1.1 Introduction
Folic acid is a synthetic form of folate, a water-soluble B-vitamin (vitamin B9) that plays a crucial role in DNA synthesis, cell division, red blood cell formation, and fetal growth and development during pregnancy. Women of reproductive age are advised to consume folic acid regularly before conception and during the early stages of pregnancy to reduce the risk of birth defects and pregnancy-related complications (WHO, 2023). Adequate folic acid intake before conception and during pregnancy is essential for preventing neural tube defects such as spina bifida and anencephaly, which are among the most common congenital abnormalities affecting newborns worldwide. Pregnancy is a critical period during which the nutritional requirements of women increase significantly to support fetal growth and maternal well-being. Similarly, the Centers for Disease Control and Prevention (2022) reported that sufficient folic acid intake contributes to healthy fetal development and promotes favorable pregnancy outcomes.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Folic acid is a synthetic form of folate, a water-soluble B-vitamin that is essential for cell growth, DNA synthesis, and the proper development of the fetus during pregnancy. It plays a critical role in the formation of the neural tube, which later develops into the brain and spinal cord of the unborn child. Adequate intake of folic acid before conception and during the early stages of pregnancy has been recognized globally as one of the most effective strategies for preventing neural tube defects and other congenital abnormalities. According to the World Health Organization (2023), folic acid supplementation before and during pregnancy significantly reduces the risk of birth defects and contributes to improved maternal and neonatal health outcomes.
Maternal nutrition remains a major determinant of pregnancy outcomes across the world. Pregnant women require increased amounts of nutrients to support fetal growth and maintain their own health during pregnancy. Among these nutrients, folic acid occupies a prominent position because of its role in reducing the occurrence of neural tube defects, low birth weight, preterm birth, and certain forms of maternal anemia. According to the Centers for Disease Control and Prevention (2022), women who consume the recommended amount of folic acid before conception and during pregnancy are more likely to experience favorable pregnancy outcomes and deliver healthy infants (Centers for Disease Control and Prevention, 2022).
Globally, governments, health organizations, and healthcare institutions have implemented various interventions to promote folic acid intake among women of reproductive age. These interventions include routine antenatal counseling, food fortification programs, community health education campaigns, and supplementation initiatives. According to the World Health Organization (2023), a substantial proportion of women in low- and middle-income countries still do not receive adequate folic acid supplementation during the critical period of pregnancy.
Knowledge regarding folic acid intake is an important factor influencing maternal health behavior. Women who understand the importance of folic acid and the consequences of inadequate intake are more likely to adhere to supplementation guidelines. Owoeye et al. (2021) reported that adequate knowledge of folic acid was positively associated with early initiation and consistent use of supplements among pregnant women. Similarly, Eze et al. (2022) asserted that awareness of the benefits of folic acid significantly improved compliance with antenatal nutritional recommendations. However, inadequate knowledge remains a challenge in many communities, especially among women with limited access to health information and educational opportunities.
Attitude toward folic acid supplementation is another important factor that influences utilization. Positive attitudes encourage women to adopt healthy nutritional practices during pregnancy, while negative perceptions may discourage compliance. Akinyemi and Adewuyi (2020) stated that pregnant women who perceived folic acid supplementation as beneficial were more likely to take the supplement regularly than those who did not appreciate its importance. Likewise, Nwobodo and Isah (2020) affirmed that favorable attitudes toward antenatal nutritional interventions contributed significantly to improved maternal health practices.
This study is set against the backdrop of persistent concerns regarding inadequate knowledge, varying attitudes, and inconsistent practices related to folic acid intake among pregnant women, as well as the need to improve maternal and neonatal health outcomes through enhanced nutritional awareness and effective antenatal healthcare interventions in Sokoto Metropolis.
1.3 Statement of Problems
Investigation revealed that folic acid intake during pregnancy remains a major public health concern in many developing countries, including Nigeria. Folic acid is essential for the prevention of neural tube defects and other adverse pregnancy outcomes, yet many pregnant women do not consume the recommended amount before conception and during early pregnancy. Oyekale (2021) reported that many women are unaware of the appropriate timing, dosage, and importance of folic acid supplementation during pregnancy.
Furthermore, some studies have reported relatively good levels of awareness and utilization of folic acid among pregnant women attending urban health facilities due to increased exposure to health education and antenatal counseling (Akinyemi et al., 2021). It is against this backdrop that this study seeks to assess the knowledge, attitude, and practice of folic acid intake among pregnant women in Sokoto Metropolis.
1.4 Aim and Objectives of Study
The aim of this study is to examine the knowledge, attitude, and practice of folic acid intake among pregnant women in Sokoto Metropolis. In achieving this aim, the following specific objectives were laid out as follows:
- To assess the level of knowledge of folic acid intake among pregnant women in Sokoto Metropolis.
- To determine the attitude of pregnant women towards folic acid supplementation.
- To examine the practice of folic acid intake among pregnant women.
- To identify factors influencing folic acid intake among pregnant women.
- To evaluate the relationship between knowledge, attitude, and practice of folic acid intake.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge of folic acid intake among pregnant women in Sokoto Metropolis?
- What is the attitude of pregnant women towards folic acid supplementation?
- What is the practice level of folic acid intake among pregnant women?
- What factors influence folic acid intake among pregnant women?
- What is the relationship between knowledge, attitude, and practice of folic acid intake?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis 1
- H0: There is no significant relationship between knowledge and folic acid intake practice among pregnant women in Sokoto Metropolis.
- H1: There is a significant relationship between knowledge and folic acid intake practice among pregnant women in Sokoto Metropolis.
Hypothesis 2
- H0: Attitude does not significantly influence folic acid supplementation practice among pregnant women in Sokoto Metropolis.
- H1: Attitude significantly influences folic acid supplementation practice among pregnant women in Sokoto Metropolis.
Hypothesis 3
- H0: There is no significant relationship between socioeconomic factors and folic acid intake among pregnant women in Sokoto Metropolis.
- H1: There is a significant relationship between socioeconomic factors and folic acid intake among pregnant women in Sokoto Metropolis.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will help the Sokoto State Ministry of Health improve maternal nutrition policies focused on folic acid supplementation in antenatal care services. The outcome of this research will also assist healthcare workers in strengthening antenatal counseling on folic acid intake for pregnant women in Sokoto Metropolis.
Furthermore, the findings will support pregnant women in improving awareness and compliance with folic acid supplementation guidelines. It will also guide public health educators in designing effective maternal nutrition awareness programs.
Lastly, the study will provide useful data for researchers studying maternal health and nutritional practices in Northern Nigeria.
1.8 Scope of Study
The scope of the research is focused on knowledge, attitude, and practice of folic acid intake among pregnant women in Sokoto Metropolis and excludes women outside the selected health facilities and other states in Nigeria.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Folic Acid:
Folic Acid refers to a synthetic form of vitamin B9 that is essential for DNA synthesis and prevention of neural tube defects during pregnancy (World Health Organization, 2023).
Knowledge:
Knowledge refers to the level of understanding pregnant women have regarding folic acid intake, including its benefits, timing, and dosage (Owoeye et al., 2021).
Attitude:
Attitude refers to the beliefs and perceptions pregnant women hold toward folic acid supplementation and its importance in pregnancy (Nwobodo & Isah, 2020).
Practice:
Practice refers to the actual use of folic acid supplements by pregnant women in accordance with recommended antenatal guidelines (Eze et al., 2022).
Pregnant Women:
Pregnant Women refers to women who are currently carrying a developing fetus and are receiving antenatal care services in health facilities (Akinyemi & Adewuyi, 2020).
…