Prevalence and associated risk factors for anaemia amongst pregnant women attending three antenatal clinics in Eswatini

Abstract

Background: Anaemia is a global health problem affecting about a third of the world’s population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries (LICs), 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy.Aim: This study aimed to determine the prevalence and risks associated with anaemia amongst pregnant women attending antenatal clinic (ANC) in three health facilities in Eswatini.Setting: This study was conducted in three health facilities in Eswatini, namely Mankayane, Raleigh Fitkin Memorial (RFM) and Mbabane Hospital.Methods: This cross-sectional study used non-probability sampling in three hospitals of Eswatini, to select 550 pregnant women, aged 15–49 years. Data were collected from January to March 2021, using face-to-face interviews with a structured questionnaire. Logistic regression was used for statistical analysis.Results: A total of 550 pregnant women were included in the study. Anaemia prevalence amongst pregnant women was 43.1% with mild, moderate and severe cases of 21.3%; 21.1% and 0.7%, respectively. Prevalence was high amongst women aged 15–19 years (53.3%). Factors associated with anaemia included living in urban areas (odds ratio [OR]: 1.8; confidence interval [CI]: 1.19–2.72), having anaemia 6 months before pregnancy (OR: 4.64; CI: 1.15–18.71), and gestational age at first ANC: third trimester (OR = 10.42; CI: 4.27–25.4) and second trimester (OR: 1.62; CI: 1.02–2.60).Conclusion: Anaemia remains prevalent amongst pregnant women in Eswatini. A comprehensive anaemia prevention programme would be justified and could lower the country’s burden of anaemia.

Prevalence and factors associated with anaemia among pregnant women attending antenatal care in a district hospital and its feeder community healthcare centre of the Limpopo Province, South Africa

“…This result is comparable to a study in Nigeria,[ 3 ] but slightly higher than the rates in many studies. [ 5 , 6 , 7 , 8 ] However, our finding is lower than the rate reported by others. [ 9 , 10 ] There is a concern with 5% of pregnant women with severe anaemia, which need urgent attention.…”

“…[ 27 ] However, lower than the rates of 37.51% found in Ethiopia[ 5 ], 72.6% in Nigeria[ 4 ], 42.7%[ 28 ] and 50.8%[ 8 ] in Ghana, and 43.1% in Eswatin. [ 6 ] Our finding is also lower than the rate of 37% reported in earlier studies in the KwaZulu Natal Province of SA. [ 7 ] The possible reason for this variation could be that countries differ in their screening policies, criteria and ethnic differences.…”

“…[ 8 ] In contrast, other studies found that anaemia is prevalent among those in the age group less than 25 years. [ 5 , 6 , 7 , 8 , 9 , 10 ] Similarly, our finding indicates that pregnant women aged <25 years are at higher risk of developing anaemia in pregnancy, but the result was not statistically significant. Poor knowledge of anaemia in pregnancy is a challenge.…”

“…Previous studies observed no association between level of education and pregnancy anaemia, with illiterate pregnant women found to be anaemic. [ 6 , 8 , 10 ] Another study revealed that pregnant women's anaemia status was significantly associated with higher education. [ 5 ] In univariate analysis, our study finding shows that anaemia is prevalent among women without formal, primary and secondary education.…”

“…The risk of moderate-to-severe anaemia rises as pregnancy progresses[ 3 , 5 , 6 , 7 , 8 , 9 , 10 ] and contributes to obstetric haemorrhage, caesarean sections and need for postpartum blood transfusion, preeclampsia, intensive care admission and prolonged hospital stay. [ 11 , 12 , 13 ] Other adverse outcomes from pregnancy anaemia include low birth weight, preterm delivery, small for gestational age, neonatal intensive care admission, stillbirth and early neonatal death.…”