Determinants of iron supplement adherence and hemoglobin status among 6-month-old infants in a high-poverty region of Peru

Fernández-Delgado J.C.M.; Díaz-Villanueva F.E.; Álvarez-Muñoz E.; Llego J. · Frontiers of Nursing (2026) · DOI: 10.2478/fon-2026-0040

Resumen

Objective: To assess hemoglobin levels, adherence to ferrous sulfate supplementation, and associated factors among 6-month-old infants in a Peruvian health center. Methods: A cross-sectional study was conducted among 57.6-month-old infants attending a public health facility. Hemoglobin levels were obtained through capillary blood samples, while adherence to ferrous sulfate was assessed using a validated Likert-type scale (Cronbach's α = 0.89; Aiken's V = 0.93), encompassing individual, family, social, and institutional dimensions. Data were analyzed using SPSS v.27 (IBM Corporation, Armonk, New York, United States). Chi-square tests and logistic regression were performed to identify associations between hemoglobin status, adherence levels, and associated factors. Results: Among participants, 57.9% had adequate hemoglobin levels (≥11.0 g/dL) and 54.4% adhered to ferrous sulfate supplementation. Significant associations were found between hemoglobin levels and adherence status (P = 0.00), maternal age (P = 0.010), maternal education (P = 0.000), socioeconomic status (P = 0.012), and rural origin (P = 0.020). Low adherence was more prevalent in the individual (75.4%) and family (70.2%) domains, while higher adherence was observed in the institutional dimension (86.0%). Adjusted odds ratios (AORs) indicated that individual (AOR = 2.8; 95% confidence interval [CI]: 1.6-5.0) and family factors (AOR = 2.0; 95% CI: 1.2-3.0) were significant predictors of hemoglobin levels. Conclusions: Adherence to iron supplementation significantly influences hemoglobin levels in infants. Individual and family-related factors negatively affect adherence, while institutional and social factors act as protective influences. These findings underscore the need to incorporate adherence-focused strategies into public health programs aimed at reducing infant anemia, particularly in socioeconomically disadvantaged settings.

Instituciones: Universidad Nacional de Cajamarca