Prevalence And Determinants Of Anaemia In Pregnant Women Attending Antenatal Clinics In Selected PHC In Akure

Project and Seminar Material for Nursing (Science)

Prevalence And Determinants Of Anaemia In Pregnant Women Attending Antenatal Clinics In Selected PHC In Akure


Abstract


This study was carried out to examine the prevalence and determinants of anaemia in pregnant women attending antenatal clinics in selected PHC in Akure. The study was carried out to ascertain the prevalence and determinants of anaemia among pregnant women attending antenatal clinics at PHC In Akure, find out the factors associated with anaemia among pregnant women attending antenatal clinics PHC In Akure and find out the causes of anaemia among pregnant women attending antenatal clinics at PHC In Akure. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of all the pregnant women in the selected PHC in Akure. In determining the sample size, the researcher conveniently selected 41 respondents and 35 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables and mean scores. While the hypotheses were tested using chi-square statistical tool, SPSS v23.The result of the findings reveals that the prevalence of anaemia among pregnant women attending antenatal clinics at PHC In Akure is high. The study also revealed that the causes of anaemia among pregnant women attending antenatal clinics at PHC In Akure incldes: advanced kidney disease, hypothyroidism, old age and long-term diseases, such as cancer, infection, lupus, diabetes, and rheumatoid arthritis. Therefore, it is recommended that health education and promotion, especially to encourage all pregnant women to book early for antenatal care and to take appropriate intervention measures. Information, Education and Communication (IEC) efforts should be directed towards increasing levels of awareness and commitment at all levels. To mention but a few.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background of the Study

Anemia in pregnancy is defined when the distribution of hemoglobin (Hgb) level is below the fifth percentile. The cut-off value varies by trimester during pregnancy. It has been determined anemia as Hgb level of less than 11 gm/dl (Hct < 33%) in the first trimester and third trimester, and less than 10.5 gm/dl (Hct < 32%) in the second trimester[1]. Anemia during pregnancy is considered severe when the hemoglobin value is less than 7.0 g/dL, moderate when hemoglobin falls between 7.0 – 9.9 g/d, and mild from 10.0 – 11 g/dL [2]. Anemia during pregnancy is a major cause of morbidity and mortality of pregnant women in developing countries and has both maternal and fetal consequences [2]. Anemia is a disorder characterized by a blood hemoglobin concentration lower than the defined normal level and usually related to the decrease in the circulating mass of red blood cells. This may result from reduced generation of red blood cells, or from their premature destruction or loss through chronic blood loss. It is one of the most frequently observed nutritional deficiency diseases in the world today. It is especially prevalent in women of reproductive age, particularly during pregnancy[3] [4]. During pregnancy, with the growth of the fetus and the placenta, the larger amount of circulating blood in the expectant mother leads to an increase in the demand for nutrients, especially iron and folic acid[5]. It is one of the frequently occurring nutritional deficiency diseases observed globally and affects more than 1.62 billion (25%) people of the world’s population, of which 56 million are pregnant women[6]. Anemia is a major public health problem affecting all ages of the world’s population. It is estimated that anemia causes > 115,000 maternal and 591,000 perinatal deaths globally per year[6].

Although the prevalence of anemia is estimated at 9% in countries with high development, in countries with low development the prevalence is 43%. Children and women of reproductive age are most at risk, with global anemia prevalence estimates of 47% in children younger than 5 years, 42% in pregnant women, and 30% in nonpregnant women aged 15 – 49 years and in Africa and Asia accounting for more than 85% of the absolute anemia burden in high risk groups[1] [7]. Anaemia contributes to 20% of all maternal deaths (WHOb, 2015). Anaemia in pregnancy causes low birth weight (Banhidy et al., 2011), fetal impairment and infant deaths (Kalaivani, 2009). Iron deficiency anaemia affects the development of the nation by decreasing the cognitive and motor development of children and productivity of adults (Balarajan et al., 2011; Vivek et al., 2012). Deficiency of folic acid during pregnancy can result in developing neural tube defect that develops in embryos during the first few weeks of pregnancy leading to malformations of the spine, skull, and brain (Wolff et al., 2009). Due to the disproportionate increase in plasma volume with respect to the red cell mass. This occurs mostly in the second and third trimesters and is not pathologic in itself, but could precipitate any anemia already present. Based on the above reasons, the World Health Organization (WHO) has supported antenatal oral supplement of iron and folic acid for the prevention of anemia in pregnancy[11][12]. The cost in hospital treatment of cases of severe anemia is also far outweighed the cost of prophylactic measures[13][14].


1.2 Statement of the Problem

In Nigeria, the cause of anaemia among pregnant women is 55.1%. and if the cause of anaemia among pregnant women is 40.0% or more, it is considered as a severe public health problem (McLean et al., 2008). Anaemia is a major cause of morbidity and mortality in pregnant women and increases the risks of foetal, neonatal and overall infant mortality (Akhtar and Hassan, 2012). In 2013, an estimated 289,000 women died worldwide. Developing countries account for 99% (286 000) of the global maternal deaths with sub-Saharan Africa region alone accounting for 62% (179 000). About 800 women a day are still dying from complications in pregnancy and childbirth globally (WHOa, 2015). Anaemia during pregnancy contributes to 20% of all maternal deaths (WHOb, 2015). According to the KDHS 2008-09, maternal deaths increased from 414/100,000 in 2003 to 488/100,000 in 2008-09 far from meeting MDG target goals for maternal mortality. From this information it can be estimated that the high cause of anaemia among pregnant women in Kenya is considered to be the main factor for maternal death.Anaemia during pregnancy is also a major risk factor for low birth weight, preterm birth and intrauterine growth restriction (Banhidy F et al., 2011and Haggaz et al., 2010). Deficiency in folic acid during pregnancy can result in serious neural tube defect (Wolff et al., 2009), heart defects and cleft lips (Wilcox et al., 2007), limb defects, and urinary tract anomalies (Goh and Koren, 2008).

Pregnant women attending antenatal clinics in Nigeria are routinely put on iron supplementation throughout their pregnancy. However, the cause of anaemia among pregnant women is still high. Moreover the available data concerning cause and specific ethologic factors of anaemia during pregnancy in Nigeria are limited. In the light of the above, this study seek to assess the prevalence and determinants of anaemia in pregnant women attending antenatal clinics in selected PHC In Akure.


1.3 Objectives of the Study

The study generally focus on the prevalence and determinants of anaemia in pregnant women attending antenatal clinics in selected PHC In Akure.

The study will specifically assess the objectives below;

  1. To ascertain the prevalence and determinants of anaemia among pregnant women attending antenatal clinics at PHC In Akure.
  2. Find out the factors associated withanaemia among pregnant women attending antenatal clinics PHC In Akure.
  3. Find out the causes ofanaemia among pregnant women attending antenatal clinics at PHC In Akure.

1.4 Research Questions

The study will be guided by the following questions;

  1. What is the prevalence of anaemia among pregnant women attending antenatal clinics at PHC In Akure?
  2. What are the factors associated withanaemia in among pregnant women attending antenatal clinics at PHC In Akure?
  3. What are the causes ofanaemia among pregnant women attending antenatal clinics at PHC In Akure?

1.5 Research Hypothesis

  • Ho: There are no factors associated with anaemia among pregnant women in Akure.
  • Ha: There are factors associated with anaemia among pregnant women in Akure.

1.6 Significance of the Study

This study will be immensely invaluable and useful to mostly pregnant in Nigeria as it will educate and enlighten them on the major causes of Anaemia during pregnancy so as to aid them in being meticulous not to be victims. The recommendations proffered in this study will as well be of great help to mothers in general. Lastly this study will add to the body of literature which has existed in this aspect of intellectual studies, thereby making it available and useful to students, researchers and other intellectuals.


1.7 Scope of the Study

This study on the Prevalence And Determinants Of Anaemia In Pregnant Women Attending Antenatal Clinics In Selected PHC in Akure will specifically figure out the prevalence of anaemia among pregnant women at Akure and identify factors associated with anaemia among pregnant women at Akure. Therefore to achieve the desired result from this study, the study will be delimited Selected PHC in Akure.


1.8 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias.

Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed.

More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other local governments, states, and other countries in the world.


1.9 Definition of Term

Knowledge:

This can be described as familiarity, awareness, or understanding of someone or something.

Prevention:

This is the act of stopping something from happening or arising.

Anaemia:

A condition in which the blood doesn’t have enough healthy red blood cells.

Pregnancy:

Pregnancy is the term used to describe the period in which a fetus develops inside a woman’s womb or uterus.


1.10 Organization of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, abnd selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the prevalence and determinants of anaemia in pregnant women attending antenatal clinics in selected PHC in Akure. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was on the prevalence and determinants of anaemia in pregnant women attending antenatal clinics in selected PHC in Akure. The study is was specifically carried out to ascertain the prevalence and determinants of anaemia among pregnant women attending antenatal clinics at PHC In Akure, find out the factors associated withanaemia among pregnant women attending antenatal clinics PHC In Akure and find out the causes ofanaemia among pregnant women attending antenatal clinics at PHC In Akure.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 35 responses were validated from the enrolled participants where all respondent wereall the pregnant women in the selected PHC in Akure.


5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

  1. The prevalence of anaemia among pregnant women attending antenatal clinics at PHC In Akure is high.
  2. The factors associated with anaemia in among pregnant women attending antenatal clinics at PHC In Akure includes: extremes of reproductive age, late antenatal booking, low maternal educational level and Low family income.
  3. The causes of anaemia among pregnant women attending antenatal clinics at PHC In Akure incldes: advanced kidney disease, hypothyroidism, old age and long-term diseases, such as cancer, infection, lupus, diabetes, and rheumatoid arthritis.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

In order to reduce the high Maternal and perinatal morbidity and mortality from anaemia seen in Nigeria, certain measures should be put in place by the government:

  1. Public enlightenment campaigns should be embarked upon to sensitize the public on what anaemia is, its causes, risk factors and complications.
  2. Health education and promotion, especially to encourage all pregnant women to book early for antenatal care and to take appropriate intervention measures. Information, Education and Communication (IEC) efforts should be directed towards increasing levels of awareness and commitment at all levels.
  3. Strategies should be put in place to increase awareness on anaemia. These should include dissemination of information via antenatal and under-five clinics, public radio, and community development meetings conducted by extension workers.
  4. Education of the girl-child should be made compulsory to avoid teenage and unplanned pregnancy. This can also help in delaying first pregnancy.
  5. Distribution of iron tablets in communities targeted at adolescent girls and women after marriage and before conception, as well as in the inter-pregnancy period will prevent iron deficiency at the onset of a pregnancy.

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