RIGBE TEWELEBIRHAN2025-06-262025-05-25https://repository.mu.edu.et/handle/123456789/726Background- Although not all birth defects can be prevented, people can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors around the time of pregnancy. Findings suggest that daily peri-conceptional intake of 0.4 mg of folic acid reduces the risk of neural tube defects occurrence by approximately 60%. A relatively high dietary intake of folate may also reduce the risk. In Ethiopia, neural tube defect-related deaths are very high with a magnitude of 104/10,000 live births. The overall occurrence of NTDs was 131 per 10,000 births in Tigray. A survey from nine regions of Ethiopia found that only 32.7% of women of reproductive age had optimal levels of serum folate; therefore, 67% had folate insufficiency. The prevalence of folate deficiency and insufficiency means that many Ethiopian women are at risk of poor birth outcomes. Objective- The aim of this study is to assess the peri-conception folic acid intake among pregnant women attending antenatal care follow-up in Mekelle city Tigray Region, Northern Ethiopia/2024. Methods; A mixed method study with facility based cross-sectional design for the quantitative part was conducted in Mekelle City from June/2024 –May/2025. The sample size of this study was 654 mothers. For the qualitative study, 3 focus group discussions of pregnant mothers’ and 6 key informant interviews with health care professionals were conducted. Systematic sampling was used to select the study participants for the quantitative data, while purposive sampling was employed for the qualitative data. Data were collected by interviewer administered questionnaire. The data were entered to Epi-data 3.1 and analyzed by using SPSS version 22. Binary logistic regression analysis was done and the strength of statistical association was measured by adjusted odds ratios at 95% confidence interval. Statistical significance was declared at P-value <0.05. Thematic analysis was employed and result of the qualitative data was presented by triangulating. Result: The prevalence of peri-conception folic acid intake was 18.3%. The main reasons for not taking folic acid supplementation were; lack of awareness, mother not getting sick, not prescribed by a doctor, getting enough folic acid from local food and unintended pregnancy. In the multivariable analysis, marital status (AOR =0.257, 95% CI: .072-0.917), number of antenatal care visits (AOR= 5.09, 95% CI: 1.780, 14.567), employment status (AOR= 2.169, 95% CI: 1.020- 4.614), place of delivery (AOR= 196, 95% CI: .074-.517), gestational age (AOR= .133, 95% CI: .037-.471), level of knowledge (AOR= 3.249, 95% CI: 1.825-5.782) were significantly associated with peri-conception folic acid intake. Conclusion and recommendation: The uptake of peri-conception folic acid in this study was low. Regional health Bureau and health facilities should work on advocating peri-conception folic acid intake in terms of training and supply provision.enThesis