Background: Adherence to iron and folate supplementation during pregnancy is considered key to prevention and control
of iron deficiency anemia. Nepal-like other developing countries-faces problems with adherence vis-a-vis iron/folate supplementation.
Objective: This descriptive survey aimed to assess the effect of knowledge and perception of pregnant women on adherence
to iron/folate supplementation in Kathmandu, Nepal.
Material and Method: The present study was conducted in Paropakar Maternity and Women’s Hospital in Kathmandu.
Systematic random sampling was used to select 406 persons who were either given a self-administered questionnaire or
interviewed.
Results: 73.2% of the respondents showed good adherence. Bivariate analysis revealed significant associations between
adherence and both knowledge and perception (p<0.05), but through multiple linear regression analysis only perception was
found to be statistically associated with adherence (p<0.05). Further multivariate analysis demonstrated that the most
important predictors of adherence were: perception of side effects, availability, forgetfulness and reminders from family.
Conclusion: Adherence to iron/folate supplementation among women during pregnancy needs continuous improvement by
minimizing the perception of constraints (viz., side-effects and forgetfulness) and, enhancing availability and family support.

Keywords: Adherence, Anemia, Iron/folate supplementation, Nepal, Pregnancy