KNOWLEDGE ON ANAEMIA AND ASSOCIATED RISK FACTORS AMONG PREGNANT WOMEN AGED (18-49) ATTENDING ANTENATAL CLINIC AT THE REGIONAL HOSPITAL, BUEA

ABSTRACT

An estimation of 41.8% of pregnant women worldwide is anaemic and at least half of the anaemia burden is assumed to be due to iron deficiency. Iron deficiency anaemia is the most common nutritional disorder in the world affecting 2 billion people worldwide with pregnant women particularly at risk (WHO, 2012).

This study was conducted on knowledge on anemia and its associated risk factors among pregnant women attending ANC at regional hospital, Buea. The objective of the study was to assess pregnant women knowledge on anmaemia in pregnancy, to asses pregnant women knowledge with regards to prevention of anaemia in pregnancy and to asses participants knowledge on the associated risk factors of anaemia in pregnancy. The study adopted a descriptive design and questionnaire to elicit pertinent information from the respondents. Non-probability (purposive) sampling techniques was used to select the sample for the study. Data was analyzed with SPSS version 20.0. Findings from this study shows 38.0% of then were between ages 26-30 which is similar to findings of Ademuyiwa, Ayanmolowo, oginni and Akinbode(2020). Also, similar to findings of Wolff et al;2009, Gosh and Koren ,2008). The highest percentage were between 26-30years, few of the participants had not heard about anemia in pregnancy while 41% are aware that is related to the blood. In conclusion, participants had adequate knowledge on anaemia in pregnancy and sufficient knowledge on its prevention but inadequate knowledge on the associated risk factors. The following recommendations were made following the results obtained: There is need for public awareness campaigns tailored towards informing pregnant women on the associated risk factors of anaemia in pregnancy emphasising on the importance of eating balanced diet containing essential nutrients like iron, this should be emphasized upon to pregnant women during antenatal care as this will help them

Non-Governmental Organizations (NGOs) should partner with healthcare centres and hospitals to help provide essential iron-rich foods and food supplement for pregnant women and also assist them to create and own their own kitchen gardens so as to harvest and eat fresh dark green leafy vegetables for their iron source.

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Anaemia is defined as a low level of haemoglobin in blood, as evidenced by fewer numbers of functioning red blood cells. Haemoglobin in red blood cells is an oxygen-carrying protein that binds oxygen through its iron component. Haemoglobin transports oxygen to most cells in the body to generate energy.  Globally, anaemia affects 1.62 billion people (25%), out of which 56 million are pregnant women (Balarajan, 2011; WHO/CDC, 2008). An estimation of 41.8% of pregnant women worldwide is anaemic and at least half of the anaemia burden is assumed to be due to iron deficiency. Iron deficiency anaemia is the most common nutritional disorder in the world affecting 2 billion people worldwide with pregnant women particularly at risk (WHO, 2012).

Anaemia during pregnancy is the major cause of morbidity and mortality in pregnant women and infants in developing countries (Akhtar and Hassan, 2012). In 2013, an estimated 289,000 women died worldwide. Developing countries account for 99% (286,000) of the global maternal death with sub-Saharan Africa region alone accounting for 62% (179,000). About 800 women a day are still dying from complication in pregnancy and childbirth globally (WHO, 2015). Anaemia contributes to 20% of all maternal deaths (WHO, 2015). Anaemia in pregnancy causes low birth weight (Banhidi et al., 2011), fetal impairment and infant deaths (Kalatvant, 2009). Iron deficiency anaemia affects the nation’s development by decreasing the cognitive and motor development of children and productivity of adults (Balarajan et al., 2011; Vivek et al., 2012). A deficiency in folic acid during pregnancy can result in developing neural tube defect that develops in embryos during the first few weeks of pregnancy leading to malformation of the spin, skull, and brain (Wolff et al., 2009).

The prevalence of anaemia in developing countries is 60% and about 7% of the pregnant women are severely anaemic (Agan et al., 2010). In Africa, 51.7% of pregnant women are anaemic (de Benoist et al., 2008). Sub-Saharan Africa is the most affected region with a prevalence of anaemia estimated to be 17.2 million among pregnant women. This is approximately 30% of the total global cases (WHO, 2008). Anaemia during pregnancy is considered severe when haemoglobin concentration (Hb) is less than 7.0g/dl, moderate when Hb concentration is 7.0 to 9.0g/dl and mild when Hb concentration is 10.0 to 10.9g/dl (Balarajan et al., 2011; Salhan et al., 2012; Esmat et al., 2010). When the prevalence of anaemia among pregnant women is 40.0% or more, it is considered a severe public health problem (McLean et al., 2008). Studies in the mount Cameroon area have shown that anaemia is a severe public health problem in pregnancy with a high prevalence of 57% (Anchang et al., 2017).

Anaemia during pregnancy has a wide variety of causes and contributing factors. Iron deficiency is the cause of 75% of anaemia cases during pregnancy (Balarajan et al., 2011; Haidar, 2010). Loss of appetite and excess vomiting during pregnancy and heavy menstruation flow before pregnancy are equally documented causes of anaemia during pregnancy (Noronha et al. 2010). Infectious diseases such as malaria, helminthes infestation and HIV are implicated with high prevalence of anaemia in sub-Saharan Africa (Ouedraogo et al., 2012 and Tolentino and Friedman, 2007). Socio-economic conditions, abnormal demands like multiple pregnancies, teenage pregnancies, maternal illiteracy, unemployment, short pregnancy intervals, age of gestation, primigravida and multigravida (Haniff et al., 2007; Noronha et al., 2010), excessive alcohol consumption, smoking are the main contributing factors of anaemia during pregnancy  (Moosa and Zein, 2011; Esmat et al., 2010)

Iron and folate requirements increase during pregnancy and hence, the likelihood of developing iron and folate deficiency is high in the absence of supplementation during pregnancy (Marti-Carvaja et al., 2002). It is therefore recommended that all pregnant women should start taking iron and folic acid supplements as early as possible to avoid complications of iron and folic acid deficiency during pregnancy. Supplementation with folic acid has been shown to reduce the risk of congenital heart defects, cleft lips, limb defects, and urinary tract anomalies (Wilcox et al., 2007; and Goh and Koren, 2008). IFAS is a major strategy to reduce iron deficiency anaemia in pregnancy as well as risk of congenital malformations on the newborn.

Iron has several vital functions in the body. It serves as a carrier of oxygen in red blood cells from the lungs to the tissue; it functions as a transport medium for electrons within cells, and as an integrated part of important enzyme systems in various tissues. Folic acid, a B vitamin (B12), plays a vital role in the production of red blood cells, synthesis of DNA, and it also acts as a co-factor in certain biological reactions (Weinstein et al., 2013). Folic acid is especially important in aiding rapid cell division and growth, such as in infancy and pregnancy. Birth defects occur within the first 3-4 weeks of pregnancy, usually before a woman even knows she’s pregnant. So it is important to have folic acid in the system during those early stages when the baby’s brain and spinal cord are developing (Folate: Dietary Supplement Fact Sheet, 2013).

1.2 Statement of Problem

Anaemia increases the risks of foetal, neonatal and overall infant mortality (Akhtar and Hassan, 2012). The prevalence of anaemia among pregnant women in the mount Cameroon area was 57% (Anchang et al., 2017). Over the past 26 years, a maximum value of 56.7% was reached in 1991 and a minimum value of 49.3% in 2016 (Stevens et al., 2016). If the prevalence of anaemia is 40.0% or more, it is considered a severe public health problem (McLean et al., 2008). From this information, it can be estimated that high prevalence of anaemia among pregnant women in Cameroon is considered to be the main factor for maternal deaths.Anaemia is a serious global public health problem that particularly affects young children and pregnant women. WHO estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anaemic. Anaemia can cause a range of symptoms including fatigue, weakness, dizziness and drowsiness, hence the nerd to carry out this study to assess pregnant women knowledge on anaemia in pregnancy and its associated risk factors amongst pregnant women attending ANC at regional hospital Buea.

1.3 Rational  

This study will help the community to prevent fetal mortality rate and it will also teach them about the causes and consequences of anemia.

1.4 Research questions

1. What knowledge do pregnant women have on the precautions of anemia in pregnancy in the Buea Regional hospital?
2. What knowledge do pregnant women attending ANC at the Buea regional hospital have with regards to anemia in pregnancy.
3. What are the risk factors associated with anaemia among pregnant women attending antenatal clinic at the Buea regional hospital?