Prevention and management of anaemia in pregnancy: community perceptions and facility readiness in Ghana and Uganda

Tancred, Tara ORCID: https://orcid.org/0000-0002-8718-5110, Mubangizi, Vincent, Dei, Emmanuel Nene, Natukunda, Syliva, Abankwah, Daniel Nana Yaw, Ellis, Phoebe, Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199, Natukunda, Bernard and Asamoah Akuoko, Lucy (2024) 'Prevention and management of anaemia in pregnancy: community perceptions and facility readiness in Ghana and Uganda'. PLOS Global Public Health, Vol 4, Issue 8, e0003610.

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Abstract

Anaemia is one of the most common conditions in low- and middle-income countries, with prevalence increasing during pregnancy. The highest burden is in Sub-Saharan Africa and South Asia, where the prevalence of anaemia in pregnancy is 41.7% and 40%, respectively. Anaemia in pregnancy can lead to complications such as prematurity, low birthweight, spontaneous abortion, and foetal death, as well as increasing the likelihood and severity of postpartum haemorrhage. Identifying and mitigating anaemia in pregnancy is a public health priority. Here we present a mixed-methods situational analysis of facility readiness and community understanding of anaemia in Ghana and Uganda. Quantitative health assessments (adapted from service availability and readiness assessments) and qualitative key informant interviews (KIIs) with district-level stakeholders, in-depth interviews (IDIs) with maternity staff, and focus group discussions (FGDs) with community members were held in 2021. We carried out facility assessments in nine facilities in Ghana and seven in Uganda. We carried out seven KIIs, 23 IDIs, and eight FGDs in Ghana and nine, 17, and five, respectively, in Uganda. Many good practices and general awareness of anaemia in pregnancy were identified. In terms of bottlenecks, there was broad consistency across both countries. In health facilities, there were gaps in the availability of haemoglobin testing—especially point-of-care testing—staffing numbers, availability of standard operating procedures/guidelines for anaemia in pregnancy, and poor staff attitudes during antenatal care. Amongst community members, there was a need for improved sensitisation around malaria and helminth infections as potential causes of anaemia and provision of education around the purpose of iron and folic acid supplementation for preventing or managing anaemia in pregnancy. Anaemia in pregnancy is a persistent challenge, but one with clear opportunities to intervene to yield improvements.

Item Type:	Article
Subjects:	WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pgph.0003610
Depositing User:	Rachel Dominguez
Date Deposited:	10 Sep 2024 15:02
Last Modified:	08 Oct 2024 09:26
URI:	https://archive.lstmed.ac.uk/id/eprint/25166

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