ABSTRACT

This study explores how internal, external, and chance health locus of control affect supplementation adherence, considering socio-demographic factors among primiparous and multiparous pregnant women in Abia State University, Uturu. A descriptive cross-sectional design was employed with a sample size of 163 pregnant women, comprising staff and female students. Socio-demographic data were collected alongside Health Locus Of Control and micronutrient supplementation behaviour using a structured questionnaire. Internal Locus of Control (ILC), External Locus of Control (ELC), and Chance Locus of Control (CLC) scores were analyzed. IBM SPSS Statistics (version 20) was used for descriptive and correlational analyses. The study revealed that 84.0% of participants were within the reproductive age range of 18–34 years, with 59.5% being multiparous and 40.5% primiparous. Most participants were married (82.8%), of Igbo ethnicity (72.4%), and possessed tertiary education (82.2%). Income distribution showed that 42.9% earned less than N50,000, with 43.6% earning N50,000–N100,000. Multiparous women demonstrated higher ILC scores (0.65) than primiparous women (0.57), reflecting greater confidence and familiarity with supplementation. For ELC, multiparous women also scored higher (0.54) than primiparous women (0.39), indicating a stronger reliance on healthcare professionals. Both groups exhibited low CLC scores, with multiparous women scoring slightly higher (-0.96) than primiparous women (-1.05), suggesting minimal belief in external factors such as luck, faith e.t.c. as a determinant of supplementation behaviour. Timely initiation of antenatal care was higher among primiparous women (75.3%) compared to multiparous women (57.6%). This study highlights the influence of HLOC on micronutrient supplementation behaviour. Multiparous women exhibited stronger internal and external locus of control, likely due to prior pregnancy experiences, while primiparous women demonstrate greater trust in structured external factors such as health care professionals. The study revealed For primiparous women, the relationship between ILC, ELC, and CLC scores with Appropriate Micronutrient Supplementation Behaviour is weak and statistically insignificant (p > 0.05). Similar results are observed for multiparous women, indicating no strong correlation between locus of control dimensions and their micronutrient supplementation behaviour due to factors beyond the locus of control, such as health literacy or healthcare access. Among low-income participants (earning less than N50,000), the correlations between locus of control dimensions and AMSB are negligible and statistically insignificant this could be due to economic constraints which might overshadow psychological factors like locus of control in influencing supplementation behaviour. Among students, ELC shows a trend of positive association, implying that external influences like healthcare guidance or institutional programs could be more effective for this group.  Interventions targeting both groups should enhance internal locus of control through tailored education on the benefits of supplementation. Healthcare systems should foster consistent support for multiparous women and build trust among primiparous women. Additionally, policies promoting early antenatal care and continuous education on micronutrient supplementation should be prioritized to improve maternal and fetal outcomes.