scholarly journals Determinants of anemia among pregnant women in northern Ghana

2019 ◽  
Author(s):  
Martin N. Adokiya ◽  
Richmond Aryeetey ◽  
Monica Yost ◽  
Andrew D. Jones ◽  
Mark L. Wilson

ABSTRACTAnemia is a global public health issue affecting half of all pregnant women in developing countries. In 2014, 42% of Ghanaian pregnant women aged 15-49 years were anemic (<11.0g/dl) but information on the determinants of anemia, particularly dietary diversity during the critical third trimester of pregnancy is limited. We assessed the association between determinants and anemia among pregnant women in northern Ghana.We employed a cross-sectional design involving 624 pregnant women (≥20 weeks of gestation) attending four antenatal care (ANC) health facilities ~25 kilometres north of Tamale, Ghana between July and August 2017. Hemoglobin concentration (measured using Hemocue HB 301) was classified as severe, moderate, or mild. Other data included socio-demographic characteristics, malaria prevention, deworming, and iron/folate tablet use. The FAO Minimum Dietary Diversity (MDD-W) metric was used to categorize women into “inadequate” (MDD-W <5 food groups) and “adequate” (MDD-W ≥5). Logistic regression models were used to determine the association between moderate/severe anemia (Hb<9.0g/dl) and mild anemia (9.0-10.9g/dl), or with ‘no anemia’ (≥11.0g/dl) using STATA 14 software.Of 624 women sampled, hemoglobin data were available for 601. The mean age was 27.81±0.25 years, gestational age was 31.93±0.13 weeks, ANC attendance was 3.89±0.07; Hb concentration was 9.73g/dl±0.07, and MDD-W index for ten food groups was 5.33±0.04. Anemia (Hb<11.0g/dl) was observed in 74.8% of women (moderate/severe anemia=33.4% and mild anemia=41.4%). Using adjusted logistic regression, women who received deworming medication had lesser odds of being moderate/severe anemic (aOR=0.51, P=0.021). While women who were engaged in other occupation (herdsmen) and no previous parity had higher odds of being moderate/severe anemic (aOR=2.90, P=0.042) and (aOR=2.13, P=0.004) respectively. Moderate/severe anemia was not statistically associated with MDD-W, nor with socioeconomic status/wealth index. Conclusion, anemia in pregnancy was nearly twice that of Ghana as a whole. Deworming medication was found to be protective intervention for anemia during pregnancy.

2020 ◽  
Vol 11 (1) ◽  
pp. 145-164
Author(s):  
Mahama Saaka

Introduction: Adequate nutrition during pregnancy is a pre-requisite for good pregnancy outcomes as well as future wellbeing, development and quality of life of the unborn child. This analytical cross-sectional study evaluated the adequacy of nutrient intakes of pregnant women resident in northern Ghana. Methods: A total of 400 pregnant women in 25 communities in the Northern, Upper East and Upper West regions of Ghana were interviewed at the household level. The nutrient intakes were assessed using a structured 24-hour dietary recall questionnaire. A dietary diversity score (DDS) was measured as a count of food groups. A nutrient adequacy ratio (NAR) of 14 nutrients as well as mean adequacy ratio (MAR) were calculated based on the 24-hour dietary recall. Results: The average energy, protein and fat intakes were 2,770.8 ± 1,127.5 Kcal/day, 59.2 ±27.5 g/day, and 105.25±58.0 g/day, respectively. The proportion of women meeting the recommended dietary allowance (RDA) of these macro-nutrients were 58.8%, 27.0% and 50.3% respectively. The average MAR of 14 nutrients was calculated to be 68% as the overall measure of nutrient adequacy. MAR correlated positively with DDS (r = 0.24 P < 0.001). Over 50% pregnant women obtained less than 66% of the RDA for iron, calcium, riboflavin, folic acid and vitamin B12. Conclusion: Diets of the majority of these pregnant women were deficient in several nutrients. Dietary diversity scores served as a useful proxy indicator of nutrient adequacy in this sample. In order to meet the requirements for essential nutrients, more effort should be made to promote dietary diversity among pregnant women in northern Ghana.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Mahama Saaka ◽  
Jeremiah Oladele ◽  
Asamoah Larbi ◽  
Irmgard Hoeschle-Zeledon

Background. Information regarding how dietary diversity is related to haematological status of the pregnant women in rural areas of Northern Ghana is limited. This study therefore evaluated maternal dietary intake and how it relates to the nutritional status of pregnant women belonging to different socioeconomic conditions in Northern Ghana.Methods. This study was cross-sectional in design involving 400 pregnant women. Midupper arm circumference (MUAC) and anaemia status were used to assess the nutritional status of pregnant women.Results. The mean dietary diversity score (DDS) of the study population from ten food groups was4.2±1.5(95% CI: 4.08 to 4.37). Of the 400 women, 46.1% (95% CI: 40.0 to 52.2) met the new minimum dietary diversity for women (MDD-W). The mean haemoglobin concentration among the pregnant women studied was 10.1 g/dl ± 1.40 (95% CI: 9.8 to 10.3). The independent predictors of haemoglobin concentration were maternal educational attainment, gestational age, frequency of antenatal care (ANC) attendance, number of under-five children in the household, size of MUAC, and maternal height.Conclusions. Irrespective of the socioeconomic status, women minimum dietary diversity (MDD-W) was not associated with anaemia among pregnant women resident in the rural areas of Northern Ghana.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenping Ding ◽  
Jianmei Lu ◽  
Yan Zhou ◽  
Weizhong Wei ◽  
Zhihong Zhou ◽  
...  

Abstract Background Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context. Methods Pregnant subjects’ KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson’s chi-square test and multivariable logistic regression analyses. Results The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule. Conclusion Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Emmanuel Amoako Agyei ◽  
Stephen Kofi Afrifa ◽  
Adam Munkaila ◽  
Patience Kanyiri Gaa ◽  
Eugene Dogkotenge Kuugbee ◽  
...  

Essential nutrients are necessary for reducing the risk of maternal mortality, prenatal mortality, and low-birthweight infants. Dietary diversity can play an important role in supplying essential nutrients to both the mother and the foetus. We evaluated nutrition knowledge, attitudes, and dietary diversity of pregnant women. In addition, we investigated the sociodemographic determinants of dietary diversity among pregnant women from a rural district in Ghana. Participants were pregnant women receiving antenatal care from a rural district hospital in Ghana. Dietary diversity was measured using a 24-hour dietary recall questionnaire. Multiple linear regression was used to determine the sociodemographic characteristics of dietary diversity. About 85% of the pregnant women knew that they should eat more in comparison to nonpregnant women, and only 16.9% knew the importance of folic acid supplementation during pregnancy. Mean (SD) dietary diversity score of the participants was 5.27 (1.35), 85.4% did not consume any fruits, and 82.3% did not take milk and milk products. Almost all participants took at least one food item in the starchy staples and green leafy vegetables food groups. Moreover, 53% consumed vitamin A-rich fruits, vegetables, and tubers; 7.7% organ meats; and 30.8% eggs. Those who earned a monthly income of ≥GHC 500 or US$ 87 (B = 1.82; 0.90–2.73; p < 0.001 ) significantly had higher dietary diversity scores compared to those who earned less. Dietary diversity of the pregnant women was suboptimal. The consumption of vitamin A- and iron-rich foods was inadequate. Income was an important determinant of the dietary diversity of pregnant women from Northern rural Ghana.


BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Abel Girma Tilahun ◽  
Abebaw Molla Kebede

Abstract Background Inadequate dietary diversity intake during pregnancy increases risks of intrauterine growth restriction, abortion, low birth weight, preterm birth, prenatal and infant mortality,and morbidity and has long-lasting health impacts. Dietary diversity during pregnancy promotes the health status of the mother and her fetus. This study aimed to assess the magnitude of minimum dietary diversity and associated factors among pregnant women attending antenatal care. Methods A facility-based cross-sectional study was conducted among 274 pregnant women who attended antenatal care at Wacha primary hospital from January to February 2021. A systematic sampling method was used to select the study participants. The data were collected through face-to-face interviews using a structured and semi-structured questionnaire. Bivariate logistic regression was done to identify factors associated with maternal dietary diversity. Finally, multivariate logistic regression was done, and variables that showed P values of < 0.05 were considered statistically significant. Result The magnitude of minimum dietary diversity was 51% (95% CI: 44.5, 56.7). The mean (±SD) minimum dietary diversity score was 4.5 (± 1.268) with a minimum of 1 anda maximum of 8 food groups consumed out of ten food groups. Age fewer than 25 years (AOR 4.649; 95% CI; 1.404, 15.396), and the age group between 25 to 34 years (AOR 3.624; 95% CI: 1.315, 10.269), husband age group of 26 to 34 years (AOR 2.238; 95% CI; 1.028,4.873), and 35 to 44 years (AOR 3.555; 95% CI; 1.228,10.292) and nutrition awareness of women (AOR 2.182; 95% CI; 1.243, 3.829) were significantly associated with minimum dietary diversity. Conclusion The consumption of minimum dietary diversity of the pregnant mothers was found to be low. Women aged less than 25 and age between 25 to 34 years, husband’s age between 26 to 34 and 35 to 44 years, and nutrition awareness were the factors significantly associated with minimum dietary diversity. Therefore, providing nutrition education and counseling service warranted to promote maternal dietary diversity.


2020 ◽  
Vol 1 (1) ◽  
pp. 51-79
Author(s):  
Haile Abebe ◽  
◽  
Teshome Alemteshay ◽  

The nutritional status of a woman during pregnancy is important as a suboptimal diet impacts negatively on the health of the mother, the fetus and the newborn. There is limited knowledge in the area of malnutrition and factors’ affecting it among pregnant women despite evidence showing that maternal nutrition has important direct and/or indirect consequences for all other age. The objective of the study was to assess the determinants of dietary diversity and nutritional status of pregnant women attending antenatal clinic at Armed Forces Comprehensive Specialized Hospital. The study was cross-sectional and conducted by using both quantitative and qualitative methods. A multistage sampling procedure was employed to draw 320 samples, pregnant women. The women were selected in random through balloting among the first five pregnant women to arrive at the antenatal clinic and thereafter systematic sampling was used and every fourth woman that arrived were sampled until the sample size is met. The data were analyzed by using a software STATA version 14. Descriptive statistics to determine the dietary diversity and nutritional status were done and also to characterize the nutritional status. The statistical model namely, logistic and ordered logistic regression was used for factors affecting the dietary diversity and nutritional status. A P value of <0.1 was considered statistically significant. According to the logistic model interpretation, negative relation implies that the dependent and independent variables are inversely related; while the positive association is the outcome and independent variable have direct relations. The findings of the descriptive analysis indicated that low dietary diversity was experienced by 61.56 percent of the respondents and the rest of the study population was in a high dietary diversity. Based on Mid-upper arm circumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent were moderately malnourished and 96.25 percent were well nourished. Findings from logistic regression revealed that income, meals that were eaten in the last 24 hours, and anemia have positively and significantly affects dietary diversity while not taking iron-fortified foods affects negatively. The results from the ordered logit model indicate that severe undernutrition is determined by not taking micronutrient daily positively where ever income and cleaning utensil properly impact negatively, although moderate undernutrition is associated with not taking micronutrient daily positively and negatively with cleaning utensil properly. Though being nourished is affected by not taking micronutrient daily negatively and positively by cleaning utensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent, 11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normal hemoglobin level respectively. The results from the multinomial regression model reveal that severe anemia is negatively associated with dietary diversity. At the same time, moderate anemia is affected positively by not taking micronutrient daily and negatively by age, dietary diversity score and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-off was affected positively by age, dietary diversity and morbidity, negatively affected by not taking micronutrient daily. Finally, the findings conclude that dietary diversity and nutritional status were very poor and socio-demographic, socio-economic, micronutrient supplementation, morbidity, environmental factors, and dietary diversity influence the nutritional status of pregnant women. It is recommended that promotion of dietary diversity and modification of diets be carried out through practical demonstrations in the community and health facilities and there should be income generation practices and entrepreneur encouragements should be practiced.


2018 ◽  
Vol 22 (4) ◽  
pp. 697-705 ◽  
Author(s):  
Yunhee Kang ◽  
Kristen M Hurley ◽  
Julie Ruel-Bergeron ◽  
Assumpta Bou Monclus ◽  
Rachel Oemcke ◽  
...  

AbstractObjectiveTo examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi.DesignCross-sectional study.SettingTwo rural districts in Central Malawi.SubjectsPregnant (n 589) and lactating (n 641) women.ResultsOf surveyed pregnant and lactating women, 66·7 and 68·6 %, respectively, experienced moderate or severe food insecurity and only 32·4 and 28·1 %, respectively, met MDD. Compared with food-secure pregnant women, those who reported severe food insecurity had a 0·36 lower DDS (P<0·05) and more than threefold higher risk (OR; 95 % CI) of not consuming meat/fish (3·19; CI 1·68, 6·03). The risk of not consuming eggs (3·77; 1·04, 13·7) was higher among moderately food-insecure pregnant women. Compared with food-secure lactating women, those who reported mild, moderate and severe food insecurity showed a 0·36, 0·44 and 0·62 lower DDS, respectively (all P<0·05). The risk of not achieving MDD was higher among moderately (1·95; 1·06, 3·59) and severely (2·82; 1·53, 5·22) food-insecure lactating women. The risk of not consuming meat/fish and eggs increased in a dose–response manner among lactating women experiencing mild (1·75; 1·01, 3·03 and 2·81; 1·09, 7·25), moderate (2·66; 1·47, 4·82 and 3·75; 1·40, 10·0) and severe (5·33; 2·63, 10·8 and 3·47; 1·19, 10·1) food insecurity.ConclusionsAddressing food insecurity during and after pregnancy needs to be considered when designing nutrition programmes aiming to increase dietary diversity in rural Malawi.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Melaku Desta ◽  
Mohammed Akibu ◽  
Mesfin Tadese ◽  
Meskerem Tesfaye

Background. Maternal dietary diversity is a proxy indicator of maternal nutrient adequacy and improves health outcomes for both mothers and babies. However, little is documented on dietary diversity among pregnant mothers. Therefore, this study assessed diet diversity and associated factors among pregnant mothers attending the antenatal clinic in Shashemane, Oromia, Central Ethiopia.Methods. An institution-based cross-sectional study was conducted on 315 systematically selected pregnant women attending antenatal clinic of Shashemane town in April 2017. Dietary diversity was assessed using a 24 h dietary recall method, and the dietary diversity score was computed for ten food groups. Bivariate and multivariate logistic regressions were computed to identify associated factors of dietary diversity.Result. In this study, only a quarter (25.4%) of pregnant mothers consumed adequate dietary diversity. Mother’s tertiary (AOR 3.18; 95% CI: 1.8, 6.35) and secondary (AOR 2.13; 95% CI: 2.32, 8.72) education, household monthly income above 3500 ETB (AOR = 2.24; 95% CI: 1.47, 7.78), livestock ownership (AOR = 4.15; 95% CI: 2.07, 9.86), women who got emotional support from the husband (AOR = 3.49; 95% CI: 1.12, 8.23), and women who participated in the shooping (AOR = 2.54; 95% CI: 3.27, 9.83) were more likely to attain the adequate dietary diversity.Conclusion. The study revealed that the overall consumption of adequate dietary diversity was found to be low. Developing the educational level of women, increasing household income and owning of livestock, increasing husbands’ support, and improving women’s participation in the shopping are recommended to improve women’s adequate dietary diversity.


2021 ◽  
Vol 10 ◽  
Author(s):  
Mahama Saaka ◽  
Sofo Mutaru ◽  
Shaibu Mohammed Osman

Abstract There is little information regarding factors that determine dietary diversity among pregnant women in Ghana. The present study, therefore, sought to assess the independent predictors of dietary diversity and its relationship with nutritional status of pregnant women in the Northern Region of Ghana. The present study was an analytical cross-sectional survey involving 423 pregnant women in different stages of gestation. The 24-h dietary recall method was used to assess minimum dietary diversity for women (MDD-W), and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Binary logistic regression was performed to assess the association between maternal dietary diversity and maternal thinness and a P value of <0⋅05 was considered statistically significant. Of the 423 women, 79⋅9 % (95 % CI 76⋅1, 83⋅7) met the MDD-W and the prevalence of undernutrition among the pregnant women was 26⋅0 %. The analysis showed that women of low household wealth index were 48 % less likely (AOR 0⋅52, CI 0⋅31, 0⋅88) of meeting the MDD-W, whereas women from households of poor food insecurity were 88 % less likely (AOR 0⋅12, CI 0⋅05, 0⋅27) of achieving the MDD-W. Women of low household size were three times more likely of meeting the MDD-W (AOR 3⋅07, CI 1⋅13, 8⋅39). MDD-W was not associated with maternal underweight during pregnancy. In conclusion, the results of the present study showed that food insecurity and not low MDD-W, associated with mothers’ thinness (underweight) during pregnancy in peri-urban setting of Northern Ghana.


Author(s):  
Tadashi Yamashita ◽  
Ramon Emilio Daniel Roces ◽  
Cecilia Ladines-Llave ◽  
Maria Teresa Reyes Tuliao ◽  
Mary Wanjira Kamau ◽  
...  

Improving the nutrition of pregnant women is essential in reducing maternal and child mortality, which is one of the global nutritional goals of 2025. This study evaluated the factors related to the quality of dietary intake among pregnant women in Muntinlupa, Philippines. We conducted a cross-sectional study of 280 pregnant women at a hospital in Muntinlupa from March 2019 to August 2019 using questionnaires. After the primary aggregation, multivariate logistic regression analysis was used to identify factors associated with the quality of dietary intake in pregnant women. Approximately half of the women (46.4%, n = 130) had a low dietary diversity during pregnancy. Less than 30% of the respondents consumed beans, soybean products, and nuts. In the logistic regression analysis, poor maternal knowledge of nutritional sources to prevent anemia (odds ratio (OR) 4.25, 95% confidence interval (CI) 1.47–12.32, p = 0.01) and less frequent meal consumption (OR 2.15, 95% CI 1.08–4.29, p = 0.03) were significantly associated with poor dietary diversity. Our findings are crucial because they suggest that increasing the knowledge of pregnant women about good nutrition and ensuring that dietary intake is frequent and adequate through antenatal care can improve the nutrition of pregnant women.


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