Sserunjogi, Louise; (1998) The epidemiology of anaemia, cultural perceptions and dietary practices among postpartum women in Tororo District, Uganda. Masters thesis (M.Sc), UCL (University College London).

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Abstract

Objectives and Study Design. The main objective of the study was to assess the prevalence and risk factors of anaemia in postpartum women, in TororoDistrict, Uganda. A cross sectional study targeted a convenient sample of 349 mothers with children between the age of 6 weeks to 12 month. Quantitative and qualitative research methods were used to collect data. Blood haemoglobin (Hb) levels were measured using a Blood Haemoglobin Photometer- the 'HemoCue. Clinical screening for anaemia was, in addition, carried out on a sub-sample of mothers to assess the sensitivity and specificity of the method. Results. Anaemia (Hb 120g/L) was detected in 64.5% of women. 16% of the mothers had moderate or severe anaemia (Hb 100g/L). The mean haemoglobin (Hb) level for all women was 113.5 g/L. The study showed no statistically significant differences in mean haemoglobin (Hb) levels of women according to age group, postpartum age, parity and household social economic status. However, anaemia was detected more among older and multiparous women. Risk factors identified for women with anaemia (Hb 120g/L) included non-supplementation with iron during pregnancy, (p 0.01); having experienced poor health since child delivery, with fever being the main symptom, (p 0.05); and reported excessive bleeding at birth, (p 0.05). Risk factors for moderate and severely anaemic women (Hb 100g/L) included presence of chronic lower abdominal pain, (p 0.050); excessive bleeding, (p 0.05); as well as fatigue and general weakness, as symptoms, (p 0.05). Clinical assessment had sensitivity value of 60% for moderate and severe anaemia, and only 25% for severe anaemia alone. The method was highly specific (100%) for both cut off points. Conclusions and Recommendations. Anaemia is highly prevalent in postpartum women during the first year postpartum. Infections, characterised by fever and lower abdominal pain; excessive bleeding at child birth; as well as lack of iron supplementation during pregnancy, were identified as risk factors, particularly, for women with moderate or severe anaemia. Prevention and treatment of infections, family planning to limit number of children, and iron supplementation for at risk women are potential strategies for control of anaemia in postpartum women. Management of excessive bleeding at community level needs to be improved.

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