Population Institute

ABSTRACT

Iron deficiency anemia remains a major maternal health concern in the Philippines despite ongoing iron supplementation programs. This study examined the predictors of iron supplement compliance among 2,822 women aged 15 to 49 years with a live birth in the two years preceding the 2022 National Demographic and Health Survey (NDHS), guided by the Health Belief Model (HBM). Using weighted survey data and binary logistic regression, the study found that under perceived susceptibility, maternal age at birth was significantly associated with compliance, with higher adherence observed among older women. For perceived barriers, wealth status, employment status, and religion were significant predictors of iron supplement compliance. Women from richer households were more likely to comply, while employed women had lower odds of completing the recommended supplementation. In addition, women with no or other religious affiliations had lower odds of adherence compared with Christian women. For cues to action, antenatal care (ANC) utilization and media exposure were both significant determinants; early initiation and more frequent ANC visits significantly increased compliance, while media exposure also positively influenced adherence. Most individual-level HBM constructs, including education, parity, pregnancy intention, autonomy, marital status, residence, and region, were not statistically significant in the adjusted model, indicating that structural and health system factors are more influential than individual perceptions.
In conclusion, iron supplement compliance in the Philippines is primarily driven by ANC utilization and socioeconomic conditions. Strengthening antenatal care services and addressing socioeconomic barriers are essential to improve adherence to iron supplementation during pregnancy.

Keywords: iron supplementation, Health Belief Model, antenatal care, maternal health, Philippines, NDHS