Determinants of Anemia Among Pregnant Women Attending Antenatal Care Clinic at Public Health Facilities in Kacha Birra District, Southern Ethiopia

Abstract

Background

Anemia is accountable for 20% of maternal death globally, and it is associated with premature birth, low birth weight, and infant death. According to the WHO report of 2008, 57.1% of pregnant women were anemic in Africa. In Ethiopia, anemia among pregnant women is 62.7%. There were no data in the study area that identified the determinants of anemia.

Objective

To identify the determinants of anemia among pregnant mothers attending ANC clinic in public health facilities in Kacha Birra District, Southern Ethiopia.

Methods

An institutional-based unmatched case–control study was conducted among pregnant women attending antenatal care clinics in public health facilities in Kacha Birra District, Southern Ethiopia, from February 1/2019–May 30/2019. An aggregate of 117 cases and 227 controls were involved in the study. Data were collected using interviewer-administered questionnaires. Controls were pregnant ladies whose blood hemoglobin level was 11 g/dl and above at their first antenatal care clinic, and cases were pregnant ladies whose hemoglobin level less than 11 g/dl. Both bivariate and multivariable logistic regression models were used to isolate independent predictors of anemia.

Results

An overall of 344 respondents (117 cases and 227controls) were included in this study with a response rate of 100%. On multivariable logistic regression models, significant predictors of anemia were: rural residence [AOR= 2.9,95% CI:1.18–5.84], previous history of heavy menstrual blood flow [AOR=2.75, 95% CI: 2.66–28.53], age of mother [AOR=4.013, 95% CI: 1.08–14.90], parasitic infection [AOR=6.39, 95% CI: 1.226–33.362], food taboo (aversion) [AOR= 3.92, CI: 95% 2.08–7.35], drinking tea/coffee instantly after meal [AOR=18.49, 95% CI:6.89–40.64].

Conclusion

Residence, previous heavy menstrual flow, age, parasitic infection, food taboo, and tea/coffee consumption immediately after meals were significant predictors of anemia among pregnant women. So, anemia prevention and control policy should include the promotion of counseling on the consumption of diversified and iron-enriched foods during pregnancy, prevention of parasitic infection as well as mass deworming, awareness creation on cultural norms that makes food aversion during pregnancy.

Keywords:

• determinants
• anemia
• pregnant women
• case
• control

Abbreviations

ANC, antenatal care; AOR, adjusted odds ratio; CDC, Center for Disease Control and Prevention; CI, confidence interval; COR, crude odds ratio; DDS, Dietary Diversity Score; G/dl, gram per deciliter; HCG, human chorionic gonadotropin; Hgb, hemoglobin; HMB, heavy menstrual bleeding; LMP, last menopausal period; SOP, standard operational procedure; WHO, World Health Organization.

Ethics Approval and Informed Consent

Ethical clearance was obtained from the Ethical Review Board of Jimma University’s official letter of cooperation from Jimma University was given to Kacha Birra district health office. Participants under the age of 18 years were approved by the Ethical Review Board of Jimma University to provide informed consent on their behalf. Study subjects were informed about the significance of the study and awareness of their contribution is critical to generate helpful information to themselves and the nation. Informed written consent was obtained from each study participants given with full information including the objectives of the study, selection criteria, confidentiality, and benefits of the study. The response of each participant was reserved confidential and it will be used only for research purposes. Every laboratory investigation was done according to the requirement of the patient.

Acknowledgments

First of all, we would like to thank the almighty God for helping us in the whole work of our study. Secondly, I gratefully thank Jimma University, institute of health, faculty of public, Nutrition, and Dietetics Department for sponsoring this study. The authors would also like to thank the study participants and data collectors.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The study was entirely sponsored by Jimma University, Institute of Health, and Faculty of Public Health.