Uptake of iron and folic acid supplements among pregnant women in Dar es Salaam, Tanzania.

Anemia in pregnancy is a public health concern globally with the highest prevalence observed in low and middle-income countries (LMICs). Tanzania is no exception. Iron and folic acid supplements (IFAS) intake is a proven intervention recommended to prevent anemia in pregnancy. Despite interventions in Tanzania, IFAS uptake has remained low due to reasons that are not well documented. This study aimed to assess the uptake and determinants of IFAS during pregnancy in Dar es Salaam, Tanzania. A quantitative cross-sectional study was conducted to assess levels and determinants of IFAS uptake during pregnancy in Dar es Salaam, Tanzania. Data was collected among 428 women post-delivery in postnatal wards of Temeke, Mwananyamala, and Amana regional referral hospitals. Descriptive analyses were conducted to determine levels and characteristics of IFAS uptake, whereas bivariate and multivariate analyses were conducted to examine determinants of uptake using SPSS version 23. Among the study participants, only 136 (31.8%) pregnant women who attended antenatal care (ANC) at referral hospitals had adequate IFAS uptake. Primiparous women were 74% less likely to achieve adequate IFAS uptake compared to multiparous women (aOR=0.26; 95% CI: 0.10 - 0.67). Women who attended five or more ANC visits (aOR=11.7; 95%CI: 1.30 - 63.66) and those from wealthier households (aOR=11.68; 95% CI: 2.91 - 89.57) were about 12 times more likely to achieve adequate IFAS uptake. Similarly, women from food-secure households had a ninefold higher likelihood of adequate uptake compared to those from severely food-insecure households (aOR=9.21; 95% CI: 1.82 - 10.33). Only one in three pregnant women attending regional referral hospitals in Dar es Salaam achieved adequate IFAS uptake to prevent anemia. Targeted interventions are urgently needed, particularly among pregnant women with higher parity, fewer ANC visits, and those facing economic hardship, food insecurity, and challenging family support.