Abstract
Anemia is a serious global public health problem that particularly affect young children and pregnant women. It is a huge contributor to maternal mortality. The World Health Organization (WHO) estimates that 40% of pregnant women worldwide are anaemic. This research aimed to determine the level of awareness and practice of anemia prevention among antenatal women. A cross-sectional study was conducted in the obstetrics ward and Obstetrics and Gynecology Clinic of In General Hospital Ijebu-Ode Ogun State Nigeria from April to May 2022. A total of 106 participants was conveniently selected and data were collected using structured self-administered questionnaire and analyzed with the Statistical Package of the Social Sciences version 26.0. Pearson’s correlation test and Pearson Chi-Square was used for data analysis. Result showed that the level of awareness of anemia among antenatal women was moderate (n=43, 40.6%) and the majority have high practice of anemia prevention (n= 105, 99.1%). The study showed no significant association between awareness and practice of anemia prevention. The study also revealed no significant association between demographic data and the practice of anemia prevention. In conclusion, antenatal women generally lack of awareness towards anemia. There is a need for public education to provide information about anemia in pregnancy, thus decreasing the risk of maternal and neonatal mortality and morbidity.
CHAPTER ONE
INTRODUCTION
1.1 Background Information
Anemia is recognized as a sign of both inadequate nutrition and poor health. It is harmful to women's health and well-being and increases the chance of adverse maternal and neonatal impacts (Teshome et al., 2020). Anemia is responsible for a variety of complications in pregnant women. Anemia is a global public health issue that affects people of all ages, with pregnant women bearing the brunt of the burden (Zekarias et al., 2017). It covers up to 20% of all maternal deaths. Pregnancy anemia also causes low birth weight, fetal damage, premature deliveries, and infant losses (Zekarias et al., 2017). Anemia is the leading cause of maternal death (Ayano and Amentie, 2017).
Iron deficiency anaemia (IDA) is the most frequent nutritional deficit in pregnancy. The World Health Organization (WHO) defines anaemia as "haemoglobin less than 11 gm/dl and a haematocrit less than 0.33." Most women begin their pregnancy with partially or completely reduced iron levels. Thus, the severity of anaemia is inversely related to the amount of iron stores (Nimbalkar et al., 2017). Anaemia is a global public health issue that affects both poor and developed countries, with serious ramifications for human health. Anaemia during pregnancy and lactation has a negative impact on maternal and child health. According to the WHO, the prevalence of anaemia among pregnant women is 14% in industrialized nations and 51% in underdeveloped countries (Nimbalkar et al., 2020).
Anemia is a serious global public health issue that disproportionately affects children under the age of five and pregnant women. According to the World Health Organization, 42 percent of children under the age of five and 40 percent of pregnant women are anemic worldwide. Although the global prevalence of anemia decreased from 33 percent to 29 percent among non-pregnant women and from 43 percent to 38 percent among pregnant women between 1995 to 2011, it remains a major public health threat that requires immediate attention in order to meet one of the six recent Global Nutrition Targets of reducing anemia by 50 percent in women of reproductive age by 2025 (WHO, 2012). Besides, among pregnant women in Nigeria, 80 to 90 percent have low iron status while 38 to 42 percent develop anemia (Milman, 2015).
Anemia can affect people at any stage of their lives, but it is more common during pregnancy due to increased iron requirements, physiological demands, blood loss, and infections (Abriha et al., 2014). Anemia occurs when the number of red blood cells or hemoglobin concentration within them is lower than normal. Hemoglobin is required to transport oxygen, and a few or abnormal red blood cells, or not enough hemoglobin, will reduced the blood's capacity to carry oxygen to the body's tissues. Symptoms includes lethargy, weakness, dizziness, and shortness of breath (WHO, 2021). The most prevalent cause of anemia in pregnancy is iron deficiency. These types of anemia develop when the body does not have enough iron to produce enough hemoglobin. That is a red blood cell protein. It is responsible for transporting oxygen from the lungs to the rest of the body (WebMD, 2021).
Nutritional deficiencies, primarily iron deficiency, though deficits in folate, vitamins B12 and vitamin A are also important causes of haemoglobinopathies and infectious illnesses, such as malaria, tuberculosis, HIV, and parasitic infections, are among the most common causes of anemia (WHO, 2021). In addition, iron deficiency anemia is linked to poor reproductive outcomes in pregnant women, including preterm birth, low-birth-weight newborns, and lower iron storage in neonates, which can contribute to developmental delays. Failure to address anemia could affect the health and quality of life of millions of mothers, as well as their children's development and learning. Therefore, anemia is a sign of poor nutrition as well as bad health (Teshale et al., 2020).
1.2 Problem Statement
Anemia in women of reproductive age is a major public health issue in low- and middle-income nations, with long-term consequences on the health of women, their children, and the economic growth of society. Despite the World Health Organization's objective of a 50 percent reduction in worldwide anaemia among women of reproductive age by 2025, with present trends, this goal is unlikely to be met (Teshale et al., 2020). Besides, severe anaemia (>7 g/L) has been associated with serious maternal and foetal problems during pregnancy. Preterm birth, low birth weight, intrauterine foetal death, neonatal death, maternal mortality, and infant mortality are all increased by it (Osman et al., 2020). Moreover, despite a national health policy of frequent iron supplementation and intermittent anti-malarial medication treatment for malaria, maternal anemia remains a leading cause of morbidity and mortality (Ademuyiwa et al., 2020).
Furthermore, iron deficiency anemia awareness is strongly tied to a community's educational and social status, and it has been observed to increase through time due to increased exploration and access to media and health care facilities. Compared to older women, younger women are more concerned about their health and are more cautious about the dietary needs of their unborn children (Hussain & Shu, 2010). According to the Ministry of Health in Nigeria, 14.2 percent of pregnant women in Putrajaya had anemia during 36 weeks of pregnancy in 2014. The proportion was higher than the Nigerian Ministry of Health's goal of 11.8 percent for the prevalence of anemia in pregnant women set in 2014 (Ministry of Health Nigeria, 2016).
The only way to prevent maternal death from anemia is by early detection and effective management, as well as creating awareness and health education (Balasubramanian et al., 2016). A cross-sectional study was conducted among antenatal women in South Ethiopia regarding the awareness of anemia in pregnancy, and the author reported that among 244 respondent, only 44.3 percent respondent have comprehensive awareness of anemia (Tadesse et al., 2017). Meanwhile, in Nigeria, there is a lack of published data to assess anemia in pregnancy awareness and practice of anemia prevention. Thus, this study is crucial to assess awareness and practice of anemia prevention in among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria.
1.3 Research Questions
i. What is the level of awareness of anemia among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria?
ii. What is the level of practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria?
iii. Is there any association between awareness and practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria?
iv. Is there any association between selected demographic variables (age, ethnicity, educational status, occupational status, household income) and practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria?
1.4 Research Objectives
General Objective
To determine the awareness of anemia, practice of anemia prevention and factor associated with anemia prevention practices among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria
Specific Objectives
i. To assess the level of awareness of anemia among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria
ii. To assess the level of practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria
iii. To examine the association between awareness and practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria
iv. To determine the association between selected demographic variables (age, ethnicity, educational status, occupational status, household income) and the practices of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria.
1.5 Significance of the Study
Anemia is one of the most frequent complications related to pregnancy. Severe anemia may develop a risk for the baby as an infant. People with anaemia are more likely to give birth prematurely or with a low-weight baby. Anemia makes it more difficult to fight infection since it raises the danger of blood loss during birth (Geng C., 2021). Anemia in pregnant women is still a serious and difficult health problem in Nigeria. We know the causes of anaemia and how to treat it, thus efforts should be focused on improving the implementation of early oral iron and vitamin prophylaxis, early anaemia diagnosis, and boosting women's low compliance with prophylactic programmes (Milman, 2015).
This study determined the level of awareness and practice of anemia prevention among antenatal women in In General Hospital Ijebu-Ode Ogun State Nigeria. This topic is crucial since anemia in pregnancy can give a bad impact to the mother and baby and also increase the rate of morbidity and mortality among women. This study can be benefit because the finding from this research can contribute updated of awareness and prevention of anemia in pregnancy. On the other hand, this study’s finding can be used as a baseline and references for future research.
1.6 Scope of the Study
This study was limited to pregnant women attending ANC at General Hospital Ijebu-Ode.
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