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BACKGROUND: Anaemia in pregnancy is associated with adverse maternal and fetal outcome.Unfortunately, in developing countries its prevalence has continued to rise. To improve the situation,iron supplement is routinely prescribed during pregnancy. We therefore examine the impact of theintervention as being currently practised in our clinical setting.METHODS: In total, 255 prenatal clinic attendees who had more than 8 weeks of prescribed ironsupplements were sampled. Data was obtained on their socio-demographic features, haemoglobinconcentration at booking, compliance with iron supplements and third trimester haemoglobin value.RESULTS: Observed iron supplementation compliance rate was 184(72.2%). There was a significantdrop in mean haemoglobin (Hb) concentration between the two time points (booking Hb: 32.56±2.99;third trimester Hb: 31.67±3.01; mean diff: 0.89±3.04; t = 4.673; 95% CI= 0.52-1.27; p= <0.001).Anaemia increased from 132(51.8%) to 150(58.8%) by the third trimester. Increase in anaemia occurredin both iron-compliant and non-compliant groups. Non-compliance however had higher odds ofpredicting anaemia by the third trimester (OR: 1.83; 95% CI: 1.03-3.26; p: 0.04).CONCLUSION: Although iron supplementation is still a good intervention in developing countries, it isnot sufficient to reduce overall prevalence of anaemia by the third trimester. There is a need to lookbeyond the approach and reinforce the importance of better feeding practices, food fortification andreduced frequency of pregnancies.