Anemia and Associated Factors among Pregnant Women Attending Prenatal Care in Rural Dembia District, North West Ethiopia: A cross-Sectional Study

ABSTRACT

Introduction: About 22% of pregnant women are anemic in Ethiopia, but there is a large variation across the country. Hence, the aim of this study identifies the prevalence of anemia and associated factors among pregnant women attending prenatal appointments in Dembia District, northwest Ethiopia.Methods and materials: A facility-based, cross-sectional study was conducted among 713 pregnant women. A multi-stage, stratified sampling technique was used to select the study participants. A structured and pretested questionnaire, laboratory data, and chart review were used to collect data. Bivariate and multivariate logistic regression analyses were used to identify factors associated with anemia in pregnant women.Results: Prevalence of anemia was 32.4% with a majority of these having moderate anemia. Type of health center being rural/urban health center, water sources, days since fasting, 4 weeks of iron supplementation, craving unusual foods, mid-upper arm circumference scores, and decision power were significant predictors of anemia.Conclusion: The present study suggests anemia among pregnant women attending prenatal in Dembia district was high. Working to enhance adherence to iron supplementation and partner involvement for joint decision-making is recommended to avert prenatal anemia. Health-care providers and programmers are advised to pay special attention to rural and fasting pregnant mothers.

Abbreviations: AOR: Adjusted Odd Ratio; CMHS: College of medicine and health sciences; CI: Confidence Interval; HFIAS: Household Food Insecurity Access Scale; RCSI: Reduced Coping Strategies Index; Hgb: Hemoglobin; MCMC: Marco Chain Monte Carlo; EPV: Events per variable; BMI: Body Mass Index; PPS: Population proportionate to size sampling; SRS: simple random sampling; DALYS: Disability-adjusted life years; MUAC: Mid-upper-arm-circumference; WHO: World Health Organization; EDHS: Ethiopian Demographic and Health Survey; SPSS: Statistical package for social science; ANC: Ante natal care; PCA: Principal component analysis; MASL: Meter above sea level; g/dl: gram per decilitre HALE: Health Action Leicester Ethiopia; WDDS: Women’s Dietary Diversity Scale

KEYWORDS:

• Anemia
• associated factors
• pregnant women
• Ethiopia

Acknowledgments

We thank our study participants who volunteered and took their time to give us all the relevant information for the study and the data collectors whose invaluable effort was crucial to get relevant data.

Availability of data and materials

All data generated or analyzed during this study are available from the corresponding author on reasonable request.

Authors’ contributions

AMB conceived, designed and coordinated the study, participated in data acquisition, carried out data collection, analysis and interpretation and reviewed the manuscript. AT, GD and GA participated in designing the study, review of the manuscript, and analysis. SAW participated in designing the study, drafted and reviewed the manuscript. All the authors have read and approved the final manuscript.

Consent to publish

Not applicable

Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Ethical clearance was obtained from the Ethical Review Board of the University of Gondar. An official letter indicating ethical clearance was presented at Kolladiba Health Center, the Dembia District Health Office Head and the six Health Center Heads. Women under 18 years of age were excluded from the study based on the National Review Ethics Guidelines of Ethiopia [43]. These women would have needed to obtain parental consent to participate, which would impose hardship on them. Data collectors read through the consent form for participants and gained their consent through a fingerprint on the consent form (regardless of literacy level, as this ensured no names were on the study materials). The data collector emphasized that participation was voluntary, they were not affiliated with the health center.

Confidentiality of the information was assured, and participants were reminded that they can withdraw at any time. After completion of the surveys, the participant retrieved their lab results, then returned to the midwife to provide lab results and receive the appropriate follow up, per guidelines of the health center. Midwives kept the data in a secure location and returned them in a sealed envelope to the supervisor or data collectors to return to the principle investigator.

Additional information

Funding

This work was supported by the Rotary Foundation and Williston Rotary Club and Health Action Leicester Ethiopia (HALE);The Rotary Foundation and Williston Rotary Club provided financial support for this survey. Health Action Leicester Ethiopia (HALE) also supported this research;