Adequacy of antenatal care services utilisation and its effect on anaemia in pregnancy (original) (raw)
Abstract
Anaemia in pregnancy remains a critical public health concern in many countries including Ghana and it poses severe consequences in the short to long-term for women and their unborn babies. Although antenatal care (ANC) is largely provided for pregnant women, the extent its utilisation protects against anaemia in pregnancy remains largely understudied. The study assessed the adequacy of ANC services utilisation and its effect on anaemia among pregnant women in the Wa Municipality of Ghana. A facility-based cross-sectional survey was conducted. Probability proportionate to size sampling and systematic random sampling were used to select the facilities and 353 respondents. While 80⋅2 % of the pregnant women reported having received a sufficient number of ANC services provided, the prevalence of the overall ANC adequacy was only 44⋅2 %. After adjusting for potential confounders, pregnant women who could not achieve adequate ANC attendance were 2⋅3 times more likely to be anaemic in the...
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References (60)
- WHO (2020) Global Anaemia Reduction Efforts Among Women of Reproductive Age: Impact, Achievement of Targets and the Way Forward for Optimizing Efforts. Geneva: World Health Organization.
- Benoist BD, McLean E, Egll I, et al. (2008) Worldwide Prevalence of Anemia 1993-2005: WHO Global Database on Anemia. Geneva: World Health Organization.
- WHO (2011) Hemoglobin Concentrations for the Diagnosis of Anemia and Assessment of Severity. Geneva: World Health Organization. (WHO/ NMH/NHD/MNM/11.1) 2011. https://www.who.int/vmnis/ indicators/haemoglobin.pdf:
- Ghana Statistical Service (GSS), Ghana Health Service (GHS), ICF International (2015) Ghana Demographic and Health Survey 2014. Rockville, MD, USA: GSS, GHS, and ICF International.
- Upper West Regional Health Directorate (2016) Annual Health Report for the Upper West Region. Wa, Ghana: Ghana Health Service.
- Zerfu TA, Umeta M & Baye K (2016) Dietary diversity during pregnancy is associated with reduced risk of maternal anemia, pre- term delivery, and low birth weight in a prospective cohort study in rural Ethiopia. Am J Clin Nutr 103, 1482-1488.
- Figueiredo ACMG, Gomes-Filho IS, Silva RB, et al. (2018) Maternal anemia and low birth weight: a systematic review and meta-analysis. Nutrients 10, 601.
- Rahman MM, Abe SK, Rahman MS, et al. (2016) Maternal anemia and risk of adverse birth and health outcomes in low-and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr 103, 495-504.
- Allen LH (2000) Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr 71, 1280S-1284S.
- Stevens GA, Finucane MM, De-Regil LM, et al. (2013) Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health 1, e16-e25.
- Obai G, Odongo P & Wanyama R (2016) Prevalence of anaemia and associated risk factors among pregnant women attending ante- natal care in Gulu and Hoima regional hospitals in Uganda: a cross sectional study. BMC Pregnancy Childbirth 16, 76.
- WHO (2001) WHO | Archived: Iron Deficiency Anaemia: Assessment, Prevention and Control -A Guide for Programme Managers. Geneva: World Health Organization.
- World Health Organization (2002) WHO Antenatal Care Randomized Trial: Manual for the Implementation of the new Model. Geneva: WHO.
- Gudu W & Addo B (2017) Factors associated with utilization of skilled service delivery among women in rural northern Ghana: a cross sectional study. BMC Pregnancy Childbirth 17, 159.
- Simkhada B, van Teijlingen ER, Porter M, et al. (2008) Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. J Adv Nurs 61, 244-260.
- Magadi MA & Madise NJ (2000) Frequency and timing of antenatal care in Kenya: explaining the variations between women of differ- ent communities. Soc Sci Med 51, 551-561.
- Health System and Community Level Interventions for Improving Antenatal Care Coverage and Health Outcomes [Database on the Internet]. Science and Education.
- WHO (2009) WHO Recommended Interventions for Improving Maternal and Newborn: Integrated Management of Pregnancy and Childbirth (IMPAC) Clinical Guidelines. Geneva, Switzerland: World Health Organization. Contract No.: WHO/MPS/07.05.
- Wa Municipal Health Directorate (2014) Annual Performance Report of Wa Municipality. Wa: Ghana Health Service.
- WHO (2016) WHO Recommendations on Antenatal Care for A Positive Pregnancy Experience. Geneva, Switzerland: WHO.
- SPRING, Ghana Health Service (2016) Ghana: Landscape Analysis of Anemia and Anemia Programming. Arlington, VA: Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project.
- Kotelchuck M (1994) An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care util- ization index. Am J Public Health 84, 1414-1420.
- Sahu JP & Mishra N (2017) Correlations of APNCU index and fetomaternal out come in tribal area of Chhattisgarh. Int J Multidiscip Curr Res 5, 320-324.
- WHO (2002) WHO Antenatal Care Randomized Trial. Manual for the Implementation of the New Model. Geneva: World Health Organization.
- Martin-Prével Y, Allemand P, Wiesmann D, Arimond M, Ballard T, Deitchler M, et al. Moving Forward on Choosing a Standard Operational Indicator of Women's Dietary Diversity. Rome, Italy: Food and Agriculture Organisation of the United Nations; 2015.
- FAO, FHI 360 (2016) Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO.
- Vyas S & Kumaranayake L (2006) Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21, 459-468.
- Filmer D & Pritchett LH (2001) Estimating wealth effects without expenditure data-or tears: an application to educational enroll- ments in states of India. Demography 38, 115-132.
- Rutstein SO & Johnson K (2004) DHS Comparative Reports 6: The DHS Wealth Index. Calverton, MD, USA: ORC Macro, MEASURE DHS.
- Howe LD, Hargreaves JR & Huttly SRA (2008) Issues in the con- struction of wealth indices for the measurement of socio-economic position in low-income countries. Emerg Themes Epidemiol 5, 3.
- Sumankuuro J, Crockett J & Wang S (2017) The use of antenatal care in two rural districts of upper west region, Ghana. PLoS ONE 12, e0185537.
- Atuyambe L, Mirembe F, Annika J, et al. (2009) Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda. J Adolesc 32, 781-796.
- Chapman RR (2003) Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk. Soc Sci Med 57, 355-374.
- Mrisho M, Obrist B, Schellenberg JA, et al. (2009) The use of ante- natal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania. BMC Pregnancy Childbirth 9, 10.
- Tuncalp Ӧ, Pena-Rosas JP, Lawrie T, et al. (2017) WHO recommen- dations on antenatal care for a positive pregnancy experience-going beyond survival. BJOG 124, 860-862.
- WHO (2018) WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience: Summary of Highlights and Key Messages from the World Health Organization's 2016 Global Recommendations for Routine Antenatal Care. Geneva, Switzerland: World Health Organization.
- Austin A, Langer A, Salam RA, et al. (2014) Approaches to improve the quality of maternal and newborn health care: an overview of the evidence. Reprod Health 11, 1.
- Benova L, Tunçalp Ö, Moran AC, et al. (2018) Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Global Health 3, e000779.
- Smith HJ, Portela AG & Marston C (2017) Improving implemen- tation of health promotion interventions for maternal and newborn health. BMC Pregnancy Childbirth 17, 280.
- WHO (2016) World Health Statistics 2016: Monitoring Health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization.
- Nonterah EA, Adomolga E, Yidana A, et al. (2019) Descriptive epi- demiology of anaemia among pregnant women initiating antenatal care in rural northern Ghana. Afr J Prim Health Care Fam Med 11, e1-e7.
- Stephen G, Mgongo M, Hussein Hashim T, et al. (2018) Anaemia in pregnancy: prevalence, risk factors, and adverse perinatal outcomes in northern Tanzania. Anemia 2018, 1846280.
- Gravett CA, Gravett MG, Martin ET, et al. (2012) Serious and life- threatening pregnancy-related infections: opportunities to reduce the global burden. PLoS Med 9, e1001324.
- Satti H, Motsamai S, Chetane P, et al. (2012) Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho. PLoS One 7, e42700.
- Teshome MS, Meskel DH & Wondafrash B (2020) Determinants of anemia among pregnant women attending antenatal care clinic at public health facilities in Kacha Birra district, southern Ethiopia. J Multidiscip Healthc 13, 1007-1015.
- Tadesse SE, Seid O, Mariam YG, et al. (2017) Determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia, unmatched case-control study. PLoS ONE 12, e0173173.
- Darnton-Hill I & Mkparu UC (2015) Micronutrients in pregnancy in low-and middle-income countries. Nutrients 7, 1744-1768.
- Lee SE, Talegawkar SA, Merialdi M, et al. (2013) Dietary intakes of women during pregnancy in low-and middle-income countries. Public Health Nutr 16, 1340-1353.
- Karaoglu L, Pehlivan E, Egri M, et al. (2010) The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey. BMC Public Health 10, 1.
- Obse N, Mossie A & Gobena T (2013) Magnitude of anemia and associated risk factors among pregnant women attending antenatal care in Shalla Woreda, West Arsi zone, Oromia region, Ethiopia. Ethiop J Health Sci 23, 165-173.
- Dim CC & Onah HE (2007) The prevalence of anemia among pregnant women at booking in Enugu, south eastern Nigeria. Med Gen Med 9, 11.
- Ebuy Y, Alemayehu M, Mitiku M, et al. (2017) Determinants of severe anemia among laboring mothers in Mekelle city public hos- pitals, Tigray region, Ethiopia. PLoS One 12, e0186724.
- Grum T, Brhane E, Hintsa S, et al. (2018) Magnitude and factors associated with anemia among pregnant women attending antenatal care in public health centers in central zone of Tigray region, northern Ethiopia: a cross sectional study. BMC Pregnancy Childbirth 18, 433.
- Mocking M, Savitri AI, Uiterwaal CSPM, et al. (2018) Does body mass index early in pregnancy influence the risk of maternal anaemia? An observational study in Indonesian and Ghanaian women. BMC Public Health 18, 873.
- Gedefaw L, Ayele A, Asres Y, et al. (2015) Anemia and associated fac- tors among pregnant women attending antenatal care clinic in Wolayita Sodo town, southern Ethiopia. Ethiop J Health Sci 25, 155-162.
- Liu X, Du J, Wang G, et al. (2011) Effect of pre-pregnancy body mass index on adverse pregnancy outcome in north of China. Arch Gynecol Obstet 283, 65-70.
- Sebire NJ, Jolly M, Harris J, et al. (2001) Is maternal underweight really a risk factor for adverse pregnancy outcome? A population- based study in London. Br J Obstet Gynaecol 108, 61-66.
- Agrawal S & Singh A (2015) Obesity or underweigh: what is worse in pregnancy? J Obstet Gynecol India 66, 448-452.
- Balarajan Y, Ramakrishnan U, Özaltin E, et al. (2011) Anaemia in low-income and middle-income countries. Lancet 378, 2123-2135.
- Sifakis S & Pharmakides G (2000) Anemia in pregnancy. Ann N Y Acad Sci 900, 125-136.