PREVALENCE AND PREDISPOSING FACTORS OF ANAEMIA AMONG PREGNANT WOMEN IN THE BOKOVA COMMUNITY

Abstract

This study title “The prevalence and the predisposing factors of anaemia among pregnant women” was carried out in Bokova community and took place from December2018 to July 2019 found in Fako Division South west region of Cameroon.

Data was collected using a well structure questionnaire with closed ended question. It was carried out with specific objectives which were to determine the prevalence of anaemia among pregnant women, to find out the predisposing factors of anaemia among pregnant women and the management of anaemia among pregnant women.

The design was a descriptive cross sectional design using a quantitative method and the population under the study were 100 participant that was sampled and a convenient sampling technique was for data collection.

From data collected through a well-structured questionnaire, it was revealed that the overall prevalence of anaemia among pregnant women was 51%.Also,majority of the pregnant women were classified under mild anaemia, of 41.0% and some of the predisposing factors that were been identified in the community were; low level of education(60.0%) , no use of LLINs(60.0%), Trimester(55.3%), no completion of ANC(60.0%) and no consumption of vegetable(55.0%).

It can be concluded that the high prevalence of anaemia in pregnancy of 51% in this community should be of a call for concern and health education  should be given to the people in this area especially the pregnant women.

CHAPTER ONE

GENERAL INTRODUCTION

1.0 Introduction

The growing foetus depends on its mother healthy body for all needs. Consequently, pregnant women must take steps to remain as healthy and well-nourished as they possibly can.

Pregnant women should take into account the health care and life style consideration since pregnant women need healthy and nutritious food in order for their baby to be healthy (Doctalk, 2007).

Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than 1.62 billion people of the world’s population of which 56 million are pregnant women (Balarajan et al., 2011).

Even if anaemia is a worldwide public health problem affecting numerous people in all age groups, but particular burden of the problem is higher among pregnant women.

Anaemia is estimated to contribute to more than 115,000 maternal deaths and 591,000 prenatal death globally per year (Sudha et al., 2011).

Since the year 1990 to the year 2015, the millennium development goals that was set up to reduce maternal mortality by 75% were not fully achieve. Yet up till date anaemia in pregnancy is still in an increase rate which need to be eradicated.

1.1 Background

Anaemia is a state where the delivery of oxygen to the tissues is impaired because of a quantitative or qualitative deficiency of haemoglobin or red blood cell (Grewal, 2010). According to  WHO ( 2011) , anaemia in pregnancy occurs when, at sea level, the haemoglobin is at 11g/dl or the haematocrit is less than 33% regardless of gestation.

Also, anaemia during pregnancy is considered severe when haemoglobin concentration is <7g/ dl, moderate when it is between 7 and 9.9g/dl, and mild when it is 10 to 11g/dl (Salhan et al., 2012) Anaemia in pregnancy is a major public health problem especially in the developing countries and it affects 41.8% of pregnant women globally with the highest prevalence in Africa of 57.1% which corresponds to 17.2million. signs and symptoms of anaemia in pregnancy include; fatigue, pale skin or pale pallor, shortness of breath, dizziness, headache and inadequate supply of   oxygen to the body during pregnancy (Mayo Clinic, 2016).

However, according to Achidi et al., (2005), reported prevalence of anaemia in pregnancy of 68.9% at ANC enrolment in the Mt Cameroon area of which 52.1% of anaemia was malaria related. Also, studies in the mount Cameroon area have shown consistently that anaemia is a severe (>50%) health problem in pregnancy (Fokam et al., 2016).

Nevertheless, global data shows that 56% pregnant women was found in low and middle income countries that have anaemia and an estimates from world health organisation report that, 35%  to 75% pregnant women in developing countries and 18% in developed countries are anaemia (WHO, 2005).

Various studies have confirmed that until recent time anaemia in pregnant women remains one of the most unresolved public health problems in developing countries because of various socio-cultural problems like illiteracy, poverty, lack of awareness cultural and religious taboos, poor dietary habits and high prevalence of parasitic infestation (karaogul et al., 2010).

In Africa, an estimate of 57% of pregnant women have been confirmed anaemic which correspond to 17.2 million of affected pregnant women with severe consequences on health, social and economic development (Baptist, 2008).

However, significant variation in the prevalence of anaemia both within and between countries necessitating a head for local data to help inform preventive programs and in Cameroon, prevalence of anaemia in pregnancy was reported to be at the minimum value of 49.30% in the year 2016 and maximum value of 56.70% in the year 1991 (WHO, 2016).

According to Dey   et al., (2010), developing countries especially the underprivileged people  often have limited access to medical   care and preventive measures, thereby increasing their risk of becoming anaemic and contributing to high maternal mortality, hence anaemia in pregnancy is known to be  associated with multiple factors like poor socioeconomic status, high parity, short birth interval, poor diet both in quantity and quality, lack of health  and nutrition awareness, a high rate of infectious disease and parasitic infection.

Nevertheless, the immediate causes of anaemia in pregnancy  can be considered to be as a decreased red blood cells/haemoglobin production due to the  result of nutritional, infectious and genetic influences and some of the important risk factors include deficiency of nutrients such as  iron which is the common , folate and vitamin B12, infections such as human  immune deficiency virus , malaria and hookworms and disorders in the in the structure or  production of haemoglobin  such as sickle cell disease and the thalassemia’s (Goonewardene et al., 2012).

In Ghana, iron deficiency is responsible for about 95% of anaemia in pregnancy which could be due to inadequate dietary intake, previous pregnancies or normal loss of iron in blood during menses and interference of iron stores by parasite Baidoo et al., (2010).

However, two known factors has contribute a lot to the development of iron  deficiency anaemia in pregnancy; the first can be trace from women whose iron are  stores at the time of conception and the second can also be trace from the amount of iron absorbed during gestation.

The fact that anaemia frequently does occur in pregnancy among women in developing countries are indications that pre-existing iron stores are often inadequate and physiological adaptations to pregnancy are insufficient to meet the increased requirements (Mcmahon, 2010).

  1.2. Problem Statement

Anaemia in pregnancy is a major health problem especially in the developing countries and it affects 41.8% of pregnant women globally with the highest prevalence in Africa of 57.1%.

Anaemia among pregnant women was reported to have dropped from 56.70% in 1991 to 49.30% in the year 2016 for the past 26 years. (Steven et al .,2013) ,though research has been carried out in developed and less developing countries but most of it was done on hospital base research and little research has been done on community base population especially in southern Cameroon.

Thus, with the lack of data from the community base setting especially in   Bokova community, the prevalence rate might be of an increase rate of anaemia which would depend on season, such as increasing in relation to malaria in wet season and in relation to food shortage at the end of dry season.

Therefore this study is been conducted to find out the prevalence and it associated risk factors of anaemia in pregnant women alongside  with the management of anaemia in pregnancy in Bokova Community.

1.3.1 General Objectives

To determine the prevalence and predisposing factors of anaemia in pregnancy in Bokova Community.

1.3. 2. Specific Objectives

1. To determine the prevalence of anaemia among pregnant women in Bokova Community.
2. To find out the predisposing factors of anaemia that affect pregnant women in Bokova community.
3. To determine the management of anaemia in pregnancy.

1.3. Research Question

1. What is the prevalence of anaemia among pregnant women in Bokova community?
2. What are the factors that predispose pregnant women to develop anaemia during pregnancy?
3. What are the management of anaemia in pregnancy?