Antenatal Care and Adherence to Multiple Micronutrient Supplementation Among Pregnant Women in Mbuji-Mayi, Democratic Republic of the Congo

Introduction: Antenatal care provides an important opportunity to counsel pregnant women, prescribe nutritional supplements, and support their regular use. However, dispensing supplements does not ensure adherence. This study describes antenatal care and adherence to multiple micronutrient supplementation (MMS) among women who delivered in Mbuji-Mayi, Democratic Republic of the Congo.

Methods: This retrospective comparative cohort study used records from 200 women who delivered, including 100 classified as exposed to MMS and 100 as unexposed. Data reported in the underlying thesis were summarized, including antenatal care attendance, timing of supplementation initiation, tablet consumption, and reported side effects. Associations were assessed using relative risks and multivariable logistic regression.

Results: Among women in the exposed group, only 29.0% met the thesis-defined threshold for acceptable adherence (at least 80% of tablets or 144 tablets), whereas 71.0% had adherence below this threshold. Supplementation started from the fourth month of pregnancy in 95.0% of women and earlier in 5.0%. Side effects were reported by 70.0%. Fewer than four antenatal care visits were recorded for 134 women: 77 in the unexposed group and 57 in the exposed group. The thesis reported an association between fewer than four visits and non-exposure to MMS (p=0.003). In the multivariable model for anemia, poor antenatal follow-up was associated with higher odds of anemia (adjusted OR=27.4; 95% CI: 8.5–87.9; p<0.001).

Conclusion: The data suggest substantial challenges in antenatal follow-up and MMS adherence. They support strengthening counseling, adherence monitoring, and management of side effects. Findings should be interpreted cautiously because of the retrospective design and statistical inconsistencies that require verification against source data.