Prevalence of anaemia and associated factors among pregnant women in doba woreda west hararge zone of oromia regional state

Abstract

Background: Anemia remains to be the most common nutritional problem worldwide. Pregnant women in Africa are among the most at risk with prevalence reaching up to 60%. In Ethiopia, despite the high occurrence of multiple risk factors, previous studies reported anemia as a moderate public health problem. Dietary factors- relatively higher dietary non heme iron intake-were suggested for the lower prevalence, particularly iron deficiency anemia, than many sub-Saharan countries. However, dietary culture in the country is diverse and anemia could be a serious problem in some communities with typical diet and food insecurity. The aim of this study is to determine magnitude and predictors of anemia among pregnant women in Doba Woreda. Methods: Community-based cross-sectional study design involving both qualitative and quantitative method was conducted from February to March 2013. A total of 552 randomly selected pregnant women living in 13 of the 41 Kebeles in the woreda were assessed for hemoglobin status and anemia risk factors. Hemoglobin concentration was determined using portable HemoCue device whereas nutritional status was assessed by MUAC. Data on sociodemographic characteristics and anemia risk factors were gathered using structured interview whereas qualitative information on socio cultural factors was obtained through focus group discussions with selected participants. Anemia was determined using altitude adjusted hemoglobin concentrations and based on the CDC Atlanta cutoff points. Bivariate and multivariable logistic regression models were used to identify predictors of anemia. Qualitative data was analyzed based on thematic frameworks to support the quantitative results. Result: The prevalence of anemia among the study population was 51.7% where 46.2%, 52.4% and 1.4% had mild, moderate and severe anemia, respectively. Multivariate logistic regression analysis showed that nutritional status (AOR [95%CI]; 0.636[0.544, 0.744], main food source (AOR [95%CI]: 2.262 [1.402, 3.648], women dietary diversity score (AOR [95%CI]: 0.819 [0.705, 0.951]) household food insecurity (AOR=2.001 [95%CI]: [1.127, 3.553] and ANC attendance (AOR [95%CI]: 2.507 [1.533, 4.099] were independent predictors of anemia. In this community pregnant women avoid eating balanced diet due to fear of obstructed labour. Conclusion and recommendations: This study has showed that anemia in pregnancy is a severe public health problem in Doba woreda. Most of the factors were directly related with women’s food intake which has been influenced by cultural and social believes of local community and make low intake of iron rich foods. Improving maternal nutrition and reducing iron deficiency anemia through iron-folic acid supplement should be maintained but more attention should be given to adherence counseling and on the improvement of awareness on the need of balanced diet for women especially during pregnancy