The Determinants Associated With Adherence to Iron-folic Acidsupplementation Among Adolescent Girls in Jhs: A Cross-sectional Study at Mawuli Junior High School, Volta Region

Abstract Background Iron and folic acid (IFA) supplementation is essential for improving the nutritional status of adolescent girls and preventing related health issues. However, adherence to IFA supplementation remains a significant challenge in many Ghanaian school settings. Objective This study aimed to provide insights into adherence to IFA supplementation among adolescent girls and identify strategies to improve their nutritional status. Method The study was conducted at Mawuli Junior High School in the Volta Region of Ghana, selected as a representative public junior high school with a large population of adolescent girls. The study involved girls aged 13 to 18 years in Forms 2 and 3. A sample of 350 participants was selected using simple random sampling. Data were collected through structured questionnaires and analysed using descriptive and inferential statistics. Results Awareness of IFA programs in school was strongly associated with receiving and taking supplements (AOR = 8.54, 95% CI: 3.12–23.36, p < 0.001). Grade level and distance to the nearest health facility did not significantly influence adherence (p > 0.05). A strong association was found between frequency of intake and adherence (AOR = 5.99, 95% CI: 2.45–14.65, p < 0.001). Logistic regression showed that hearing of IFA programs in school significantly predicted adherence (AOR = 8.78, 95% CI: 2.91–26.45, p = 0.003). Although knowledge of IFA benefits was not a significant predictor of supplement intake overall (p = 0.155), the perceived importance of adherence increased the likelihood of initiation (AOR = 8.54, 95% CI: 2.33–21.65, p = 0.003). Forgetfulness emerged as the most common barrier to regular intake, followed by fear of side effects, lack of knowledge, and unavailability of supplements. Conclusion Strategies to improve adherence should focus on enhancing knowledge and attitudes toward IFA supplementation, addressing practical barriers such as forgetfulness and side effects, and integrating supplementation into adolescents’ daily routines. The study provides valuable insights into factors influencing adherence and offers direction for strengthening school-based IFA programs.