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Lakew G, Yirsaw AN, Berhie AY, Belayneh AG, Bogale SK, Getachew E, Andarge GA, Seid K, Bogale EK. Prevalence and associated factors of anemia among postpartum mothers in public health facilities in Ethiopia, 2024: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:327. [PMID: 38678183 PMCID: PMC11055361 DOI: 10.1186/s12884-024-06525-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Postpartum anemia, characterized by hematocrit or hemoglobin levels below the defined cutoff point (< 11gm/dl or hematocrit < 33%), is a prevalent global issue. It serves as an indirect contributor to maternal mortality and morbidity. Mothers in the postpartum period experience diminished quality of life, impaired cognitive function, emotional instability, and an increased risk of postpartum depression due to anemia. Additionally, infants of affected mothers may face challenges such as insufficient breast milk supply and a lack of proper care. Examining the combined prevalence and factors associated with postpartum anemia is crucial for addressing maternal health risks and complications during the postnatal phase attributed to anemia. OBJECTIVE The study aimed to synthesize the existing literature on the prevalence and associated factors of postpartum anemia in public health facilities of Ethiopia, in 2024. METHODS The study was conducted by searching through the Google Scholar, PubMed, and Cochrane Library search engines. The search utilized keywords and MeSH terms such as anemia, low hemoglobin, postpartum, postnatal women, and Ethiopia. The collected data underwent analysis and comparison with the WHO criteria to determine if it met the threshold for declaring a public health concern. Heterogeneity was evaluated through the Cochran Q test and I2 statistics. Prevalence and odds ratio estimations were performed using a random-effects model with a 95% confidence interval. RESULT Four studies were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among postpartum women in Ethiopia was 69% (95% CI: 60- 77%).Lack of formal education(OR = 3.5;CI:2.639,4.408),Low Pre-delivery hemoglobin (OR = 4.2;CI: 1.768-6.668), Postpartum women < 4 ANC visit (OR = 2.72; 95% CI:2.14,3.3 ),history of post partum hemorrhage (OR = 2.49; CI: 1.075-3.978),history of Forceps/vacuum delivery(OR = 3.96; CI:2.986-4.947), Poor iron and folic acid adherence (OR = 2.8;95% CI:2.311,3.297), C/S (OR = 4.04; 95% CI: 3.426,4.671),lower dietary diversity (OR = 4.295% CI:1.768,6.668) were significantly associated postpartum anemia. CONCLUSION Postpartum women in Ethiopia continue to face a considerable public health challenge in the form of anemia. Consequently, there is a pressing need for the government to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the substantial regional disparities influenced by interconnected factors, with the aim of reducing the prevalence of anemia among postpartum women in Ethiopia.
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Affiliation(s)
- Gebeyehu Lakew
- Health Promotion and Communication Department, School of public health, College of medicine and health sciences, Gondar University, Gondar, Ethiopia.
| | - Amlaku Nigusie Yirsaw
- Health Promotion and Communication Department, School of public health, College of medicine and health sciences, Gondar University, Gondar, Ethiopia
| | - Alemshet Yirga Berhie
- Nursing department, college of medicine and health science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Asnake Gashaw Belayneh
- Department of emergency and critical care nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Solomon Ketema Bogale
- Department of Nutrition, Antsokiya Gemza wereda Health Office, North Shoa, North East, Ethiopia
| | - Eyob Getachew
- Health Promotion and Communication Department, School of public health, College of medicine and health sciences, Gondar University, Gondar, Ethiopia
| | - Getnet Alemu Andarge
- Department of Nutrition, Antsokiya Gemza wereda Health Office, North Shoa, North East, Ethiopia
| | - Kedir Seid
- Bati Primary Hospital, Oromia Special Zone, North Shoa, North Central, Ethiopia
| | - Eyob Ketema Bogale
- Health Promotion and Behavioral science department, school of public health, College of medicine and health science, Bahir Dar University , Bahir Dar, Ethiopia
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Abneh AA, Kassie TD, Gelaw SS. The magnitude and associated factors of immediate postpartum anemia among women who gave birth in Ethiopia: systematic review and meta-analysis, 2023. BMC Pregnancy Childbirth 2024; 24:317. [PMID: 38664625 PMCID: PMC11044590 DOI: 10.1186/s12884-024-06495-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND The immediate postpartum period is a very crucial phase for both the life of the mother and her newborn baby. Anemia is the most indirect leading cause of maternal mortality. However, anemia in the immediate postpartum period is a neglected public health problem in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of immediate postpartum anemia and the pooled effect size of associated factors in Ethiopia. METHODS Searching of published studies done through PubMed, Medline, Cochrane, African index Medicus, List of Reference Index, Hinari, and Google Scholar. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) godliness. The quality of studies was assessed by using a Newcastle- Ottawa Scale (NOS) assessment tool. Analysis was performed using a random effect model by using STATA 17 version software. Egger's weighted regression and I2 test were used to evaluate publication bias and heterogeneity respectively. RESULTS In this systematic review and meta-analysis, a total of 6 studies were included. The pooled magnitude of immediate postpartum anemia in Ethiopia was 27% (95%CI: 22, 32). Instrumental mode of delivery (OR = 3.14, 95%CI: 2.03, 4.24), mid-upper arm circumference (MUAC) measurement < 23 cm (OR = 3.19, 95%CI: 1.35, 5.03), Antepartum Hemorrhage (OR = 4.75, 95%CI: 2.46, 7.03), postpartum hemorrhage (OR = 4.67, 95%CI: 2.80, 6.55), and no iron/foliate supplementation (OR = 2.72, 95%CI: 1.85, 3.60) were the identified factors associated with developing anemia in the immediate postpartum period. CONCLUSION The overall pooled magnitude of anemia in the immediate postpartum period among Ethiopian women was still a moderate public health problem. Instrumental mode of delivery, mid upper arm circumference (MUAC) measurement < 23 cm, antepartum hemorrhage, postpartum hemorrhage, and no iron/foliate supplementation were the identified factors associated with higher odds of developing anemia among immediate postpartum women in Ethiopia. Therefore, midwives, and doctors, shall focus on prevention of maternal hemorrhage, nutritional advice and counseling including iron /foliate supplementation, and avoid unnecessary instrumental delivery to prevent and reduce anemia related maternal mortality and morbidity in Ethiopia. PROSPERO REGISTRATION CRD42023437414 with registration date on 02/08/2023.
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Affiliation(s)
- Aysheshim Asnake Abneh
- Department of public health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
| | - Tadele Derbew Kassie
- Department of public health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of public health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
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Eshete NA, Mittiku YM, Mekonnen AG, Welu TH, Haile TG. Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study. BMC Womens Health 2024; 24:185. [PMID: 38509546 PMCID: PMC10953169 DOI: 10.1186/s12905-024-03017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia. METHODS Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant. RESULTS This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia. CONCLUSIONS The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.
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Affiliation(s)
- Nigus Amime Eshete
- Department of Midwifery, Shewarobit Hospital, North Shewa, Amhara, Ethiopia
| | - Yohannes Moges Mittiku
- Department of Midwifery, College of Health Sciences, Debre Brhan University, Debre Brhan, Ethiopia
| | - Alemayehu Gonie Mekonnen
- School of Nursing and Midwifery, College of Health Sciences, Debre Brhan University, Debre Brhan, Ethiopia
| | - Tesfay Hailu Welu
- Department of Midwifery, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, Aksum, Tigray, Ethiopia.
| | - Teklehaimanot Gereziher Haile
- Department of Maternity and Neonatal Nursing, School of Nursing, College of Health Sciences, Comprehensive Specialized Hospital, Aksum University, Aksum, Tigray, Ethiopia
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Etemady M, Hajizadeh M, Gidaszewski B, Swain JA, Chua SC, Khajehei M. Use of iron in perinatal anaemia: Indications for women’s health care policies and procedure. World J Obstet Gynecol 2023; 12:33-44. [DOI: 10.5317/wjog.v12.i4.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/04/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
This paper reviews management of obstetric anaemia and the role of intravenous iron for the treatment of obstetric anaemia. Red blood cell transfusions are routinely used for haemoglobin restoration in anaemic women. The decision for red blood cell transfusion is made on a combination of haemoglobin level and clinical status, and it is suggested that transfusions are not necessary in those who are well compensated or when alternative therapy is available. To reduce the risk, intravenous iron infusion is proposed as a bloodless therapeutic approach. There are a variety of iron preparations. Intravenous iron infusion can reduce the requirement for blood transfusion in hemodynamically stable women with perinatal anaemia, especially in resource-scarce settings. It a cost-effective bloodless approach for the treatment of anaemia than can enhance patient outcomes. According to the literature, when haemoglobin is greater than 90 g/L, blood transfusion is not often required. In perinatal women with anaemia, the decision whether to administer blood or iron is based on patient preferences, haemoglobin levels, clinical symptoms, past and present medical conditions and the clinician’s judgement. Nevertheless, due to the lack of rigid criteria for blood transfusions in the majority of clinical settings, it is considered the default treatment for anaemia in perinatal women.
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Affiliation(s)
- Mike Etemady
- School of Health Sciences, University of Sydney, Sydney, Australia, Sydney 2000, NSW, Australia
| | - Melika Hajizadeh
- Stotts College, Acknowledge Education, Sydney 2000, NSW, Australia
| | - Beata Gidaszewski
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Westmead Clinical School, University of Sydney, Sydney 2000, NSW, Australia
| | - Julie Ann Swain
- Women's and Newborn Health, Westmead hospital, Westmead 2145, NSW, Australia
| | - Seng Chai Chua
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Clinical School, Western Sydney University, Sydney 2145, NSW, Australia
| | - Marjan Khajehei
- Department of Women’s and Newborn Health, Westmead Hospital, Westmead 2145, NSW, Australia
- Westmead Clinical School, University of Sydney, Sydney 2000, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney 2145, NSW, Australia
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Derbo ZD, Debelew GT. The Effect of Fresh Moringa Leaf Consumption During Pregnancy on Maternal Hemoglobin Level in Southern Ethiopia: Multilevel Analysis of a Comparative Cross-Sectional Study. Int J Womens Health 2023; 15:1125-1137. [PMID: 37489178 PMCID: PMC10363345 DOI: 10.2147/ijwh.s412241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose Anemia, especially iron-deficiency anemia during pregnancy, significantly impacts maternal health, fetal growth, and development. Moringa leaf is an iron-rich food that can overcome anemia, but there is a lack of evidence on the association between fresh moringa leaf consumption and maternal hemoglobin level during pregnancy. The aim of this study is to test the effect of fresh moringa leaf consumption during pregnancy on maternal hemoglobin levels in southern Ethiopia. Methods A community-based comparative cross-sectional study was conducted from May to June 2022 among 230 fresh moringa leaf consumers and 230 non-consumers pregnant women. Data were collected using an interviewer-administered structured questionnaire and hemoglobin level was determined by HemoCue Hb 301. Multivariate multilevel linear regression models were fitted using Statistical Software for Data Science (STATA) version 14. Results The overall mean hemoglobin level among pregnant women was 11.76 g/dl ± 1.47 [12.06 g/dl ± 1.22 among fresh moringa leaf consumers and 11.45 g/dl ± 1.64 among non-consumers] with a significant coefficient of association (β) of 0.90 g/dl [β = 0.90 g/dl, 95% CI: 0.54, 1.27]. A number of under-five children, bleeding during the current pregnancy, male-headed household, and current antenatal care visit were the individual-level factors. Distance from the nearest health facility and urban dweller was identified as the community-level factor associated with maternal hemoglobin level during pregnancy. Conclusion This study showed that the consumption of fresh moringa leaf during pregnancy increases the level of hemoglobin. So policymakers and maternal and child health program managers need to target moringa tree scale-up and encourage fresh moringa leaf consumption during pregnancy, but its use needs additional rigorous clinical trials. In addition to this, mark the above factors in their efforts to increase maternal hemoglobin levels during pregnancy.
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Affiliation(s)
- Zeritu Dewana Derbo
- Department of Midwifery, Arba Minch Health Science College, Arba Minch, Ethiopia
| | - Gurmesa Tura Debelew
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Wemakor A, Kpewou DE, Wemah K. Correlates of haemoglobin level in mothers of children under two years in Nanton district: A cross-sectional study from Ghana. Heliyon 2023; 9:e16021. [PMID: 37215882 PMCID: PMC10192525 DOI: 10.1016/j.heliyon.2023.e16021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/24/2023] Open
Abstract
Objectives Anaemia, defined using haemoglobin level, is one of the most prevalent nutritional deficiency diseases among women of childbearing age. Whilst most studies of anaemia were conducted on pregnant women, data are lacking on the haemoglobin level and its correlates of mothers in Ghana. In this paper, we report data on the correlates of haemoglobin level among mothers in Nanton district, Northern Region, Ghana. Method A cross-sectional study design was used to study 420 mothers of children under 2 years selected randomly from the child welfare clinics (CWCs) of five health facilities in Nanton District, Ghana. Women were interviewed on their socio-demographic characteristics, dietary practices, reproductive history, and knowledge on anaemia using a structured questionnaire in health facilities. Haemoglobin values during pregnancy were retrieved from antenatal clinic files whilst finger-pricked blood test samples were obtained and used to determine haemoglobin levels during the survey. Multiple linear regression was used to identify the correlates of haemoglobin level of the mothers. Results The mean age (±SD) and parity of the subjects were 29.4 (±6.36) years, and 3.36 (±1.78) respectively. The mean haemoglobin (±SD) was 10.35 (±2.17) g/dl and 56.0% of the subjects had anaemia. Multivariable regression analysis identified 12 haemoglobin correlates, but based on standardized regression coefficients, the seven most important correlates of haemoglobin were: parity (β = -0.396), age (β = 0.352), having malaria infection postpartum (β = - 0.340), frequency of fruit consumption (once weekly, β = 0.322), frequency of vegetable consumption (twice weekly, β = 0.296), overall index of anaemia knowledge (richest tertile, β = 0.125), and CWC attendance (β = 0.110). It is recommended to strengthen family planning and malaria prevention programmes, and to intensify education on fruit and vegetable consumption, and anaemia.
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Affiliation(s)
- Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
| | - Daniel Edem Kpewou
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
| | - Khadidjah Wemah
- Department of Global and International Health, School of Public Health, University for Development Studies, P O Box TL 1883, Tamale, Ghana
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Agmassie GA, Alamneh GD, Ayicheh MW, Getahun WT, Abneh AA. The magnitude and associated factors of immediate postpartum anemia among women who gave birth in east Gojjam zone hospitals, northwest- Ethiopia, 2020. PLoS One 2023; 18:e0282819. [PMID: 36921015 PMCID: PMC10016639 DOI: 10.1371/journal.pone.0282819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Globally around half a million maternal death occurred annually related to labor and delivery of which twenty percent is contributed by post-partum anemia. Postpartum anemia contributes about two percent of total maternal mortality in Ethiopia. Immediate postpartum anemia is a common public health problem in most parts of the globe, being frequent in low and middle-income countries including in the developed world. The previous studies cut off point for immediate postpartum Anemia is 11mg/dl which is the cutoff point of anemia after one week of postpartum, environmental factors like barefoot were not addressed in the previous studies and the previous studies were conducted in a single facility This study aimed to assess the magnitude and associated factors of immediate post-partum anemia among women who gave birth in East Gojjam zone hospitals, Northwest Ethiopia. METHODS Institutional based cross-sectional study was conducted from October 20-November 20 2020 on immediate post-partum anemia. During the study 467 study participants were included by using systematic random sampling method Data were collected using a structured interviewer-administered questionnaire and a blood sample was used for hemoglobin determination. Data were checked, coded, and entered into Epi-Data Version 4.2 and then exported to SPSS version 25 for analysis. Binary logistic regressions were done to identify predictors of immediate post-partum anemia and a 95% confidence interval of odds ratio at a p-value less than was taken as a significance level. RESULTS The overall magnitude of immediate postpartum anemia among mothers who gave birth in East Gojjam Zone Hospitals were found to be 21.63% (95% CI:18.12%, 25.11%), not having antenatal care follow-up (Adjusted Odds Ratio (AOR) = 2.92;95% CI:1.20,7.06), assisted instrumental delivery (AOR = 2.72; 95% CI:1.08,6.78),mid-upper arm circumferences less than 23cm (AOR = 5.75;95% CI:3.38, 9.79), antepartum hemorrhage (AOR = 4.51; 95% CI:2.42, 8.37), never wearing shoes (AOR = 2.60; 95% CI:1.10, 6.14) were found to be significantly associated with immediate postpartum anemia. CONCLUSION This study indicates that immediate postpartum anemia is a moderate public health problem in the study area. A more careful strategy is ideal to increase antenatal care follow-up that sticks to national guideline contact schedule, safe reduction of instrumental and cesarean deliveries to the minimum, quick and timely linkage and treatment of malnourished pregnant mothers to the center where they get adequate health care services, along with a high index of suspicion in mothers diagnosed with antepartum hemorrhage, wise and vigilant advice on consistent use of the shoe for pregnant mothers are recommended to tackle the burden of immediate post-partum anemia.
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Affiliation(s)
| | - Genet Degu Alamneh
- Departments of Midwifery, Debre Markos University, Debre Markos, Ethiopia
- Departments of Public Health, Debre Markos University, Debre Markos, Ethiopia
| | - Moges Wubie Ayicheh
- Departments of Midwifery, Debre Markos University, Debre Markos, Ethiopia
- Departments of Public Health, Debre Markos University, Debre Markos, Ethiopia
| | - Worku Taye Getahun
- Department of Midwifery, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia
- * E-mail:
| | - Aysheshim Asnake Abneh
- Department of Midwifery, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia
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Bambo GM, Kebede SS, Sitotaw C, Shiferaw E, Melku M. Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study. Front Med (Lausanne) 2023; 10:1105307. [PMID: 37153091 PMCID: PMC10157165 DOI: 10.3389/fmed.2023.1105307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/15/2023] [Indexed: 05/09/2023] Open
Abstract
Background Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally. Objective The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia. Methods A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant. Results The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18). Conclusion The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.
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Affiliation(s)
- Getachew Mesfin Bambo
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
- Department of Medical Laboratory Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
- *Correspondence: Getachew Mesfin Bambo,;
| | - Samuel Sahile Kebede
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
- Department of Medical Laboratory Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Chomaw Sitotaw
- University of Gondar Comprehensive Specialized Hospital Laboratory, Gondar, Ethiopia
| | - Elias Shiferaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Abdelbagi OM, Hassan B, Eltayeb R, ALhabardi N, Adam I. Prevalence of anaemia and its associated factors among lactating mothers in eastern Sudan: a cross-sectional study. Trans R Soc Trop Med Hyg 2022; 116:1123-1128. [PMID: 35474480 DOI: 10.1093/trstmh/trac037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/19/2021] [Accepted: 03/30/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Lactating mothers are susceptible to anaemia. Little published data are available on lactational anaemia in Africa, including Sudan. This study was conducted to assess the prevalence of and associated factors for anaemia among lactating mothers in eastern Sudan. METHODS A cross-sectional study was conducted and sociodemographic and clinical characteristics were gathered through a questionnaire. RESULTS A total of 650 lactating mothers were included in the analysis. Their median age and parity were 28.0 y (interquartile range [IQR] 23.7‒32.0) and 3.0 (IQR 2.0‒4.0), respectively. Haemoglobin (Hb) levels ranged from 7.0 to 15.0 g/dL (median 11.2 [IQR 10.4‒12.0]). Of the 650 lactating mothers, 442 (68.0%) had anaemia (Hb <12.0 g/dL). In multivariate analysis, lactating mothers with education less than the secondary level (adjusted odds ratio [AOR] 1.58 [95% confidence interval {CI} 1.05 to 2.37]) and lactating mothers who underwent caesarean delivery (AOR 1.74 [95% CI 1.17 to 2.58]) had a higher probability of being anaemic. Employment was associated to a lower frequency of anaemia (AOR 0.39 [95% CI 0.20 to 0.79]). CONCLUSIONS This study showed a high prevalence of anaemia among lactating mothers. Public health intervention activities designed towards education would be helpful to reduce anaemia.
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Affiliation(s)
- Omer M Abdelbagi
- Department of Pathology, Faculty of Medicine, Umm-Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Bahaeldin Hassan
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Reem Eltayeb
- Department of Clinical Laboratory Science, College of Applied Medical Science, University of Hail, Hail, Saudi Arabia
| | - Nadiah ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
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Kebede TB, Mengesha S, Lindtjorn B, Engebretsen IMS. Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2 years of age in the rural Dale district, southern Ethiopia: A community‐based study. MATERNAL & CHILD NUTRITION 2022; 18:e13423. [PMID: 36006033 PMCID: PMC9480945 DOI: 10.1111/mcn.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m2. Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m2. The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers. Anaemia and underweight were less prevalent among mothers with young children in the rural Dale district, southern Ethiopia, than the national report of the Ethiopian Demographic and Health Survey in 2016. Dietary diversity is positively associated with haemoglobin level and body mass index among mothers with children younger than 2 years of age. The existing nutrition interventions such as the Productive Safety Net Programme need strengthening, to improve the sustained food access to rural households. Planing and implementing community‐based small‐scale activities, such as school gardening, and fish and poultry farming, to ensure the availability and affordability of nutritious foods.
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Affiliation(s)
- Tsigereda B. Kebede
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
| | - Selamawit Mengesha
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Sidama Regional Health Bureau Sidama region Hawassa Ethiopia
| | - Bernt Lindtjorn
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
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Abebe GT, Kure MA, Yadeta TA, Roba KT, Amante TD. Immediate postpartum anemia and associated factors among women admitted to maternity ward at public hospitals in Harari Regional State, Eastern Ethiopia: A facility-based cross-sectional study. Front Glob Womens Health 2022; 3:916245. [PMID: 36204254 PMCID: PMC9531123 DOI: 10.3389/fgwh.2022.916245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Anemia in the postpartum period remains a considerable public health problem in developing countries, particularly in sub-Saharan Africa. It is the most common indirect cause of maternal morbidity and mortality. It is also a major health problem in women of reproductive age, affecting their quality of life, occupational capacity, lactation, and immunological function. Immediate postpartum anemia has a significant impact on women's quality of life, although its predictors have received little attention in Ethiopia, notably in Harari Regional State. Therefore, this study aimed to determine its magnitude and contributing factors in Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from June 1st to August 30th, 2021, among 484 postpartum women admitted to two public hospitals in Harari Regional State, Eastern Ethiopia. Data were collected using a pre-tested, structured interviewer-administered questionnaire. About 2 mL of blood samples were collected and analyzed using the cell-Dyne 1,800 machine. The collected data were entered into Epi-Data version 4.6 and analyzed using SPSS version 25. A multivariable logistic regression analysis was conducted to estimate the effect of independent variables on immediate postpartum anemia. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to report the presence of the association. Statistical significance was declared at a p-value of < 0.05. Results The overall magnitude of immediate postpartum anemia was 28.1% [95% CI (23.7, 32.1)]. Lack of formal education [AOR: 3.92; 95% CI: (1.85, 8.33)], having antenatal care < 4 visits [AOR: 3.18; 95% CI: (1.53, 6.61)], a history of cesarean delivery [AOR: 3.40; 95% CI: (1.89, 6.10)], a history of maternal blood loss [AOR: 4.78; 95% CI: (2.22, 10.30)], pre-delivery Hgb level < 11 g/dl [AOR:5.46; 95% CI: (3.09,9.67)], and having no iron-folate supplementation [AOR:3.27; 95% CI: (1.31, 8.15)] were factors statistically associated with immediate postpartum anemia. Conclusions In this study, nearly one-third of mothers admitted for postpartum care developed anemia within 48 h of giving birth. Women's educational level, frequency of antenatal care, mode of delivery, a history of maternal blood loss, pre-delivery hemoglobin level, and iron-folate supplementation status were identified as immediate postpartum anemia risk factors. Therefore, promoting the benefits of adequate antenatal care and iron-folate supplementation during pregnancy is crucial to avoiding the risks of postpartum anemia.
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Affiliation(s)
- Gizaw Taddesse Abebe
- Department of Midwifery, College of Health and Medical Sciences, Dilla University, Dilla, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- *Correspondence: Mohammed Abdurke Kure
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tariku Dingeta Amante
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Arinda IK, Sserwanja Q, Kamara K, Mukunya D, Agnes N, Edirisa Juniour N, Christinah N, Kagali A, Lee S. Anemia and Associated Factors Among Lactating Women in Sierra Leone: An Analysis of the Sierra Leone Demographic and Health Survey 2019. Nutr Metab Insights 2022; 15:11786388221105732. [PMID: 35734028 PMCID: PMC9208047 DOI: 10.1177/11786388221105732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background Anemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual's physiological needs. The prevalence of anemia among women of reproductive age is high in Sub-Saharan Africa (SSA), including Sierra Leone. However, data on anemia among lactating women in Sierra Leone are scarce. Therefore, this study was conducted to estimate the prevalence of anemia and determine its associated factors among lactating women in Sierra Leone. Methods The 2019 Sierra Leone Demographic and Health Survey (SLDH) data were used of which 1543 lactating women aged 15 to 49 years old had hemoglobin measurements. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariate binary logistic regression was used to determine factors associated with anemia among lactating women in Sierra Leone. Results The general prevalence of anemia among lactating women in Sierra Leone was 52.9% (95% CI = 50.9-55.8). Almost a quarter, 23.8% (95% CI = 22.1-26.3) of the lactating women had mild anemia, 27.4% (95% CI = 25.3-29.7) had moderate anemia and 1.7% (95% CI = 1.1-2.5) had severe anemia. The use of modern contraceptives (aOR = 1.64, 95% CI = 1.09-2.47), not being visited by a field worker in the past year (aOR = 1.51, 95% CI = 1.12-2.03) and being Muslim (aOR = 1.46, 95% CI = 1.11-1.91), were associated with higher odds of being anemic. Being given and having bought iron supplements during pregnancy (aOR = 0.46, 95% CI = 0.25-0.87) was associated with less odds of being anemic. Conclusion More than half of the lactating mothers in our study were anemic. The risk factors for anemia in our study included: use of modern contraceptives, not being visited by a field worker in the past year and being Muslim. Receiving iron supplements during pregnancy was protective against anemia. According to the results from this study, the recommendation for lactating women was to maintain routine interface with the healthcare system which includes being visited by a field worker who should prescribe and issue iron supplements to them. Lactating women especially Muslims should receive routine nutrition education by the health workers at the health facilities during antenatal care visits or postnatal care in regard to anemia and means of prevention and treatment. Community stakeholders should also work in collaboration to establish scalable methods to correctly identify pregnant women with risk factors, inform them about anemia with caution, and apply appropriate measures as trained or instructed.
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Affiliation(s)
- Ivan Kato Arinda
- Department of Nutrition Research, Nutri-worth International, Kampala, Uganda
| | | | - Kassim Kamara
- Directorate of Health Security and Emergencies, Applied Epidemiology and Disease control, Ministry of Health and Sanitation, Sierra Leone, Freetown, Sierra Leone
| | - David Mukunya
- Department of Public Health, Busitema University, Mbale, Uganda
| | - Napyo Agnes
- Department of Public Health, Busitema University, Mbale, Uganda
| | | | - Nuwahereza Christinah
- Department of Community Health and Behavioural Sciences, Makerere School of Public Health, Kampala, Uganda
| | - Anitah Kagali
- Department of Public Health, Busitema University, Mbale, Uganda
| | - Seungwon Lee
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
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Nigussie J, Girma B, Molla A, Tamir T, Tilahun R. Magnitude of postpartum hemorrhage and its associated factors in Ethiopia: a systematic review and meta-analysis. Reprod Health 2022; 19:63. [PMID: 35264188 PMCID: PMC8905908 DOI: 10.1186/s12978-022-01360-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/11/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1000 ml after cesarean delivery within 24 h. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia. METHODS Primary studies were searched from PubMed/MEDLINE online, Science Direct, Hinari, Cochrane Library, CINAHL, African Journals Online, Google and Google Scholars databases. The searching of the primary studies included for this systematic review and meta-analysis was limited by papers published from 2010 to October 10/2021. The data extraction format was prepared in Microsoft Excel and extracted data was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias. RESULT A total of 21 studies were included in this meta-analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.24% [(95% CI 7.07, 9.40]. Older age [OR = 5.038 (95% CI 2.774, 9.151)], prolonged labor [OR = 4.054 (95% CI 1.484, 11.074)], absence of anti-natal care visits (ANC) [OR = 13.84 (95% CI 5.57, 34.346)], grand-multiparty [OR = 6.584 (95% CI 1.902, 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI 2.347, 8.079)] were factors associated with the occurrence of postpartum hemorrhage. CONCLUSIONS The pooled magnitude of postpartum hemorrhage among post-natal mothers in Ethiopia was moderately high. The finding of this study will strongly help different stakeholder working in maternal and child health to focus on the main contributors' factors to reduce post-partum hemorrhage among postnatal mothers. Health professionals attending labor and delivery should give more attention to advanced aged mothers, grand-multipara mothers and mothers who had a history of post-partum hemorrhage due to higher risk for postpartum hemorrhage. Encouraging to continue ANC visit and prevent prolonged labor should also be recommended to decrease postpartum hemorrhage.
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Affiliation(s)
- Jemberu Nigussie
- Department of Nursing College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
| | - Bekahegn Girma
- Department of Nursing College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Alemayehu Molla
- Department of Psychiatry College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Takla Tamir
- Department of Nursing College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Ruth Tilahun
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
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Sivahikyako SA, Owaraganise A, Tibaijuka L, Agaba DC, Kayondo M, Ngonzi J, Mugisha J, Kanyesigye H. Prevalence and factors associated with severe anaemia post-caesarean section at a tertiary Hospital in Southwestern Uganda. BMC Pregnancy Childbirth 2021; 21:674. [PMID: 34610802 PMCID: PMC8493736 DOI: 10.1186/s12884-021-04157-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 09/27/2021] [Indexed: 01/19/2023] Open
Abstract
Background Severe anaemia after caesarean section adversely affects the woman and the new-born. While prenatal anaemia is extensively studied, the literature on post-caesarean section anaemia is limited and characteristics of women at the highest risk of developing severe anaemia after caesarean section are unknown. This study aimed to determine the prevalence and factors associated with severe anaemia on day three post caesarean section. Methods On the third day after caesarean section, women were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital (MRRH). Women who got transfused peripartum were excluded. For every woman, we measured haemoglobin (Hb) concentration and collected data on sociodemographic, obstetric, and medical characteristics. The primary outcome was severe anaemia after caesarean section, defined as Hb < 7 g/dl. We used logistic regression analysis to determine factors associated with severe anaemia after caesarean section. P-value < 0.05 was considered statistically significant. Results From December 2019 to March 2020, 427 of 431 screened women were enrolled in the study. Their mean age was 26.05 (SD ± 5.84) years. Three hundred thirteen (73.3%) had attended at least four antenatal care visits. The prevalence of severe anaemia post-caesarean section was 6.79%. Foetus with macrosomia (aOR 7.9 95%CI: 2.18–28.85, p < 0.01) and having mild or moderate anaemia pre-caesarean section (aOR:9.6, 95%CI: 3.91–23.77, p < 0.01) were the factors associated with severe anaemia after caesarean section. Conclusion Severe anaemia in women post-caesarean section is relatively uncommon at our institution. It is associated with preoperative anaemia and macrosomic birth. Women with a low preoperative Hb concentration and those whose foetus have macrosomia could be targeted for haemoglobin optimisation before and during caesarean section. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04157-x.
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Affiliation(s)
- Sylvie Atosa Sivahikyako
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Asiphas Owaraganise
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda. .,Infectious Diseases Research Collaboration, Kampala, Uganda.
| | - Leevan Tibaijuka
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - David Collins Agaba
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Musa Kayondo
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Joseph Ngonzi
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Julius Mugisha
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Hamson Kanyesigye
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Yalew M, Adane B, Damtie Y, Kefale B, Arefaynie M, Yasin T. Trend and determinants of anemia change among pregnant and/or lactating women in Ethiopia: A multivariate decomposition analysis. PLoS One 2020; 15:e0241975. [PMID: 33206682 PMCID: PMC7673507 DOI: 10.1371/journal.pone.0241975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 10/25/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Even though anemia was highly targeted in different global strategies, many pregnant and/or lactating women and children were suffering from it and its complications. Besides this, prior trend analysis has not been conducted among pregnant and/or lactating women in Ethiopia. Therefore, this study aimed to assess the trend and determinants of anemia change among pregnant and/or lactating women in Ethiopia. METHODS The study utilized two consecutive Ethiopia Demographic and Health Survey (EDHS) datasets. A total of 6,106 and 5,641 pregnant and/or lactating women in 2011 and 2016 survey respectively were included in the analysis. The data were analyzed by using Stata version 14.0. Logit based decomposition analysis was done to identify contributing factors for anemia change and statistical significance was determined by using P-value. RESULTS The trend of anemia was increased from 19% in 2011 to 29% in 2016 EDHS. The analysis revealed that, 8% of the overall change in anemia was because of the change in women's composition. Changes in the composition of pregnant and/or lactating women according to region, economic status and tobacco and/or cigarette use were the major sources of the change. Greater than 90% of the increase in anemia was due to differences in the coefficient. Mostly, the change in behaviors of the Amhara population, those who had a history of terminated pregnancy and use tobacco and/or cigarette were the sources of the change. CONCLUSIONS Anemia among pregnant and/or lactating women was increased against government interventions over the last half-decade in Ethiopia. Programmatic interventions targeting Somali and Dire Dawa regions are still needed to decrease anemia.
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Affiliation(s)
- Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Toyeb Yasin
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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