Prevalence and determinants of Anemia among pregnant women in sub-Saharan Africa: a systematic review and Meta-analysis

Abstract

Background Anemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was carried out very prudently in order to give up the pooled prevalence and determinants of anemia in Sub-Saharan Africa. Methodology To carry out this ephemeral systematic review and meta-analysis, a correlated literature review was done from various sources, PubMed Medline and Google Scholar Journals. Anemia related searching engine was used to make the study more evocative and intensive. We used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to evaluate the quality of the study in relations of their inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was tracked to conduct this study. The pooled effect size was computed using the review manager and Compressive Meta-analysis software. Results Twenty-fife studies, which encompassed 15,061 pregnant women, were chosen for the analysis. From those an overall prevalence of anemia in pregnancy in SSA was 35.6%. However, the result from meta-analysis showed that women who were infected with intestinal parasite were 3.59 times more likely to develop anemia compared to those who were not infected [OR:3.59, 95% CI (2.44,5.28)].The result showed that women who had no iron and folic-acid supplementation were 1.82 times more likely to develop anemia compared to those women who had iron and folic-acid supplementation {OR:1.82, 95% CI (1.22,2.70]. Women who had women were in third trimester pregnancy were 2.37 times more likely to develop anemia compared to those who were in first and second trimester [OR:2.37, 95% CI (1.78, 3.24)]. Women who had low dietary diversity score were 3.59 times more likely to develop anemia compared to those who had high dietary diversity score [OR: 3.59, 95% CI (2.44, 5.28]. Conclusions Our finding from this systematic review and meta-analysis displays the high case in prevalence of anemia among pregnant women in Sub-Saharan Africa. Predictors for this includes: intestinal parasite, iron and folic-acid supplementation, third trimester pregnancy and dietary diversified intake score were statistically correlated positively with anemia in pregnancy. These need cautious evaluation of impact of prevention effort for operational policy, programs and design nutrition intrusions for refining maternal food consumption during pregnancy. Also, dietary education intrusion requires to be prearranged to satisfy the desires of pregnant women. The finding of this work will be used as an evidences for policy makers of Africa; entirely for maternal and child health care. Lastly, we suggested further investigations to be carried out in the area of the study for more rigorous and comprehensive recommendations.

Maternal determinants of non-compliance to folic acid supplementation and iron among pregnant women in Nakuru North Sub-County, Kenya

“…However, the study noted a significant relationship between the knowledge of the benefits of IFAS and the IFAS compliance status of pregnant women. Similar findings established that adherence to IFAS supplementation among pregnant women in Sub-Saharan Africa is not influenced by their income levels or levels of education (Fite et al, 2021). However, in contrast to these findings, research in Kiambu found that the education level of pregnant women did influence their compliance with IFAS in Kiambu County, Kenya (Kamau et al, 2018).…”

The association of maternal anaemia with adverse maternal and foetal outcomes in Somali women: a prospective study

“…To our knowledge, this is the largest series of pregnant women to examine the impact of maternal anaemia at delivery on adverse maternal and foetal outcomes in the Sub-Saharan Africa region. The prevalence of anaemia at delivery was alarmingly high at 64.8%, representing the second highest rate across all African countries, after that reported from the Republic of Benin (68.2%) [ 7 ], a relatively small west African country with a smaller population as compared with Somalia (≈13 vs 17 million). In Somalia, the prevalence of anaemia among pregnant women was reported to be 49% by the World Bank report 2019 ( https://data.worldbank.org/indicator/SH.PRG.ANEM?locations=SO ).…”

Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa

“…For PPH detection, the healthcare providers across three countries mostly followed the blood loss threshold of ≥500 ml (and ≥1,000 ml for severe PPH) through visual estimation and assessment of vital signs recommended in international PPH guidelines (5, 10). However, we also found that participants questioned the applicability of the blood loss threshold (≥500 ml) for all women, particularly in sub-Saharan Africa with its' high prevalence of women with anaemia (50). These findings suggest that existing guidelines concerning blood loss thresholds for PPH detection and management may need context-specific adaptations (14,51), with more attention to Hb measurements during pregnancy and on admission in labour to enhance risk assessment.…”