scholarly journals Factors Associated with Anemia among Pregnant Women of Underprivileged Ethnic Groups Attending Antenatal Care at Provincial Level Hospital of Province 2, Nepal

Anemia ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Umesh Kumar Yadav ◽  
Prabesh Ghimire ◽  
Archana Amatya ◽  
Ashish Lamichhane

Background. This study aims at determining the factors associated with anemia among pregnant women of underprivileged ethnic groups attending antenatal care at the provincial level hospital of Province 2. Methods. A hospital-based cross-sectional study was carried out in Janakpur Provincial Hospital of Province 2, Southern Nepal. 287 pregnant women from underprivileged ethnic groups attending antenatal care were selected and interviewed. Face-to-face interviews using a structured questionnaire were undertaken. Anemia status was assessed based on hemoglobin levels determined at the hospital’s laboratory. Bivariate and multiple logistic regression analyses were used to identify the factors associated with anemia. Analyses were performed using IBM SPSS version 23 software. Results. The overall anemia prevalence in the study population was 66.9% (95% CI, 61.1–72.3). The women from most underprivileged ethnic groups (Terai Dalit, Terai Janajati, and Muslims) were twice more likely to be anemic than Madhesi women. Similarly, women having education lower than secondary level were about 3 times more likely to be anemic compared to those with secondary level or higher education. Women who had not completed four antenatal visits were twice more likely to be anemic than those completing all four visits. The odds of anemia were three times higher among pregnant women who had not taken deworming medication compared to their counterparts. Furthermore, women with inadequate dietary diversity were four times more likely to be anemic compared to women having adequate dietary diversity. Conclusions. The prevalence of anemia is a severe public health problem among pregnant women of underprivileged ethnic groups in Province 2. Being Dalit, Janajati, and Muslim, having lower education, less frequent antenatal visits, not receiving deworming medication, and having inadequate dietary diversity are found to be the significant factors. The present study highlights the need of improving the frequency of antenatal visits and coverage of deworming program in ethnic populations. Furthermore, promoting a dietary diversity at the household level would help lower the prevalence of anemia. The study findings also imply that the nutrition interventions to control anemia must target and reach pregnant women from the most-marginalized ethnic groups and those with lower education.

2020 ◽  
Author(s):  
Umesh Kumar Yadav ◽  
Prabesh Ghimire ◽  
Archana Amatya ◽  
Ashish Lamichhane

Abstract Background: This study aims to determine the predictors of anemia among pregnant women of underprivileged ethnic groups attending antenatal care at provincial level hospital of Province 2.Methods: A hospital based cross-sectional study was carried out in Janakpur Provincial Hospital of Province 2, Southern Nepal. 287 pregnant women from underprivileged ethnic groups attending antenatal care were selected and interviewed. Face to face interviews using structured questionnaire was undertaken. Anemia status was assessed based on hemoglobin levels determined at the hospital’s laboratory. Bivariate and multiple logistic regression analyses were used to identify the predictors of anemia. Analyses were performed using IBM SPSS version 23 software.Results: The overall anemia prevalence in the study population was 66.9% (95% CI 61.1-72.3). The women from most under-privileged ethnic groups (Terai Dalit, Terai Janajati and Muslims) were twice more likely to be anemic than Madhesi women. Similarly, women having education lower than secondary level were about 3 times more likely to be anemic compared to those with secondary level or higher education. Women who had not completed four antenatal visits were twice more likely to be anemic than those completing all four visits. The odds of anemia were three times higher among pregnant women who had not taken deworming medication compared to their counterparts. Furthermore, women with inadequate dietary diversity were four times more likely to be anemic compared to women having adequate dietary diversity.Conclusions: The prevalence of anemia is a severe public health problem among the pregnant women of under-privileged ethnic groups in Province 2. Being Dalit, Janajati and Muslim, having lower education, less frequent antenatal visits, not receiving deworming medication and having inadequate dietary diversity are found to be the significant predictors. The present study highlights the need of improving the frequency of antenatal visits and coverage of deworming program in ethnic populations. Furthermore, promoting a dietary diversity at the household level would help lower the prevalence of anemia. The study findings also imply that the nutrition interventions to control anemia must target and reach pregnant women from most-marginalized ethnic groups and those with lower education.


Author(s):  
Nyasiro S Gibore ◽  
Agatha F Ngowi ◽  
Mariam J Munyogwa ◽  
Mwanaisha M Ali

Abstract Background Anemia is a major cause of morbidity and mortality of pregnant women and increases the risks of fetal and neonatal morbidity and mortality. Approximately 50% of all anemia is estimated to be caused by low dietary intake of iron, poor absorption of dietary iron, or blood loss. The objective of the present study was to determine the prevalence and assess the dietary habits associated with anemia among pregnant women receiving antenatal care in Unguja Island, Tanzania. A cross-sectional study was conducted to select 338 pregnant women at Kivunge, Mwembeladu and Mnazimmoja hospitals from March to June, 2018. Hemoglobin concentration was measured using a HemoCue photometer on capillary blood. Sociodemographic data and dietary habits were collected using a structured questionnaire. The data were analysed using the SPSS version 21.0. Multivariate logistic regression analysis was carried out to determine the predictors of anemia among pregnant women. The overall prevalence of anemia was 80.8%. Of these 68.64% had mild anemia, 11.24% had moderate anemia and 0.89% had severe anemia. Anemia was significantly associated with inadequate dietary diversity (Adjusted Odds Ratio (AOR) = 1.16, 95%CI = 0.57–2.36, p < 0.05), drinking tea or coffee with meal (AOR = 0.06, 95%CI = 0.03–0.13, p < 0.001), consuming less than three meals per day (AOR = 2.92, 95%CI = 1.60–5.84, p < 0.001), higher education level (AOR = 3.4, 95%CI = 1.6–7.2, p < 0.0001), birth interval of less than two years (AOR = 3.6, 95%CI = 1.1–11.9, p < 0.05) and multigravida (AOR = 1.2, 95% = 0.3–4.4, p < 0.0001). The prevalence of anemia in this study demonstrates a severe public health problem among pregnant women. Inadequate dietary diversity coupled with inadequate daily meal intake and consumption of tea or coffee were the dietary habits predictors of anemia among pregnant women. Other predictors of anemia were higher education level, multigravida and birth interval of less than two years. Nutrition policy interventions are needed in order to complement antenatal care services by providing important information on healthy eating habits during pregnancy.


2020 ◽  
Author(s):  
Gaurab Acharya ◽  
Wandee Sirichokchatchawan ◽  
Keshab Sanjel

Abstract BackgroundAnemia is a global public health problem, consisting 40% of pregnant women being anemic worldwide. Manifold factors directly or indirectly contribute to anemia during pregnancy and amplify the risk of maternal and fetal mortality and morbidity. However, factors associated with anemia among pregnant women are not broadly understood in sub-national level. Thus, this study has made an effort to ascertain the prevalence and associated factors of anemia among pregnant women in AMDA Hospital of Eastern Nepal. MethodsHealth-facility based cross-sectional study was conducted among pregnant women of age 18-49 years attending antenatal care (ANC) in AMDA Hospital. A total of 420 samples were recruited through systematic random sampling. Data was collected through a validated semi-structured questionnaire. Hemoglobin concentration was recorded from laboratory test report. Collected data were entered in EpiData and analyzed in SPSS Version 22 licensed by Chulalongkorn University. Chi-square test was used for bivariate analysis and later, significant variables at p-value<0.10 were processed on multivariate analysis. Finally, the adjusted odd ratio was reported considering significant at p-value <0.05 with 95% confidence interval. ResultsThe overall prevalence of anemia was 42.1% (37.4%–47.0%). Almost 46%, 41% and 14% of women were with mild, moderate and severe types respectively. Factors such as age less than 20 years (7.23, 2.50–20.87) and between 20- 24 years (2.80, 1.31–5.96), religious minorities (3.09, 1.35–7.06), vegetarian diet pattern (4.33, 1.49–12.59), inadequate frequency (DGLV: once a week, fruits: twice in a week) of eating DGLV (8.71, 2.26 – 33.63) and fruits (2.73, 1.41–2.29), inadequate dietary diversity (7.16, 3.15–16.27), as well as no intake of multivitamins during pregnancy (4.23, 1.49– 11.98) were statistically associated with anemia among pregnant women. ConclusionOverall, the prevalence of anemia was found to be high in the study area. The associated factors of anemia ranged from socio-economic, dietary and obstetric care, and included age, religion, diet pattern, and frequency of eating DGLV and fruits, dietary diversity, as well as intake of multivitamins during pregnancy. The study recommends enhancing community-based interventions considering the identified factors.


2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.


2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.


2020 ◽  
Author(s):  
Tsegahun Worku Brhanie ◽  
Walelgn Tefera ◽  
Mamo Dereje

Abstract Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and newborn. Dietary diversity is a proxy indicator of maternal nutrient adequacy. However, little is documented on the prevalence of dietary diversity among pregnant women. This study was aimed to assess the dietary diversity practice and associated factors among pregnant women attending antenatal care in health centers of the coffee keranyo sub city, Addis Ababa, Ethiopia. Methods: Institution based cross-sectional study was conducted on 406 randomly selected pregnant women attending ANC in health centers of the coffee keranyo sub city, Addis Ababa from March 2-April 2/ 2018. Data were collected by using interviewer and 24 H dietary recall method. Data had entered and analyzed using SPSS version 21. Multiple logistic regression was run to assess factors associated with the dependent variable at P<0.05. Results: The mean Dietary Diversity Score of pregnant women was 5. 45+-1. 83. About 60.9% of pregnant women had good dietary diversity practice. Pregnant women who learned collage and above had more dietary diversity practice than the illiterate one [AOR=2.26, 95% CI: (1.066, 4.808)]. Pregnant women with monthly income more than 5,000 ETB had more dietary diversity than income less than 2,000 ETB [AOR=2.33, 95% CI: (1.234, 4.416)]. Pregnant women at second antenatal care visit had more dietary diversity than at the first visit [AOR=2.42, 95% CI: (1.183, 4.952)]. Having nutrition information during pregnancy increases 2 times better dietary diversity practice than none informed ones [AOR=2.10, 95% CI: (1.294, 3.422)].Conclusions: The mean Dietary Diversity Score of pregnant mothers was 5.45. And 60.9% of pregnant women had a good dietary diversity score, whereas 39.1 % of them had a poor diet diversity score. Mothers’ education, monthly income, second and third antenatal care visit and nutrition information had a significantly associated with pregnant mothers’ dietary diversity.


2020 ◽  
Author(s):  
Desta Samuel Umuro ◽  
Yared Lasebew Asres ◽  
Gezahegn Mamo Muluneh

Abstract Background This study aimed to assess magnitude and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods Institution based cross sectional study design was conducted from December 1–30, 2018 on 405 pregnant women attending antenatal clinic. All pregnant women visiting the Antenatal care clinic during the study period and who fulfilled the eligibility criteria were included in the study. Secondary data was collected from clients register and personal files on hemoglobin, HIV, stool, and other variables. Descriptive statistics was used to analysis some variables by using SPSS. Logistic regression was carried out to identify factors associated with anemia in pregnancy. Adjusted odds ratio with their 95% of confidence interval and p < 0.05 are consider to have significant association. Results The magnitude of Anemia in pregnant women in this study was 19.8%, (95% CI 16.00-23.70). HIV infection (AOR = 6.12(95% CI 2.19, 17.08) parasitic infestation (AOR = 11.88 (95% CI 5.60, 25.20) and history of not taking fruit after meal during pregnancy (AOR = 3.12(95% CI 1.72, 5.67) were the major determinants of anemia. Conclusion This study showed that the magnitude of anemia among pregnant women was high especially at third trimester. Living with HIV /AIDS, parasitic infestation and no history of taking fruits after meal were the main factors.


2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Kristen H Kjerulff ◽  
Muzi Na ◽  
Guodong Liu ◽  
...  

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.


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