A Cross-Sectional Study of Barriers in Prevention of Anemia in Pregnancy

Abstract

Introduction Anemia in pregnancy is a significant health challenge in India and other developing countries. Various health programs aiming anemia prevention are existing in India for many decades. Despite that, anemia affects more than half of pregnant women. Our objective for performing this study was to evaluate the barriers in the prevention of anemia and to evaluate the perceptions and practices of anemic women towards their condition. Methods A cross-sectional questionnaire-based study, including 210 anemic women, was conducted in a tertiary care center in Delhi, India. In-depth interviews were conducted with 50 participants. Results Our important observations were that anemia was more prevalent in multigravida, and 43.80% of anemic patients were not taking iron supplements at the time of diagnosis. Chronic diseases were associated with 28.2% (n=59) of anemic women. Only 19% (n=40) of women sought antenatal care in the first and second trimester; the rest all booked themselves in the third trimester only. Twenty-two percent (n=48) of women reached our hospital after 36 weeks. Ignorance to anemia symptoms and the importance of consistent intake of the oral iron supplements was seen in 35.2% (n=74). One hundred and sixty-five (74.8%) women accepted that healthcare provider had informed them about iron-rich and high protein diet, but only 47.1% (n=98) actually made dietary modifications. Only 9.5% (n=20) of women were consistent in iron intake. Side effects of iron were reported by 30% (n=64) of women, and 15% (n=32) were intolerant to oral iron. Non-availability, change of residence, and forgetfulness were the main reasons behind non-compliance to oral iron. Conclusion We emphasize motivation for early registration, regular antenatal care, adequate iron supplement supply, and persistent counseling to ensure compliance to iron supplements by the antenatal care provider. Behavior-changing communication is needed at a societal level for antenatal mothers and their families aiming to prevent anemia in pregnancy instead of focussing on treatment.

Prevalence and Associated Risk Factors for Anaemia Among Pregnant Women Attending Ante-Natal Clinic, Eswatini

“…Similarly, a study from India noted an association between anaemic pregnant women with a chronic illness in pregnancy or the recent past (11). There is a relative de ciency of iron in the body; therefore, the body cannot effectively use iron to generate new blood cells.…”

“…There is no record of previous studies on anaemia in pregnancy in Eswatini. According to the World Health Organisation (WHO), anaemia among pregnant women is a signi cant health problem in LICs (11). WHO has de ned anaemia in pregnancy as haemoglobin (Hb) levels of less than 11g/dl (5,12).…”

“…In addition, anaemic pregnant women are more prone to many complications, including decreased work productivity, increased risk of cardiac diseases, preterm labour and delivery, postpartum haemorrhage, impaired immune function, and maternal mortality (7,11). Anaemia during pregnancy has been estimated to account for 23% of the indirect causes of maternal deaths in developing countries (6,19).…”

“…Around 40% of women begin their pregnancy with decreased iron stores, which becomes insu cient to meet the increased iron needs during pregnancy (2,20). Other factors include physiological haemodilution, underlying in ammatory conditions, and malnutrition, leading to insu cient vitamins, proteins, iron, and iodine (11,13). In addition, in SSA, infections like malaria, helminths, and Human Immunode ciency Virus (HIV) also contribute to anaemia in pregnancy (13,21).…”

“…In addition, in SSA, infections like malaria, helminths, and Human Immunode ciency Virus (HIV) also contribute to anaemia in pregnancy (13,21). Despite the broader scope of the problem, little research data has been explored about the severity of anaemia at ANC clinic in this study area; hence, there is a need to identify and treat anaemia to avoid its complications in pregnancy (1,11). Furthermore, assessing the different factors contributing to anaemia in pregnancy is essential for effective anaemia management during pregnancy and provides the information necessary for planning and policy-making (7,9).…”