Researchers in Tanzania discovered that only about 1 in 3 pregnant women are taking enough iron and folic acid supplements to stay healthy during pregnancy. Iron and folic acid are important vitamins that prevent a condition called anemia, which can be dangerous for both mom and baby. The study found that women who were richer, went to more doctor visits, and had enough food at home were much more likely to take their supplements regularly. First-time moms were less likely to take them than women who had been pregnant before. These findings suggest that pregnant women need better support and education about why these supplements matter.

The Quick Take

  • What they studied: How many pregnant women in Dar es Salaam, Tanzania are taking iron and folic acid supplements as recommended, and what factors help or prevent them from taking these vitamins
  • Who participated: 428 women who had just given birth at three large hospitals in Dar es Salaam. The researchers asked them about their supplement use during pregnancy
  • Key finding: Only about 32 out of every 100 pregnant women (31.8%) took enough iron and folic acid supplements. Women who were wealthier, went to more prenatal doctor visits, and had reliable food at home were about 12 times more likely to take their supplements regularly
  • What it means for you: If you’re pregnant or planning to become pregnant, iron and folic acid supplements are important for preventing anemia. However, this research shows many women face barriers like poverty and food insecurity that make it harder to take these supplements consistently. Talk to your doctor about how to make sure you’re getting enough of these nutrients

The Research Details

Researchers conducted a straightforward survey study where they asked 428 women who had recently given birth at three hospitals in Dar es Salaam about their supplement use during pregnancy. This type of study, called a cross-sectional study, takes a snapshot of a situation at one point in time rather than following people over months or years.

The women answered questions about whether they took iron and folic acid supplements, how many prenatal doctor visits they attended, their family’s income level, whether they had enough food at home, and other details about their lives. The researchers then used statistics to figure out which factors made women more or less likely to take their supplements regularly.

This approach is useful for identifying problems and understanding what might be causing them, though it can’t prove that one thing directly causes another. The researchers collected information from women at three different hospitals to get a more complete picture of the situation in the city.

Understanding why pregnant women don’t take their iron and folic acid supplements is crucial because anemia during pregnancy can cause serious problems for both the mother and the baby. By identifying the specific barriers—like poverty, lack of food security, and limited doctor visits—researchers can design better programs to help women get the supplements they need. This type of study is the first step in solving a public health problem

This study has several strengths: it included a reasonably large number of women (428), used multiple hospitals to avoid bias from just one location, and asked detailed questions about many different factors. However, there are some limitations to keep in mind. The study only looked at women at referral hospitals, which might not represent all pregnant women in the city. Also, women were asked to remember details about their pregnancy after they had already given birth, which means some details might not be perfectly accurate. The study shows what factors are connected to supplement use but can’t prove that one thing causes another

What the Results Show

The main finding was striking: only about 1 in 3 pregnant women (31.8%) who attended prenatal care at these hospitals took enough iron and folic acid supplements during their pregnancy. This is concerning because these supplements are a proven way to prevent anemia, a condition where the blood doesn’t carry enough oxygen to the body.

The research identified several important factors that affected whether women took their supplements. First-time mothers were much less likely to take adequate supplements compared to women who had been pregnant before—they were 74% less likely to reach adequate intake levels. This suggests that experience and knowledge from previous pregnancies matter.

Women who attended five or more prenatal doctor visits were about 12 times more likely to take enough supplements compared to those with fewer visits. Similarly, women from wealthier households were about 12 times more likely to take adequate supplements than poorer women. Women whose families had reliable access to food were about 9 times more likely to take enough supplements than women facing severe food insecurity.

These findings paint a clear picture: pregnant women with more resources, more healthcare contact, and better living conditions were much more likely to take their iron and folic acid supplements regularly.

The study also revealed that food security was a major factor in supplement use. Women who didn’t know where their next meal would come from were significantly less likely to prioritize taking supplements. This suggests that when families are struggling to afford basic food, taking vitamins becomes a lower priority. Additionally, the number of prenatal visits emerged as a critical touchpoint—each additional doctor visit increased the likelihood of proper supplement use, suggesting that healthcare providers play an important role in encouraging and supporting supplement intake

This research aligns with previous studies from other low and middle-income countries showing that anemia in pregnancy remains a significant public health problem. Other research has also found that poverty, food insecurity, and limited healthcare access are barriers to taking preventive supplements. However, this study provides specific data from Tanzania that confirms these patterns exist locally and quantifies how strong these barriers are. The finding that only about 1 in 3 women achieve adequate intake is consistent with reports from other African countries facing similar challenges

Several important limitations should be considered. First, the study only included women at three referral hospitals, which are larger, more advanced facilities. Women who gave birth at smaller clinics or at home might have different patterns of supplement use. Second, women were asked to remember details about their pregnancy after giving birth, which can lead to inaccurate recall. Third, the study shows which factors are connected to supplement use but cannot prove that one thing causes another—for example, while wealthier women took more supplements, we can’t be certain that wealth directly causes better supplement use versus other factors. Finally, the study doesn’t explain the specific reasons why women didn’t take supplements, such as side effects, lack of knowledge, or difficulty accessing them

The Bottom Line

If you are pregnant or planning to become pregnant, talk to your healthcare provider about iron and folic acid supplements. These supplements are recommended for all pregnant women to prevent anemia. If you face barriers like cost, food insecurity, or difficulty remembering to take them, discuss these challenges with your doctor—they may be able to help you find solutions. Attend all your prenatal appointments, as these visits are important opportunities to get support with supplement use. (Confidence level: High—these supplements are proven to prevent anemia)

This research is most relevant to pregnant women in low and middle-income countries, particularly those facing economic challenges or food insecurity. Healthcare providers, public health officials, and policymakers in Tanzania and similar countries should pay special attention to these findings. First-time mothers and women with limited access to healthcare should be prioritized for additional support. However, the findings also apply to pregnant women everywhere, as anemia prevention is important universally

Iron and folic acid supplements work best when taken consistently throughout pregnancy. You won’t see dramatic changes overnight, but regular use prevents anemia from developing over the months of pregnancy. Most women need to take supplements for several months to build up adequate iron stores. If you start taking supplements, continue them as directed by your healthcare provider throughout your pregnancy and even for a few months after birth

Want to Apply This Research?

  • Set up a daily reminder to take your iron and folic acid supplement at the same time each day (for example, with breakfast). Track whether you took your supplement each day using a simple yes/no checklist in the app. Aim for at least 5-6 days per week of consistent use
  • Use the app to schedule your prenatal appointments and set reminders to attend them—each visit is an opportunity to discuss supplements with your healthcare provider. Create a shopping list in the app to ensure you always have your supplements on hand. If cost is a barrier, use the app to research free or low-cost supplement programs in your area
  • Track your supplement use weekly and monthly to identify patterns. Note any side effects or challenges you experience and discuss them with your healthcare provider. Monitor your prenatal visit attendance to ensure you’re getting regular healthcare support. If you notice you’re missing doses, use the app to identify what’s getting in the way and adjust your strategy

This research describes patterns in supplement use among pregnant women in Tanzania and should not replace personalized medical advice. All pregnant women should consult with their healthcare provider about iron and folic acid supplementation, as individual needs vary based on health status, diet, and other factors. If you are pregnant or planning to become pregnant, speak with your doctor before starting any supplement regimen. This article is for educational purposes and is not a substitute for professional medical diagnosis, treatment, or advice. The findings apply specifically to the population studied and may not represent all pregnant women or all geographic regions