Factors Associated with Anemia among Pregnant Women of Underprivileged Ethnic Groups Attending Antenatal Care at Provincial Level Hospital of Province 2, Nepal

Abstract

Background. This study aims at determining the factors associated with anemia among pregnant women of underprivileged ethnic groups attending antenatal care at the provincial level hospital of Province 2. Methods. A hospital-based cross-sectional study was carried out in Janakpur Provincial Hospital of Province 2, Southern Nepal. 287 pregnant women from underprivileged ethnic groups attending antenatal care were selected and interviewed. Face-to-face interviews using a structured questionnaire were undertaken. Anemia status was assessed based on hemoglobin levels determined at the hospital’s laboratory. Bivariate and multiple logistic regression analyses were used to identify the factors associated with anemia. Analyses were performed using IBM SPSS version 23 software. Results. The overall anemia prevalence in the study population was 66.9% (95% CI, 61.1–72.3). The women from most underprivileged ethnic groups (Terai Dalit, Terai Janajati, and Muslims) were twice more likely to be anemic than Madhesi women. Similarly, women having education lower than secondary level were about 3 times more likely to be anemic compared to those with secondary level or higher education. Women who had not completed four antenatal visits were twice more likely to be anemic than those completing all four visits. The odds of anemia were three times higher among pregnant women who had not taken deworming medication compared to their counterparts. Furthermore, women with inadequate dietary diversity were four times more likely to be anemic compared to women having adequate dietary diversity. Conclusions. The prevalence of anemia is a severe public health problem among pregnant women of underprivileged ethnic groups in Province 2. Being Dalit, Janajati, and Muslim, having lower education, less frequent antenatal visits, not receiving deworming medication, and having inadequate dietary diversity are found to be the significant factors. The present study highlights the need of improving the frequency of antenatal visits and coverage of deworming program in ethnic populations. Furthermore, promoting a dietary diversity at the household level would help lower the prevalence of anemia. The study findings also imply that the nutrition interventions to control anemia must target and reach pregnant women from the most-marginalized ethnic groups and those with lower education.

Predictors of Anemia among Pregnant Teenagers Presenting at a Tertiary Level Teaching Hospital in Mid-western Uganda

“…Observed also was that pregnant teenagers who had had antenatal care attendance of less than four were more than 8 fold likely to be anemic than the teenagers who had attended more than four times. This nding was consistent with results in studies carried out by Jusoh et al, (7) in Malaysia, Yadav et al, (21) in Nepal, and Anlaakuu and Anto (22) in Ghana, as all these studies showed that pregnant teenagers with less than four antenatal care clinic visits had higher chances of having anemia than those four visits or more. Certain antenatal care packages such as early trimester screening for hemoglobin status and appropriate intervention for those detected with anemia, health education of every pregnant woman about anemia in pregnancy, its complications and prevention, timely initiation on iron and folate supplements, deworming to prevent hookworm infestation, and intermittent presumptive treatment for malaria are all key components of Uganda's antenatal care package and these are all known to have a serious preventive impact on anemia in pregnancy.…”

High coverage but low quality of maternal and newborn health services in the coverage cascade: who is benefitted and left behind in accessing better quality health services in Nepal?

“…This study identified that women of economic, ethnic, geographic disadvantage, and linguistic minorities (e.g., Maithili speaking women) received poor quality MNH services. These women also have low levels of power and poor social positioning in Nepalese society [ 84 , 85 ] compared to women from advantaged ethnic groups, who usually also have wealth status. These latter groups are usually Nepali native speakers with good access to education, employment, and health information, compared to disadvantaged ethnicities who belong to the lower strata in the hierarchical caste system of Nepal [ 86 ].…”

Prevalence of anaemia and its associated factors among HIV-infected adults at the time of ART initiation at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective cross-sectional study

“…When HIV infection is observed among those who have not attended formal education, the risk of poor nutrition and the occurrence of anaemia will be double burdened. Additionally, non-educated patients are not fully aware of anaemia symptoms, so they will come to the hospital quite late with high anaemic grades 31 32…”