Folic acid awareness and usage among Syrian women of pregnancy age, impact of education, socioeconomic status, and source of information: a cross-sectional questionnaire study

Objectives: Syria, a country under crisis since 2011, suffers from deterioration of its healthcare system especially social services for population subgroups such as infants and pregnant women. In the last decade, research was mainly focusing on health and disease of Syrian refugees in neighboring countries. This revealed higher rates of neural tube defects compared to hosting populations. However, very limited research has investigated women’s health and heath awareness inside Syria during times of conflict. The aim of this study was to explore the knowledge and awareness of folic acid use during pregnancy among Syrian women living in Syria. Methods: A cross-sectional questionnaire, distributed through online and offline means between December 2024 and January 2025, was administered to women (≥18 years) living in Syria. Key findings: In total, 238 out of 480 respondents were aware of folic acid importance among pregnant females. Women taking folic acid after pharmacist consultation were more aware than women getting folic acid based on friends and family advice. Less educated females showed lower score levels compared those with higher education. Conclusions: Lower awareness of folic acid usage in pregnancy was evident in less educated females. Healthcare professionals’ community engagement sessions to educate females on the importance of folate, mainly pharmacists, could potentially be an effective route to improve women’s knowledge, especially those with lower educational status. Those sessions could be led by local community pharmacies.