supplementation [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, a study conducted in a smaller city found that only 52.5% were compliant to IFA supplementation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. A number of factors can be attributed to non- compliance with IFA supplementation. Multiple studies evaluating factors influencing IFA supplementation found that knowledge of IFA supplementation, number of antenatal care visits, birth order, economic status, educational level and age of pregnant women play important roles in compliance to IFA supplementation in India [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHence, it is important to monitor and evaluate the compliance status of IFA consumption in any country where there is high prevalence of anemia among women, especially among pregnant women. The present study attempts to assess the level of compliance to IFA supplementation among pregnant women aged 15\u0026ndash;49 years in India during 2019-21. The specific objectives are: 1) to study the percentage distribution of respondents failing to comply with the consumption of IFA supplementation for at least 100 days and at least 180 days across their socio-economic backgrounds, 2) to study the pattern of progression of a woman\u0026rsquo;s beginning of IFA tablets consumption to her continuation for a minimum of 100\u0026thinsp;+\u0026thinsp;days and then from 100\u0026thinsp;+\u0026thinsp;to 180\u0026thinsp;+\u0026thinsp;days, and 3) to investigate how different socio-economic and demographic covariates influence a woman\u0026rsquo;s propensity to consume IFA tablets/syrup for at least 100 and at least 180 days.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe data for the analysis are obtained from the \u0026ldquo;Children\u0026rsquo;s Recode\u0026rdquo; (IAKR file) of National Family Health Survey (NFHS)-5 conducted during 2019-21. The NFHS is conducted on a regular interval across all states of India. NFHS-5 collects data on several socio-demographic and public health parameters at both individual and household level, claiming to cover a representative sample of more than 95% of the Indian population. During the survey, women who have given a birth in the last five years were interviewed to understand the percentage of women who were given or who purchased IFA tablets during the pregnancy for their recent birth. From a sample of 664,972 selected households, 747,176 eligible women are identified for individual interviews, and this study analyses a sample size of 151171 women, those who bought or received IFA tablets or syrup during pregnancy.\u003c/p\u003e \u003cp\u003eThe first part of analyses consists of descriptive analysis to understand the percentage distribution of women complying to consumption of 100 and 180 IFA tablets across various socio- economic characteristics. The second part entails computation of probabilities of i) IFA initiation, ii) IFA continuation till 100\u0026thinsp;+\u0026thinsp;tablets and iii) continuation from 100\u0026thinsp;+\u0026thinsp;to 180\u0026thinsp;+\u0026thinsp;IFA tablets for the sampled women with different background characteristics. The third and final part of analyses involves causal analysis to investigate how different socio-economic and demographic covariates influence a woman\u0026rsquo;s propensity to fail to consume 100 IFA tablets and 180 IFA tablets.\u003c/p\u003e \u003cp\u003eFor the second part of analyses, the probabilities are calculated as follows:\u003c/p\u003e \u003cp\u003eLet, T: number of IFA tablets consumed by a woman from a particular socio\u0026thinsp;\u0026minus;\u0026thinsp;economic background\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003en(T\u0026thinsp;=\u0026thinsp;t): number of women consuming t number of tablets\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$P(T=t): Probability of a woman consuming t number of tablets$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThen, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\left(i\\right) P\\left(consuming at least one IFA tablet\\right)is given by:\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Equb\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$P(T\\ge 1)= \\frac{n(T\\ge 1)}{n(T\\ge 1)+n(T=0)}$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equc\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equc\" name=\"EquationSource\"\u003e\n$$\\left(ii\\right)P\\left(consuming at least100 IFA tablets|the woman initiated IFA consumption\\right)$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equd\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equd\" name=\"EquationSource\"\u003e\n$$P(T\\ge 100|T\\ge 1)=\\frac{n(T\\ge 100)}{n(T\\ge 1)}$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Eque\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Eque\" name=\"EquationSource\"\u003e\n$$\\left(iii\\right)P\\left(consuming at least 180 IFA tablets|the woman consumed at least 100 tablets\\right)$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equf\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equf\" name=\"EquationSource\"\u003e\n$$P(T\\ge 180|T\\ge 100)=\\frac{n(T\\ge 180)}{n(T\\ge 100)}$$\u003c/div\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eFor the third part of analyses, two separate binary logit regression are run, delineated as follows:\u003c/p\u003e \u003cp\u003eModel-1\u003c/p\u003e \u003cp\u003eDependent variable:\u003c/p\u003e \u003cp\u003eY\u0026thinsp;=\u0026thinsp;1: if a woman fails to consume at least 100 IFA tablets; (Y\u0026thinsp;=\u0026thinsp;0, otherwise)\u003c/p\u003e \u003cp\u003eModel-2\u003c/p\u003e \u003cp\u003eDependent variable:\u003c/p\u003e \u003cp\u003eY\u0026thinsp;=\u0026thinsp;1: if a woman fails to consume at least 180 IFA tablets; (Y\u0026thinsp;=\u0026thinsp;0, otherwise)\u003c/p\u003e \u003cp\u003eThe general form of binary logit regression model is given by:\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Equg\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equg\" name=\"EquationSource\"\u003e\n$$ln\\left(\\frac{p(Y=1)}{1-p(Y=1)}\\right)={\\beta }_{0}+{\\beta }_{1}{X}_{1}+{\\beta }_{2}{X}_{2}+....+{\\beta }_{k}{X}_{k}+{ϵ}_{i}$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equh\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equh\" name=\"EquationSource\"\u003e\n$$where,the ratio \\frac{p(Y=1)}{1-p(Y=1)} is called the odds ratio$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equi\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equi\" name=\"EquationSource\"\u003e\n$$the odds ratio implies the likelihood of ocurrence of Y=1 as compared to Y=0$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equj\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equj\" name=\"EquationSource\"\u003e\n$${X}_{1}{X}_{2},....,{X}_{k} are the independent variables$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equk\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equk\" name=\"EquationSource\"\u003e\n$${\\beta }_{1}, {\\beta }_{2},\\dots .,{\\beta }_{k} are the changes in the log-natural of odds ratios given as:$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equl\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equl\" name=\"EquationSource\"\u003e\n$${\\beta }_{i}=ln\\left(\\frac{\\frac{p(Y=1|{X}_{i}=1)}{1-p(Y=1|{X}_{i}=1)}}{\\frac{p(Y=1|{X}_{i}=0)}{1-p(Y=1|{X}_{i}=0)}}\\right)$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equm\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equm\" name=\"EquationSource\"\u003e\n$$Alternatively, {e}^{{\\beta }_{i}} is the change in the odds ratios, given as:$$\u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Equn\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equn\" name=\"EquationSource\"\u003e\n$${e}^{{\\beta }_{i}}=\\left(\\frac{\\frac{p(Y=1|{X}_{i}=1)}{1-p(Y=1|{X}_{i}=1)}}{\\frac{p(Y=1|{X}_{i}=0)}{1-p(Y=1|{X}_{i}=0)}}\\right)$$\u003c/div\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe list of independent variables for both the models includes place of residence (\u0026lsquo;rural\u0026rsquo; reference category), age grouped into five categories (\u0026rsquo;40\u0026ndash;49\u0026rsquo; reference category), wealth index (\u0026lsquo;richest\u0026rsquo; reference category), highest education level of women (\u0026lsquo;higher\u0026rsquo; reference category), caste groups (\u0026lsquo;none of them\u0026rsquo; reference category), religion (\u0026lsquo;Hindu\u0026rsquo; reference category), antenatal care visits (\u0026lsquo;yes\u0026rsquo; reference category), partner\u0026rsquo;s education level (\u0026lsquo;higher\u0026rsquo; reference category), working status of women (\u0026lsquo;no\u0026rsquo; reference category), husband or partner\u0026rsquo;s presence during ANC visits (\u0026lsquo;yes\u0026rsquo; reference category), and birth order of child (\u0026lsquo;three and above\u0026rsquo; reference category).\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eCompliance Pattern of IFA Tablets among Indian Women\u003c/h2\u003e\n \u003cp\u003eCompliance to IFA tablets is measured as whether a woman actually consumes the tablets after receiving/purchasing them. In 2019-21, there are more than 60% of women in Uttar Pradesh, Bihar, Jharkhand and Ladakh along with a few north-eastern states such as Arunachal Pradesh, Nagaland, Tripura (Fig. 1), who received IFA tablets/syrup but did not consume for more than 100 days. The non- compliance percentage further increases in case of consumption of IFA supplementation for at least 180 days, with Rajasthan accounting for more than 80% non-compliance (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Non-compliance for 100 IFA tablets is lesser than 20% in the southern states of India, including, Kerala, Tamil Nadu and Goa (Fig. 1). The same set of states has been performing better as compared to the rest of the country with respect to non-compliance for minimum 180 days, portraying a non-compliance percentage of less than 40% (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e presents the non-compliance in terms of consumption of IFA for at least 100 days and for at least 180 days by women\u0026rsquo;s socio-economic and demographic characteristics. It is observed that 45.6% of rural women do not consume IFA tablets for 100 days, even after receiving or buying the tablets/syrup. At the same time, 63.1% of rural women do not consume IFA tablets for 180 days. The non-compliance even after receiving IFA tablets significantly decreases with rise in age; for both the categories (100 days\u0026rsquo; consumption and 180 days\u0026rsquo; consumption). The non-compliance to IFA tablet consumption is highest among the poorest wealth quintile (50.9% and 66.6% for 100 days and 180 days respectively), which significantly drops with the advancement of economic profile. On the other hand, approximately 32% of richest women do not consume IFA tablets even after receiving it for 100 days; the percentage is higher (51.4%) when the reference period is 180 days. Education of women being an important factor; those respondents with no education show the highest non-compliance for both the criteria; 50.5% and 64.4% for 100 days and 180 respectively. It is noteworthy that one out of three women with higher education do not consume the tablets even for 100 days, while more than half of them could not meet the consumption criteria for 180 days. There is a significantly higher percentage of scheduled caste women who did not consume IFA tablets for 100 days (45%) and 180 days (62.3%). More than 40% of Hindus and Muslims demonstrate non-compliance to 100 days of IFA consumption, while the figures surge by another twenty percentage points in case of 180 days\u0026rsquo; reference period. Christian women and women belonging to other religions show much better compliance rate. Those who have more than four ANC visits happen to demonstrate better consumption practices as compared to those who received less than four ANC visits. Even though the gap still remains statistically significant, it reduces considering 180 days\u0026rsquo; compliance pattern. Working status does not impact the criteria of meeting 100 days or 180 days IFA supplements consumption landmarks very strongly. Higher is the education level of husband or partner, the rate of non-compliance to IFA tablets statistically significantly declines among their spouses/partners. Half of the women whose partners has no education is found to be non-compliant to IFA tablet for at least 100 days. However, among those whose partners have achieved higher education, percentage of women not consuming at least 100 IFA tablets fall to 36%. Non-compliance to consumption of at least 180 IFA tablets increases drastically irrespective of education levels of the women\u0026rsquo;s partners. NFHS-5 data also finds that husband or partner\u0026rsquo;s presence during pregnancy is significantly associated with the distribution of IFA non-compliance, as 48.3% of those whose husbands were not present for ANC checkup are found to be non-compliant with IFA tablets for at least 100 days, as compared to 41.5% among those whose husbands/partners were present. In case of non-compliance for at least 180 days, 63.2% of those whose husbands did not accompany for ANC visits are non-compliant with IFA supplementation. Yet another significant variable is the birth order of the child, as the birth order increases the non-compliance to IFA consumption also increases. When the birth order is three and above, approximately 60% and 78% women are non-compliant for 100 days and 180 days respectively.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003ePercent distribution of women showing non-compliance to IFA supplementation for at least 100 days and at least 180 days different background characteristics of women even after receiving/ purchasing IFA tablets/ syrup\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDeterminants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNot consuming IFA tablets for at least 100 days\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eChi-squared Sig\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNot consuming IFA tablets for at least 180 days\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eChi-squared Sig\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eType of place of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u0026ndash;19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eWealth index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRicher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRichest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eHighest educational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eCaste/Tribe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule caste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule tribe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone of them\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eANC Visit four and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eworking status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.362\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eHusband/partner\u0026apos;s education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHusband/partner\u0026rsquo;s presence during ANC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOne\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTwo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThree and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eProgression and Dropouts in IFA Consumption\u003c/h2\u003e\n \u003cp\u003eTable-2 presents the following probabilities: 1) the probability of consuming IFA supplementation for at least one day 2) the conditional probability of consuming IFA supplementation for at least one day provided they were given/bought iron tablets/syrup, 3) the conditional probability of consuming IFA supplementation for at least 100 days given the woman consumed for at least one day, and 4) the conditional probability of consuming IFA supplementation for at least 180 days given the woman consumed for at least 100 days. The idea is to study the pattern of progression of a woman\u0026rsquo;s initiation of consumption of IFA tablets to her continuation till 100\u0026thinsp;+\u0026thinsp;days and then from 100\u0026thinsp;+\u0026thinsp;to 180\u0026thinsp;+\u0026thinsp;days. As observed from Table-2, for each background variable, the likelihood of a woman\u0026rsquo;s initiation of consumption of IFA tablets is substantially high ranging from 0.75 to 0.89. Even for women with no education, their chance of taking IFA tablet is considerably high at 0.752. Provided a woman has obtained IFA tablets or syrup, the probability of initiating the consumption increases considerably (at least 95%) irrespective of her socioeconomic background. However, for women of all backgrounds, the likelihood of continuing to consume IFA tablets for at least 100 days decreases significantly. Women with no education and women with lesser than four ANC visit have only 36% and 36.5% chance respectively of continuing the IFA consumption for at least 100 days. High dropout rate in consumption of IFA tablets is observed among women with no or primary education, poorest or poorer wealth index, no ANC visit, rural background, and women from scheduled caste social group, where the dropout percentage from initiation to 100\u0026thinsp;+\u0026thinsp;days is more than 50%. Even for women with urban background, and women from higher to richest wealth index have 0.625 to 0.66 probability of continuing IFA tablets up to 100\u0026thinsp;+\u0026thinsp;days. Likelihood to initiate consumption of IFA supplementation is considerably high among women who are currently working, or who husbands are highly educated.\u003c/p\u003e\n \u003cp\u003eOne noteworthy finding from Table-2 is that once a woman consumes IFA tablets at least 100 days, her likelihood to continue the consumption to at least 180 days increases for all background variables (except for Christians, it is slightly lower). For e.g. while the probability to reach consumption of IFA tablets to 100 days mark is only 0.361 for women having no education, the probability for consumption of tablets for 180\u0026thinsp;+\u0026thinsp;days once they finish consuming tablets for at least 100 days is 0.49. For the poorest and richest groups, these proportions are respectively 0.49 and 0.67. Among religious groups, Christian women showcase a higher probability to comply to the IFA targets as compared to women from Hindu and Muslim communities. While women with at least four ANC visits exhibit better initiation (0.895) and continuation to 100 days IFA consumption mark (0.615), their continuation to 180\u0026thinsp;+\u0026thinsp;days (0.612) is just slightly higher than those having less than four ANC visits (0.525).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eProbability of initiation and Conditional Probabilities of continuation of IFA tablets\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eProbability of consuming IFA supplementation for at least one day\u003c/p\u003e\n \u003cp\u003e(1)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConditional Probability of consuming IFA supplementation for at least one day provided they were given/bought iron tablets/syrup (2)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConditional Probability of consuming IFA supplementation for at least 100 days given the woman consumed for at least one day (3)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConditional Probability of consuming IFA supplementation for at least 180 days given the woman consumed for at least 100 days (4)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.637\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.566\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eAge groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u0026ndash;19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.596\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.541\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.760\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.505\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eWealth index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.388\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.830\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.590\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRicher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.621\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRichest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.884\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.660\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.665\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eHighest educational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.752\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.489\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.547\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.654\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eCaste/ tribe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule caste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.491\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule tribe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.854\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.556\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone of them\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.848\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.518\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.938\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.656\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.684\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eANC Visit four and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.525\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.972\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.615\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eworking status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.635\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.521\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eHusband/partner\u0026apos;s education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.485\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.544\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.660\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.964\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.549\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.581\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHusband/partner\u0026rsquo;s presence during ANC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.767\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.551\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.842\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.594\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOne\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTwo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.702\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThree and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.644\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.843\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\n \u003ch2\u003eFactors influencing non-compliance to IFA tablet consumption\u003c/h2\u003e\n \u003cp\u003eThe logistic regression presented in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e shows that the chance of not taking IFA tablets for at least 100 days and at least 180 days are lesser by approximately 21% and 15% for urban with respect to rural women. Wealth index exhibits a significant impact on the compliance to consumption of IFA tablets. When compared to the richest, the poorest face nearly 1.6 times higher odds of failure to consume IFA for least 100 days, and nearly 1.962 times higher odds of failure for consuming IFA for at least 180 days. An increase in level of education among pregnant women and among their partners significantly decreases the odds for non-compliance with IFA consumption. When compared to those with higher education, women with no education show increased odds of failure to consume IFA by 1.72 times for minimum 100 days and 1.46 times for minimum 180 days. The chances of non-compliance are significantly lower for scheduled tribes (STs) women; around 21% lesser with reference to \u0026lsquo;none of them\u0026rsquo; (general) castes women. However, those belonging to scheduled castes (SCs) do not show any significant difference as compared to general category. Christian women, when compared to women belonging to other religions have significantly much lower likelihood to not consume the tablet for at least 100 days (OR\u0026thinsp;=\u0026thinsp;0.585) and a minimum of 180 days (OR\u0026thinsp;=\u0026thinsp;0.569). Those who have not received at least four Antenatal Care (ANC) check-up have at least two times higher likelihood to not consume the tablet for at least 100 or 180 days. Those who are economically engaged show a significantly higher chance (OR\u0026thinsp;=\u0026thinsp;0.879), at 5% level of significance, of failing to comply with minimum 180 days criterion. Also, as compared to those women with birth order three and above, women with one and two birth order showed around 35% and 25% lower odds to not comply with IFA supplementation for 100 days and 180 days respectively.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBinary logistic regression on non-compliance with IFA supplementation for at least 100 days and at least 180 days even after receiving or purchasing IFA supplementation\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"10\"\u003e\u003c/colgroup\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eDeterminants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003eIFA 100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003eIFA 180\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eExp(\u0026beta;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e95% C.I. for Exp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e95% C.I. for Exp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExp(\u0026beta;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.735\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.790\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.918\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u0026ndash;19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.775\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.421\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.521\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.411\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.159\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.664\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eWealth index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRichest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.816\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.717\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.243\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePoorer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.530\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.605\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.804\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.434\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRicher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.979\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.675\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.521\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.729\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.604\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.936\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.996\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.092\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eCaste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone of them\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule caste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchedule tribe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.785\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.695\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.760\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.864\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.891\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.917\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.964\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.106\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.725\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.569\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.467\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.693\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther religion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.981\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.816\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.694\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eANC Visits: four and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.948\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.248\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eEducation level of partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.245\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.259\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.889\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.778\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.938\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.858\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eWorking status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.901\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.840\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.815\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.947\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eHusband/partner\u0026rsquo;s presence during\u003c/p\u003e\n \u003cp\u003eANC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.322\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThree and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOne\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.739\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTwo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.745\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.806\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.758\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.694\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.828\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e demonstrates the scatter plot between anemia and IFA non-compliance for 100 days in India. The analysis shows a positive correlation (correlation coefficient\u0026thinsp;=\u0026thinsp;0.320) between anemia and IFA non- compliance. The outlying state or union territory in this case is Ladakh, with more than 90% prevalence of \u0026lsquo;any anemia\u0026rsquo; (\u0026lt;\u0026thinsp;11.0 g/dl) in women. More than 50% women in Ladakh are not consuming IFA tablets for 100 days. Figure \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e exhibits a similar pattern in the case of non-compliance for 180 days. The correlation coefficient is 0.258, representing a weak, yet positive association between state-wise prevalence of anemia and IFA non-compliance for 180 days and above across states. As in the previous case, 64% women in Ladakh are not consuming the tablet for 180 days with an extremely high prevalence of anemia.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eUnder the backdrop of an unwavering anemia prevalence, this study highlights a considerable gap in compliance to IFA consumption for a minimum of 100 days among Indian pregnant women. The probability of consuming IFA supplementation among pregnant women for at least one day is more than eighty percent. Even if ensuring the availability of IFA supplementation has almost made it certain that a woman will at least start taking IFA tablets/syrup, the probability of consuming those tablets or syrup for 100 days and above given that they have consumed at least one IFA tablet decreases tremendously. At the same time, if a woman consumes IFA tablets/ syrup at least for 100 days, that individual has a higher likelihood to consume at least 180 tablets irrespective of her socio-economic conditions.\u003c/p\u003e \u003cp\u003eThe probability of consuming more than 100 IFA tablets has remained very low, while that of 180\u0026thinsp;+\u0026thinsp;tablets is appalling across all socioeconomic groups. However, there is a prominent regional variation in this regard. Southern states are doing better than the northern region, and urban population showing more compliance than their rural counterparts. Wealth index and education profile plays a significant role in determining compliance with intake of IFA tablet supplementation. Higher frequency of ANC visits certainly improves the compliance.\u003c/p\u003e \u003cp\u003eOur study findings support the observations of Chourasia et al (2017)\u0026rsquo;s study which found that the women from highest socioeconomic stratum have significantly higher (two-times) odds for consumption of IFA tablets for at least 90 days. On the contrary, Deori et al. (2021) showed that the compliance was lower among well-off women (67.6%), while it was higher among women from lower socioeconomic status (82.1%) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. A study conducted in Philippines observed that rural poor was more compliant as compared to the urban poor women [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEven though our study does not find any significant association between age and IFA non- compliance, earlier studies in India showed that IFA compliance increases with age [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Chourasia et al. (2017) showed that women aged 30 years and above has 1.5 times higher chance to consume 90\u0026thinsp;+\u0026thinsp;IFA tablets as compared to 15-19-year-old respondents [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, a survey conducted in Ethiopia found that women in the higher age group (more than 35 years) showed less adherence when compared to women in the age group between 25 and 29 years [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Previous research showed IFA compliance is lower with teenage pregnancy [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSimilar to our findings, earlier studies have also found that education of pregnant women is positively associated with IFA compliance [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Chourasia et al. (2017) showed that well educated women are four times likely to adhere to the recommended dose of IFA supplementation [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A study shows that women with higher level of education along with knowledge of hemoglobin status and iron pill dose has shown higher compliance to iron pills [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Studies from other developing countries also demonstrate a similar pattern [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur results bolster the fact that ANC visits of women significantly influence IFA consumption. In sub-Saharan Africa it was found that IFA supplementation scenario could be improved by escalating the awareness among women about anemia and IFA supplementation, and more than four antenatal care visits [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A study based on urban slums in India found that increase in the number of ANC visits increases the compliance to iron pills [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Similar to our observations, other studies also have highlighted that there is a positive significance of the presence of partner during antenatal care visits on women consuming IFA tablets for at least 90 days [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Beside higher frequency of prenatal care visits, registering pregnancy during first trimester and being attended by any healthcare provider increases the probability of consuming IFA for at least 100 days [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSome of the most common cited reasons for non-compliance to IFA tablets are forgetfulness [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], women\u0026rsquo;s tendency to ignore personal health issues, or even the size of the tablets [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], side effects of the tablets [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], and so on. The reasons such as forgetfulness, size and taste of the tablets, unawareness about the consumption pattern etc. can be mitigated by the proper involvement of the community health workers. Earlier studies conducted in developing countries such as India [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], and Brazil [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] found the primary reason for non-compliance was the gap in the information provided by the healthcare workers. The other factors which resulted in a gap in the consumption of IFA tablets were inadequate counselling and distribution of tablets, poor utilization of healthcare services provided by the facilities and the prevalence of misconceptions around consuming medicines during pregnancy [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. A study conducted on tribal adolescent girls in India observed that several qualitative factors influence the compliance and feasibility of IFA supplementation, that include creating awareness by active involvement of anganwadi workers, ensuring quality of tablets and its timely supply [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. A study conducted in Uttar Pradesh noted that even if the women are given 100 pills of IFA supplements by the ASHA (Accredited Social Health Activists) workers for a period of three months, they only visit the villages once or twice per month, except attending emergency cases [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Informative posters about taking iron supplements, patient centric therapeutic approaches in case of side-effects, providing calendar based reminders can significantly improve the compliance [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the high focus states of India, birth order (below 2) and mass media exposure showed a significance to women consuming IFA tablets for at least 90 days [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Our study supports the findings of Chourasia et al., (2017) that consumption of IFA supplementation decreases with rise in birth order [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, Mithra et al. (2014) found that the compliance increases with birth order [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Studies on backward districts in Gujarat, observed that the external factors constraining the compliance with IFA supplementation are inaccessibility to healthcare facilities, and the economic cost to avail ANC services including IFA supplementation [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrevalence of anemia among post-natal women in Indian states varies between 26.5\u0026ndash;96.4% across Indian states [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Smitha et al. (2024) observed that only one-fifth of post-natal women were compliant with IFA supplementation, while more than half of them consumed IFA tablets during pregnancy [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Although Government of India has launched a weekly iron-folic acid supplementation program (WIFS) for adolescents in 2012, adolescent girls demonstrate high prevalence rate of anemia in India with a poor IFA consumption pattern [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Studies have shown that higher compliance to IFA tablets supplementation reduces prevalence of anemia substantially [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Therefore, this is important that the policymakers take the issue of IFA consumption seriously also for the women under post-natal care as well as those who are adolescents and non- pregnant women. Involving community health workers in providing ANC services can improve quantity and quality of ANC [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] and subsequent improvement in compliance to IFA consumption.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eEven though the availability of IFA supplementation and the proportion of women initiating with the supplementation have been considerably high among pregnant women in India, the non-compliance with consuming minimum 100 and minimum 180 IFA tablets, even after receiving them is highly prevalent among pregnant women in India. This study has helped to understand the dynamics around the progression of likelihood of consuming IFA supplementation for a desired number of days. This is important to emphasize the need of educating and communicating about the importance of iron and folic acid consumption among adolescent girls and women of reproductive age. The IFA supplementation is one of several important tools or measures to control anemia [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The Government of India has launched Anemia Mukt Bharat in 2018 as part of intensified National Iron Plus Initiative (NIPI), targeting children and adolescents of both gender, women of reproductive age, pregnant women and lactating mothers. It aims at reducing the prevalence rate of anemia at a rate of 3% points per annum. Studies have suggested that health workers play a significant role in achieving the national policy goals by effectively mobilizing the community to consume IFA supplementation properly (Debi et al., 2020). The Pradhan Mantri Surakshit Matritva Abhiyan, launched by the Government of India, aims to provide comprehensive antenatal care at free of cost for each and every pregnant woman, on the ninth day of every month, besides diagnostic and counselling services for the women as a part of the strategy focusing on Reproductive Maternal Neonatal Child and Adolescent Health. Yet, uniform health care programs may not help in India, a country which is socio-culturally extremely diverse. Therefore, policies and strategies need to tailor-fit specific groups. A systemic approach is required to make a sustainable change in the ecosystem, involving people, frontline health workers, processes, public and private healthcare providers and the state. These findings wish to draw attention of the researchers studying maternal health issues, not only in India but in other low- and middle-income countries as well where anemia among pregnant women is a bothering public health concern.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThe approach of this study and its findings are not completely void of limitations. The analysis is based on secondary data and the information on gap between receiving and consuming IFA tablets are neither exhaustive nor explicit. A few of the reasons are obtained through literature review, could not be examined given the paucity of data in NFHS dataset. Many indicators related to perceptions about IFA supplementation among women could not be captured in this study. More primary researches understanding the roles of community health workers in social mobilization and motivating women reaching a higher IFA consumption level is required.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e The protocol and the content of all the data collection tools for the National Family Health Survey (NFHS)-5, was reviewed and approved by the Institutional Review Board of International Institute for Population Sciences (IIPS) and the ICF Institutional Review Board, alongside the U.S. Centers for Disease Control and Prevention (CDC).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e We state that all three authors have seen and approved the final version of the manuscript being submitted. All the authors have given their consent to submit this manuscript at BMC Pregnancy and Childbirth for a potential publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eNational Family Health Survey data is publicly available at free of cost, and can be downloaded from the Demographic Health Survey website (https://www.dhsprogram.com/)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors do not have any conflict of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eSince this manuscript is an outcome of a student\u0026rsquo;s dissertation work, this study has not received any financial support from any individual or organization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAS: Conceptualization, Methodology, Writing- Original draft preparation, Supervision, Validation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMP: Conceptualization, Data curation, Analysis, Writing- Original draft preparation\u003c/p\u003e\n\u003cp\u003eTD: Writing- Reviewing and Editing, Analysis, Validation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eThe authors would like to thank the editorial team and the reviewers for their time and efforts\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMolloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin b12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr. Bull. 2008;29:S101-S111. https://doi.org/10.1177/15648265080292S114\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Guideline: daily iron and folic acid supplementation in pregnant women. 2012. World Health Organization.\u003c/li\u003e\n\u003cli\u003eFelipe-Dimog EB, Yu C-H, Ho C-H, Liang F-W. Factors influencing the compliance of pregnant women with iron and folic acid supplementation in the Philippines: 2017 Philippine Demographic and Health Survey Analysis. Nutrients. 2021;13:3060. https://doi.org/10.3390/nu13093060\u003c/li\u003e\n\u003cli\u003eYadav KD, Yadav UN, Wagle RR, Thakur DN, Dhakal S. Compliance of iron and folic acid supplementation and status of anaemia during pregnancy in the Eastern Terai of Nepal: findings from hospital based cross sectional study. BMC Res. Notes. 2019;12:1-6. https://doi.org/10.1186/s13104-019-4167-6\u003c/li\u003e\n\u003cli\u003eDeori TJ, Ramaswamy G, Jaiswal A, Loganathan V, Kumar R, Mahey R, Yadav K, Kant S. Compliance with iron folic acid (IFA) tablets and associated factors among pregnant women attending ante-natal care clinic at Sub District Hospital, Ballabgarh. J Family Med Prim Care. 2021;10(5):2006-2011. 10.4103/jfmpc.jfmpc_1742_20\u003c/li\u003e\n\u003cli\u003eChoudhuri P, Debbarma A, Debbarma S, Reang T. Compliance to iron and folic acid tablets among pregnant women attending antenatal clinic in Agartala Government Medical College. J Family Med Prim Care. 2022;11(6):2763-2767. 10.4103/jfmpc.jfmpc_1914_21\u003c/li\u003e\n\u003cli\u003eKumar G, Choudhary TS, Srivastava A, Upadhyay RP, Taneja S, Bahl R. et al. Utilisation, equity and determinants of full antenatal care in India: analysis from the National Family Health Survey 4. BMC Pregnancy Childbirth. 2019;19:327. https://doi.org/10.1186/s12884-019-2473-6\u003c/li\u003e\n\u003cli\u003eInternational Institute for Population Sciences (IIPS). National Family Health Survey (NFHS)-5. 2022;IIPS, Mumbai\u003c/li\u003e\n\u003cli\u003eSaha S, Pandya AK, Raval D, Wanjari MB, Saxena D. A study of maternal anemia and utilization of antenatal and postnatal care services in Devbhumi Dwarka, Gujarat. Cureus. 2022;14(10). 10.7759/cureus.30427\u003c/li\u003e\n\u003cli\u003eRai SS\u0026rsquo; Ratanasiri T, Koju R, Arkaravichien T. Effect of knowledge and perception on adherence to iron and folate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thai. 2014;97(10):S67-74.\u003c/li\u003e\n\u003cli\u003eWorkineh Y, Semachew A, Ayalew E, Temesgen WA. Compliance to iron-folic acid supplementation and its association with the number of ANC visits in Ethiopia: systematic review and meta-analysis. Adv Prev Med. 2019;3602585. https://doi.org/10.1155/2019/3602585\u003c/li\u003e\n\u003cli\u003eFite MB, Roba KT, Olijira L, Tura AK, Yadeta TA. Compliance with Iron and Folic Acid Supplementation (IFAS) and associated factors among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis. PLOS ONE. 2021;16(4):e0249789. https://doi.org/10.1371/journal.pone.0249789\u003c/li\u003e\n\u003cli\u003eMithra P, Unnikrishnan B, Rekha T, Nithin K, Mohan K, Kulkarni V, Holla R, Agarwal D. Compliance with iron-folic acid (IFA) therapy among pregnant women in an urban area of south India. Afr Health Sci. 2014;14(1):255-260. http://dx.doi.org/10.4314/ahs.v14i1.39\u003c/li\u003e\n\u003cli\u003eDebi S, Basu G, Mondal R, Chakrabarti S, Roy SK, Ghosh S. Compliance to iron-folic-acid supplementation and associated factors among pregnant women: A cross-sectional survey in a district of West Bengal, India. J Family Med Prim Care. 2020;9(7):3613-3618. 10.4103/jfmpc.jfmpc_392_20\u003c/li\u003e\n\u003cli\u003eKhanam A, Vohra K, Achary MG T, Ranjith A, Bharti H, Rupam, Kaur R. Yadav K. A systematic review of factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Indian J Community Health. 2022;34(4):456-463. https://doi.org/10.47203/IJCH.2022.v34i04.002\u003c/li\u003e\n\u003cli\u003eChourasia A, Pandey CM, Awasthi A. Factors influencing the consumption of iron and folic acid supplementations in high focus states of India. Clin Epidemiol Glob Health. 2017;5(4):180-184. https://doi.org/10.1016/j.cegh.2017.04.004\u003c/li\u003e\n\u003cli\u003eSendeku FW, Azeze GG. Fenta SL. Adherence to iron-folic acid supplementation among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC pregnancy childbirth. 2020;20:138. https://doi.org/10.1186/s12884-020-2835-0\u003c/li\u003e\n\u003cli\u003eSingh PK, Dubey R, Singh L, Kumar C, Rai RK, Singh S. Public health interventions to improve maternal nutrition during pregnancy: a nationally representative study of iron and folic acid consumption and food supplements in India. 2020; Public Health Nutr. 2020;23(15):2671-2686. 10.1017/S1368980020001007\u003c/li\u003e\n\u003cli\u003eDutta AJ, Patel P, Bansal RK. Compliance to iron supplementation among pregnant women: a cross sectional study in urban slum. Nat J Community Med. 2014;5(04), 457-462.\u003c/li\u003e\n\u003cli\u003eGalloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, et al. Women\u0026rsquo;s perceptions of iron deficiency and anemia prevention and control in eight developing countries. Soc Sci Med. 2002;55(4):529-44. 10.1016/s0277-9536(01)00185-x\u003c/li\u003e\n\u003cli\u003eManasa K, Chandrakumar SG, Prashantha B. Assessment of compliance with iron-folic acid therapy during pregnancy among postnatal mothers in a tertiary care centre, Mysuru. Int J Community Med Public Health. 2019;6(4):1665-1669. https://doi.org/10.18203/2394-6040.ijcmph20191402\u003c/li\u003e\n\u003cli\u003eNiquini RP, Bittencourt SDDA, Lacerda EMDA, Saunders C, Leal MDC. Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro. Rev Bras Saude Mater Infant. 2016;16:189-199. https://doi.org/10.1590/1806-93042016000200007\u003c/li\u003e\n\u003cli\u003eChakma T, Rao PV, Meshram PK. Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India. Public Health Nutr. 2012;16(2):377-380. https://doi.org/10.1017/S1368980012002704\u003c/li\u003e\n\u003cli\u003eSharma J, Devanathan S, Sengupta A, Rajeshwari PN. Assessing the prevalence of iron deficiency anemia and risk factors among children and women: A case study of rural Uttar Pradesh. Clin Epidemiol Glob Health. 2024;101545. https://doi.org/10.1016/j.cegh.2024.101545\u003c/li\u003e\n\u003cli\u003eGalloway R, McGuire J. Determinants of compliance with iron supplementation: Supplies, side effects, or psychology?. Soc Sci Med. 1994;39(3):381-390. https://doi.org/10.1016/0277-9536(94)90135-X\u003c/li\u003e\n\u003cli\u003eSmitha MV, Indumathi P, Parichha S, Kullu S, Roy S, Gurjar S, Meena S. Compliance with Iron-Folic Acid supplementation, associated factors, and barriers among postpartum women in Eastern India. Hum Nutr Metab. 2024;35:200237. https://doi.org/10.1016/j.hnm.2023.200237\u003c/li\u003e\n\u003cli\u003eSelvaraj R, Ramakrishnan J, Sahu SK, Kar SS, Laksham KB, Premarajan KC, Roy G. High prevalence of anemia among postnatal mothers in Urban Puducherry: A community-based study. J Family Med Prim Care. 2019;8(8):2703-2707. 10.4103/jfmpc.jfmpc_386_19\u003c/li\u003e\n\u003cli\u003eRathi N, Kansal S, Raj A, Pedapanga N, Joshua I, Worsley A. Indian adolescents\u0026rsquo; perceptions of anaemia and its preventive measures: Aqualitative study. J Nutr Sci. 2024;13:e9. 10.1017/jns.2024.4\u003c/li\u003e\n\u003cli\u003eWangaskar SA, Sahu SK, Majella MG, Rajaa S. Prevalence of anaemia and compliance to weekly iron-folic acid supplementation programme amongst adolescents in selected schools of urban Puducherry, India. Niger Postgrad Med J. 2021;28(1):44-50. 10.4103/npmj.npmj_336_20\u003c/li\u003e\n\u003cli\u003eNadella P, Subramanian SV, Roman-Urrestarazu A. The impact of community health workers on antenatal and infant health in India: a cross-sectional study. SSM Population Health. 2021;15:100872. https://doi.org/10.1016/j.ssmph.2021.100872\u003c/li\u003e\n\u003cli\u003eTaner CE, Ekin A, Solmaz U, Gezer C, Cetin B, Kelesoglu M, et al. Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery. J Turk Ger Gynecol Assoc. 2015;16(4):231-236. 10.5152/jtgga.2015.15071\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Footnote","content":"\u003cp\u003e1 Full ANC is defined as at least antenatal visits, one or more tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) tablets/syrup for at least of 100 days\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Iron and Folic Acid, Antenatal Care, Non-compliance, Pregnancy, Anemia, India","lastPublishedDoi":"10.21203/rs.3.rs-4587207/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4587207/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eIron and Folic Acid (IFA) supplementation is one of the highly recommended strategies to tackle anemia. Under the backdrop of high anemia prevalence, this study examines the level of non- compliance with IFA supplementation among pregnant women in India.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe analysis is conducted on a sample of 151171 women, who bought or received IFA tablets/syrup during pregnancy, and was surveyed during the National Family Health Survey-5 (2019-21). Descriptive statistics and conditional probabilities are calculated to examine the initiation and attainment of different levels of IFA consumption across selected background variables. Binary logistic regressions are employed to understand the influence of socio-economic factors on non-compliance of IFA supplementation for minimum 100 days and 180 days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e While the probability of initiation of IFA tablets is fairly high among pregnant women in India, the probability of consuming at least 100 tablets declines drastically for pregnant women irrespective of their socio-economic profile. The chances of not taking IFA for at least 100 days and at least 180 days are lesser by 21% and 15% for urban with respect to rural women. Age is not a significant parameter. When compared to the richest, the poorest face 1.6 times higher odds for not consuming IFA for at least 100 days, and 1.96 times higher in case of non-compliance for minimum 180 days. Women with no education shows 1.73 and 1.46-times higher likelihood do be non-compliant with both criteria as compared to those with higher education. Those who have received less than four ANCs are at least two times more likely to be non-compliant. Risk of non-compliance is lesser among women with lower birth order as compared to pregnancies of third and higher birth order.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eInvolvement of community health workers in awareness generation and close monitoring of IFA consumption behaviour ensuring compliance for a minimum of 180 days, might improve the scenario.\u003c/p\u003e","manuscriptTitle":"Non-compliance to IFA Consumption among Indian Pregnant Women: Evidences from NFHS-5 Data (2019-21)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 20:12:36","doi":"10.21203/rs.3.rs-4587207/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-24T16:16:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-22T00:25:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-22T00:24:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2024-06-15T15:52:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"af35e33f-b8cb-4749-92f2-efa5e3512914","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-06T13:38:04+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 20:12:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4587207","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4587207","identity":"rs-4587207","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}