1

ANEMIA AND ITS ASSOCIATED FACTORS AMONG PREGNANT

WOMEN ATTENDING ANTINATAL CARE IN TERTIARY CARE
HOSPITAL PESHAWAR

A Research Project For Degree of MPH

Submitted by

Mumtaz Begum

Subject Research

Supervisor

Dustar Ali

Lecturer at NCS system University town Peshawar

Session,2015/17

NCS University Of Peshawar

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Table of contants

Contents
Abstract ......................................................................................................................................................... 3
INTRODUCTION ........................................................................................................................................ 4
The Problem and Its Background.............................................................................................................. 4
PURPOSE ................................................................................................................................................. 6
SIGNIFICANCE OF THE STUDY.......................................................................................................... 6
OPERATIONAL DEFINITIONS ............................................................................................................. 6
LITRATURE REVIEW ................................................................................................................................ 6
LITRATURE SEARCH............................................................................................................................ 7
METHODOLOGY ....................................................................................................................................... 9
Study Design: ............................................................................................................................................ 9
Study Population: .................................................................................................................................... 10
Study Setting: ............................................................................................. Error! Bookmark not defined.
Study Duration: .......................................................................................... Error! Bookmark not defined.
Study Sample: ............................................................................................ Error! Bookmark not defined.
Sampling Technique: ................................................................................. Error! Bookmark not defined.
Inclusion Criteria: ................................................................................................................................... 11
Exclusion Criteria: .................................................................................................................................. 11
ETHICAL CONSIDERATION: ............................................................................................................. 11
DATA COLLECTION TOOL: ............................................................................................................... 11
DATA COLLECTION PROCEDURE:.................................................................................................. 11
DATA ANALYSIS PROCEDURE: ....................................................................................................... 12
RESULTS ................................................................................................................................................... 12
Chapter Introduction ............................................................................................................................... 12
4.1 Demographic Variable ...................................................................................................................... 12
DISCUSSIONS ........................................................................................................................................... 25
CONCLUSION ........................................................................................................................................... 27
REFERENCES ........................................................................................................................................... 28
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Abstract
Background

Blood disorders specifically anemia is one of the major problems around the world that
contribute to a significant level of morbidity and mortality among women during pregnancy.
Global data shows that 56% of pregnant women in low and middle income countries (LMIC)
have anemia. In Pakistan, the prevalence of anemia among married women aged 15 to 44 has
been reported as 26% in urban areas and 47% in rural areas.

Methodology

This was a cross sectional descriptive study among pregnant women sample of 134 in tertiary
care public sector hospitals Peshawar. Data was collected through a semi structured self
administrated questionnaire after taking consent. Data was analyze through SPSS.

Result

In this study the mean age of the participants were 26.8 years, 62.7% have no formal education,

and 88.1% women were housewives, 60.4% were from rural areas where 39.6% were from

Urban areas. 78.4% women were found with the low HB level of 8-10%, 16.4% with 5-7% HB

and only 5.2% with more than 11% HB.

Conclusion

It is concluded that anemia is one of the major concern among Pakistani women that needs to be
taken care properly to avoid its complication in terms of its morbidity and mortality.

Key words: Knowledge, anemia, pregnant women , Public Sector, Tertiary Care Hospital
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CHAPTER 1

INTRODUCTION

The Problem and Its Background

Blood disorders specifically anemia is one of the major problems around the world that

contribute to a significant level of morbidity and mortality among women during pregnancy.1, 2

Iron deficiency anemia is the most common medical complication of pregnancy, primarily

because of expansion of plasma volume without normal expansion of maternal hemoglobin

mass.3 Global data shows that 56% of pregnant women in low and middle income countries

(LMIC) have anemia 4. Anemia lead to 0.11 million maternal deaths across the globe.5 Iron

deficiency anemia is an important public health problem for pregnant women, living in

developing countries. It is estimated that 20 – 50% of the world population is suffering from iron

deficiency anemia.6 The prevalence of anemia is highest among pregnant women in Sub-

Saharan Africa (57%), followed by pregnant women in Southeast Asia (48%), and lowest

prevalence (24.1%) among pregnant women in South America. South Asian regional anemia

prevalence has been estimated to be 75% among pregnant women, the highest in the world.7 In

Pakistan, the prevalence of anemia among married women aged 15 to 44 has been reported as

26% in urban areas and 47% in rural areas. 8–10 furthermore, the prevalence of anemia among

ever-married women aged 15 to 44 is reported to be 26% in urban areas and 47% in rural areas.2

Anemia is more common in women with no previous antenatal checkup and it is more common

in women of low socioeconomic group. If not treated during pregnancy, anemia leads to

increased risks of premature delivery, low birth weight, maternal and prenatal deaths.11 In urban

areas of Pakistan 90.5% of pregnant women were anemic among them 0.7% were severely

anemic.4
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Maternal anemia is widely recognized as a major public health issue in the developing world,

and it is estimated that between 10% and 19% of women in many countries of the developing

world are anemic. In addition to overt maternal under nutrition and short stature, micronutrient

deficiencies are widespread and play a major role in increasing maternal morbidity and mortality.

Many factors associate to anemia including eating behviours, poverty, lack of proper antenatal

care, financial constraints, health facilities, cultural influences education, unemployment, and

unawareness of balanced diet among pregnant women.12

It is estimated that iron deficiency contributes to an excess 115,000 maternal deaths and 0.4% of

global total disability-adjusted life years (DALYs) lost.5

The primary cause of anemia during pregnancy worldwide is iron deficiency secondary to

chronic inadequate dietary intake and menstruation, heightened by the physiologic demands of

the fetus and maternal blood volume expansion during pregnancy.2 Women who start their

pregnancy with low stored iron are at great risk to be- come anemic during the course of

pregnancy.4 Iron demand increases rapidly in the second and third trimester of pregnancy with

the needs of the developing fetus, with a daily requirement of up to 10 mg.8 During pregnancy,

anemia is associated with increased risks of premature delivery and low birth weight, and severe

anemia with increased risks of maternal and prenatal death.13 Majority of the women lack

awareness regarding the anemia and its associated factors while attending antenatal care

therefore they need to be educated for better outcomes during pregnancy .14
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PURPOSE
The purpose of this study was to identify the knowledge regarding anemia and other related risk

factors of pregnant women regarding anemia, attending antenatal care in a tertiary care hospitals

of Peshawar Pakistan.

SIGNIFICANCE OF THE STUDY

To formulate the preventative strategy of pregnant women towards anemia in pregnancy should

be assessed at antenatal care unit of hospital. The Women are assumed to have good knowledge

with regards to anemia and its prevention. So, this study is expected to give information on this

particular group of people.

OPERATIONAL DEFINITIONS

• Anemia: World Health Organization (WHO) has defined anemia in pregnancy as the

haemoglobin (Hb) concentration of less than 11 g/dl

• Antenatal Care: The care that is provided during pregnancy is known as antenatal care

• Factors: Number of Antenatal Visit, Eating behaviours, education, Iron Supplements,

unemployment, lack of health facilities, financial constraints, and unawareness about

taking the proper diet intake.

CHAPTER 2

LITRATURE REVIEW
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The literature was reviewed for related topic. Articles related to knowledge regarding anemia

among pregnant women were examined. Advance Knowledge in care during pregnancy is

required to avoid anemia.

LITRATURE SEARCH
The topic “knowledge regarding anemia among pregnant women in Hayatabad Medical

Complex Hospitals Peshawar” and other related articles results got and saved which was helpful

for our research study. Articles searched on Google, Google scholar, pub med and other sites.

Iron is an essential component of hemoglobin, the oxygen-carrying pigment in the blood. Iron is

normally obtained through the food diet and by recycling iron from old red blood cells and in the

absence of the required iron blood concentrations, blood cannot carry oxygen effectively and

hence normal functioning of every cell in the body will be affected.3

A study done in Nepal Regarding the knowledge on causes of anemia during pregnancy, almost

all of mothers (98%) know inadequate iron containing diet as the cause of anemia. more than

two-third of the mothers (67.5%) said green leafy vegetables, followed by meat, fish, egg are

rich source of iron. 72.1% stated the use of iron drug, 21.8% stated increase birth interval, 10.2%

stated treatment of worms’ infestation and 9.0% responded regular ANC visit are the preventive

measures of anemia in pregnancy.16

In Indonisia, the study regarding anemia prevalence in Pregnancy, 86.7% pregnant women had

anemia, of whom 71.4% had mild anemia and 15.2% had moderate anemia and was more

prevalent in third semester.17

A study done in Sierra Leone shows that few individuals were able to identify specific elements

of inadequate nutrition as causes of anemia. 6% of the participants have inadequate nutrition

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while 38% not consuming iron-rich foods and 5% not taking preventive measures. Forty-five

percent of participants did not provide correct information about cause of anemia. A majority of

participants 53% were able to correctly identify preventive and treatment options for anemia. 15

A study done in India shows that Most of women had knowledge regarding prevention and

treatment of anemia. Most of the women were doing healthy practice to prevent anemia but

majority of women who were educated up to higher secondary were doing healthy preventive

practice to prevent anemia.18 Another study done in India shows that The majority of the

antenatal mothers (54%) had satisfactory knowledge, 38% had poor knowledge, and 8% had

good knowledge about anemia during pregnancy.19

Study in India regarding knowledge of anemia during pregnancy results shows that Assessment

of knowledge revealed that only 39.87% of the participants were aware of the term anemia.

53.8% of the participants accepted that pregnant women were more vulnerable to anemia and

66.1% responded correctly that the fetus will be affected by severe anemia. 32.6% response that

pregnant women should take iron supplementation in spite of taking a healthy diet.20

Study done in Kerala India shows that 89.2% of the participants had heard about anemia. Most of

the subjects 53.5% recognized fatigue as a cause of anemia and majority of them 68.1%

recognized lack of iron in food as the cause for anemia. More than half of the subjects 57.3% did

not know about the complications of anemia during pregnancy. About 69.7 percent pointed out

that consuming iron rich foods could prevent anemia. Also 73 percent thought that leafy

vegetables were iron rich. A little more than fifty percent of subjects knew that vitamin C rich

foods helps in iron absorption but most of them 53% did not know about the food items that

inhibited iron absorption.21

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Study done in Sindh shows that majority of women had moderate anemia while 36% were mildly

anemic. Severe anemia was seen in 12% of patients. About 8% of women delivered before term,

while 12.5% of babies were born with low birth weight. The prevalence of perinatal mortality

was 2.1%. Furthermore, 4% of women suffered from PPH.22

Another study done in Sindh regarding antenatal care shows women who received antenatal care

knew the importance of adequate intake of proteins, vegetables, fruits and milk during

pregnancy. They also knew that green leafy vegetables and organ meat were beneficial in

preventing anaemia.23

Studies done in Peshawar Pakistan results were showing very high prevalence of moderate

anemia almost 90-95%. Moreover 60 % of women were multifarious with no child spacing at all.

Poor nutrition because of poor socio economic condition was another very important factor.

76.6% of the women were not educated. Almost 67% of the women presented first time during

the third trimester of the pregnancy with moderate anemia.24

CHAPTER 3

METHODOLOGY

Study Design:
This was a cross sectional descriptive study design
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Study Population:
The study was conducted in tertiary care hospital of Peshawar. The population of

Peshawar city, according to the 1998 census, is 2,026,851, of which 49% were

urban[24].Pregnant women who were receiving care in Tertiary care hospitals Peshawar

and some of people from other cities are rely on this hospital.

Study Setting: Hospital based study in tertiary care hospitals Peshawar.

Study Duration: This study was completed in 04 months duration starting from February

2019 to May 2019 after approval of proposal from ethical committee.between this duration we

have collected data from 134 patients.

Study Sample: : Sample size will be calculated by using Open Epi software

Margin of Error=05

Confidence Interval=95

Population= 205

Response Distribution=50%

Sample Size:134 and the anticipated proportion of Knowledge regarding anemia were 20%.

Sampling Technique: Convenient Sampling technique was used to select the sample as

shortage of time.

SAMPLE SELECTION
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Inclusion Criteria:
1. All pregnant women who visit HMC hospital for antenatal care checkup.

2. Those pregnant women who voluntarily participate in study at HMC hospital.

Exclusion Criteria:

1. Women who are not voluntarily participating in this study.

ETHICAL CONSIDERATION:
• Informed consent was taken from the participants before taking part in the study

Approval of data collection was obtained from the hospital. All ethical standards were

taken care during data collection.

DATA COLLECTION TOOL:

To conduct this study the data was collected through an adopted questionnaire. The

questionnaire will have two sections including (Demographic Variables Section and Knowledge

based questions women regarding anemia and its associated factors during pregnancy and

antenatal care in a public sector hospital of Peshawar

DATA COLLECTION PROCEDURE:

Data was collected through adopted questionnaires after taking a written consent form attached

to the questionnaire from participants at the time of data collection. Each participant was given

20 minutes to fill the questionnaire. Queries were clarified during filling the questionnaire.
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DATA ANALYSIS PROCEDURE:

Data was analyzed through SPSS version 16. In a descriptive statistic, data was calculated for

presented in frequencies, percentages, in tables, and charts. For inferential statistics chi-squire

test was used for the significance in categorical variables.

CHAPTER 4

RESULTS
Chapter Introduction

This chapter gives an overview of detailed analysis of collected data regarding the knowledge

among pregnant women in tertiary care hospitals Peshawar. The association of demographic data

and relevant variable in context of the study has been determent during the analyses of data.

Each variable has been critically described in terms of frequencies percentages and figures.

4.1 Demographic Variable Affecting The Knowledge of pregnant women regarding anemia
in pregnancy
In a sample of 134 pregnant women visit antenatal care in tertiary care hospitals with a mean

age 26.8 years. Majority of the participants have no formal education with a proportion of

62.7% and maximum number of the women were housewives (88.1%). Among the 134 women,

60.4% were from rural areas where 39.6% were from Urban areas have participated in the study.

Table: 1
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Frequency Table of Demographic Variables of Pregnant women visit antenatal care unit

S.No Variables Categories Frequencies Percentages

1 Age in years <20 4 3.0
21-25 34 25.4
26-30 49 36.6
31-35 39 29.1
>35 8 6.0
2 Education No Formal Education 84 62.7
Primary Level Education 15 11.2
Secondary Level 19 14.2
Education
Higher Secondary Level 5 3.7
Education
Graduation 11 8.2
3 Occupation Government worker 11 8.2
Self Employed 4 3.0
Un Employed 1 0.7
House wife 118 88.1
4 Residence Rural 81 60.4
Urban 53 39.6

4.2 How many time in a week do you take an egg during this pregnancy?

It is obvious from results that in a sample of 134, the participants responded to the question No 1

where it was asked that how many time in a week you take an egg during this pregnancy.

Majority of the participants 60.4 % were not taking while 25.4% answer once 6.7% of the

participant answer twice and 7.5% of the participants answer that they take an egg three or more

times in a week.

Table 2

How many time in a week do you take an egg during this pregnancy?
Valid Cumulative
Category Frequency Percent Percent Percent
Never 81 60.4 60.4 60.4
34 25.4 25.4 85.8
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once 9 6.7 6.7 92.5

twice 10 7.5 7.5 100.0
three or more times
134 100.0 100.0
Total

4.3 How many time in a week do you take meat/fish during this pregnancy?

The result shows that in a sample of 134 participants, the respondents have answered the above

question no 2 that how many time in a week do you take meat/fish during this pregnancy? 38.1%

of the participants answer in never while 47.0% of the participants were using once and 10.4%

respondent were taking twice while 4.5% of the participants were taking meat/fish three or more

than three times a week.

Table 3

How many time in a week do you take meat/fish during this pregnacy?
Valid Cumulative
Category Frequency Percent Percent Percent
Never 51 38.1 38.1 38.1
Once 63 47.0 47.0 85.1
Twice 14 10.4 10.4 95.5
three or more
6 4.5 4.5 100.0
times
Total 134 100.0 100.0

4.4 How many time in a week do you take green leafy vegetable/ fruits during this

pregnancy?
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When asked about taking green leafy vegetable/ fruits during pregnancy. Only 3% of the

respondents answer in not while 16.4% of the participants answer once, 35.1% answer twice and

45.5% of the respondents answer that they take such diet three or more times in a week during

pregnancy.

Table 4

How many time in a week do you take green leafy vegetable/ fruits
during this pregnancy?
Valid Cumulative
Category Frequency Percent Percent Percent
Never 4 3.0 3.0 3.0
Once 22 16.4 16.4 19.4
Twice 47 35.1 35.1 54.5
three or more
61 45.5 45.5 100.0
times
Total 134 100.0 100.0

4.5 Have you taken iron supplementation during this pregnancy?

Majority of the respondent proportion 90.3% answer that they use iron supplementation during

this pregnancy while 9.7% of the participants answer that they not use iron supplementation

during this pregnancy.

Table 5

Have you taken iron supplementation during this pregnancy?

Categ Valid Cumulative
ory Frequency Percent Percent Percent
Yes 121 90.3 90.3 90.3
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No 13 9.7 9.7 100.0

Total 134 100.0 100.0

4.6 How many time did you take iron supplementation during pregnancy?

Among total participants 17.9%, 44.8%, 30.6%, 6.7% take iron supplementation once,

sometimes, always, and never respectively.

Table 6

If yes How many time did you take iron supplimentation during
pregnancy?
Valid Cumulative
Category Frequency Percent Percent Percent
Once 24 17.9 17.9 17.9
Sometimes 60 44.8 44.8 62.7
Always 41 30.6 30.6 93.3
Never 9 6.7 6.7 100.0
Total 134 100.0 100.0

4.7 Do you have an ITN (insecticide-treated-nets)?

Results show that 32.8% answer yes of the statement that do you have an ITN (insecticide

treated nets) while 67.2% answer no to the above statement.

Table 7

Do you have an ITN (insecticide-treated-nets)?

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Categ Valid Cumulative

ory Frequency Percent Percent Percent
Yes 44 32.8 32.8 32.8
No 90 67.2 67.2 100.0
Total 134 100.0 100.0

4.8 Have you had malaria during this pregnancy?

This study shows that among sample of 134 a majority of the participant proportion 99.3 %

answer no to the statement that have you had malaria during this pregnancy while only 0.7%

answer yes to the above statement.

Table 8

Have you had malaria during this pregnancy?

Categ Valid Cumulative
ory Frequency Percent Percent Percent
Yes 1 .7 .7 .7
No 133 99.3 99.3 100.0
Total 134 100.0 100.0

4.9 If yes, at what time of the Pregnancy had you malaria (weeks)?

Result shows that only 1 participant among total 134 had malaria at 9th week of pregnancy.

Table 9
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If yes, at what time of the Pregnancy had you malaria

(weeks)?
Categ Valid Cumulative
ory Frequency Percent Percent Percent
0 133 99.3 99.3 99.3
9 1 .7 .7 100.0
Total 134 100.0 100.0

4.10 At what time of the pregnancy did you come for the first ANC? (weeks)

Majority of the participant 71.6 % of participants visit during 1-10 weeks of pregnancy, 14.9%

visit 11-20 weeks, 11.2% participants visit 21-30 weeks while 2.2% of the total participants visit

antenatal care center during 31 and above weeks of pregnancy.

Table 10

At what time of the pregnancy did you come for the first ANC?
(weeks)
Valid Cumulative
Category Frequency Percent Percent Percent
1-10 weeks 96 71.6 71.6 71.6
11-20 weeks 20 14.9 14.9 86.6
21-30 weeks 15 11.2 11.2 97.8
31 and above 3 2.2 2.2 100.0
Total 134 100.0 100.0

4.11What is the current Gestational Age? (weeks)

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Minimum of the participant 5.2 % were in 1-10 weeks of gestational age, 19.4% were between

11-20 weeks, 24.7% were 21-30 weeks while majority of the participants proportion 50.7% were

in 30 and above weeks of gestational age.

Table 11

What is the current Gestational Age? (weeks)

Valid Cumulative
Category Frequency Percent Percent Percent
1-10 weeks 7 5.2 5.2 5.2
11-20 weeks 26 19.4 19.4 24.6
21-30 weeks 33 24.6 24.6 49.3
31 and above 68 50.7 50.7 100.0
Total 134 100.0 100.0

4.12 How many times have you come for ANC during the current pregnancy?

This study shows that in a sample of 134 participants the proportion 77.6 % visit ANC 1-5 times

21.6% visit 6-10 times while 0.7% of the participants visit more than 15 times during current

pregnancy.

Table 12

How many times have you come for ANC during the current
pregnancy?
Valid Cumulative
Category Frequency Percent Percent Percent
1-5 104 77.6 77.6 77.6
6-10 29 21.6 21.6 99.3
16 and above 1 .7 .7 100.0
Total 134 100.0 100.0
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4.13 Have you received any deworming medicine during the current pregnancy?

Majority of the participants proportion 94.8% answer no to the above statement while only 5.2%

of the participants answer yes that they received deworming medicine during this pregnancy.

Table 13

Have you received any deworming medicine during the

current pregnancy?
Categ Valid Cumulative
ory Frequency Percent Percent Percent
Yes 7 5.2 5.2 5.2
No 127 94.8 94.8 100.0
Total 134 100.0 100.0

4.14 Have you received IPTp (intermittent preventive treatment in pregnancy) during

current pregnancy?

In this study among total participants a proportion of 96.3% participants stated No to above

question regarding receiving of IPTs and only 3.7% answer yes to that statement.

Table 14

Have you received IPTp (intermittent preventive treatment in

pregnancy) during current pregnancy?
Categ Valid Cumulative
ory Frequency Percent Percent Percent
Yes 5 3.7 3.7 3.7
No 129 96.3 96.3 100.0
Total 134 100.0 100.0
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4.15 At what time of the Pregnancy did you receive the first dose of IPTp? (weeks)

Among the participants who receive IPTs during pregnancy a proportion 0.7% and 3.0%

received IPTs on 1st and 3rd week respectively.

Table 15

At what time of the Pregnancy did you receive the first dose
of IPTp? (weeks)
Categ Valid Cumulative
ory Frequency Percent Percent Percent
129 96.3 96.3 96.3
1 1 .7 .7 97.0
3 4 3.0 3.0 100.0
Total 134 100.0 100.0

4.16 Gravidity (number of Pregnancy)

This study shows that 47.8% participants have 1-3 numbers of pregnancies while 35.1%, 12.7%

and 4.5% participants have 4-6, 7-9, and 10 and above pregnancies respectively.

Table 16

Gravidity (number of Pregnancy)

Category Valid Cumulative
Frequency Percent Percent Percent
1-3 64 47.8 47.8 47.8
4-6 47 35.1 35.1 82.8
7-9 17 12.7 12.7 95.5
10 and above 6 4.5 4.5 100.0
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Gravidity (number of Pregnancy)

Category Valid Cumulative
Frequency Percent Percent Percent
1-3 64 47.8 47.8 47.8
4-6 47 35.1 35.1 82.8
7-9 17 12.7 12.7 95.5
10 and above 6 4.5 4.5 100.0
Total 134 100.0 100.0

4.17 Parity (number of children)

Results shows that a proportion of 62.7% have 1-3 children, 26.1% have 4-6, 9.7% have 7-9 and

1.5% of the participants have 10 and above children.

Table 17

Parity (number of children)

Valid Cumulative
Category Frequency Percent Percent Percent
1-3 84 62.7 62.7 62.7
4-6 35 26.1 26.1 88.8
7-9 13 9.7 9.7 98.5
10 and above 2 1.5 1.5 100.0
Total 134 100.0 100.0

4.18 What is the interval between the last child and current pregnancy?
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Of the respondent total sample of 134 a proportion 29.1% answer 1 year to the above question

regarding the interval between the last child and current pregnancy, 41.0%, 17.2%, 12.7% of the

participants answer 2 years, 3 years and more than 3 years respectively.

Table 18

What is the interval between the last child and current pregnancy?
Valid Cumulative
Category Frequency Percent Percent Percent
1 year 39 29.1 29.1 29.1
2 years 55 41.0 41.0 70.1
3 years 23 17.2 17.2 87.3
More than 3
17 12.7 12.7 100.0
years
Total 134 100.0 100.0

4.19 Trimester of current Pregnancy?

Results shows that 14.2% of the participants have their 1st trimester at the time of data collection

while 26.9%, 59.0% have their 2nd and third trimester respectively.

Table 19

Trimester of current Pregnancy?

Valid Cumulative
Category Frequency Percent Percent Percent
1st trimester 19 14.2 14.2 14.2
2nd Trimester 36 26.9 26.9 41.0
3rd Trimester 79 59.0 59.0 100.0
Total 134 100.0 100.0
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4.20 Hb at first ANC?

The result shows that among participants proportion 7.5%, Hb % at first ANC were 5-7 while

55.2%, 37.3% were 8-10, and 11 and above respectively.

Table 20

Hb at first ANC?
Valid Cumulative
Category Frequency Percent Percent Percent
5-7 10 7.5 7.5 7.5
8-10 74 55.2 55.2 62.7
11 and above 50 37.3 37.3 100.0
Total 134 100.0 100.0

4.21 Hb at current ANC?

The participant proportion 16.4% Hb at current ANC were 5-7 and 78.4% of the participants Hb

were in rang of 8-10 while a minimum proportion 5.2% Hb were 11 and above.

Table 21

Hb at current ANC?
Valid Cumulative
Category Frequency Percent Percent Percent
5-7 22 16.4 16.4 16.4
8-10 105 78.4 78.4 94.8
11 and above 7 5.2 5.2 100.0
Total 134 100.0 100.0
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CHAPTER 5

DISCUSSIONS

This chapter includes the discussion of study finding in compression with relevant previous

literature. Similarities and difference of this study related to previous study are discussed in

details with possible reasons.

This study is done in public sector tertiary care hospital of Peshawar Pakistan to assess the

knowledge and awareness of pregnant women regarding anemia in pregnancy. In this study a

mean age of participants were 26.8 years. A similar study done in Vientiane where the subject
 26

age was between 20 and 30 yrs.25 In current study majority of the participants have no formal

education with a proportion of 62.7%. A study done in Iran support this study where 76% of the

participants were have no formal education26. Another study done in Karachi against current

study where 84.3% of the participant were to grade 10 education.27 This study shows that

maximum number of the women proportion 88.1% were housewives. This study support by a

study done in India where 92.4% female were housewives.28 In this study 60.4% participants

were from rural areas where 39.6% were from urban areas. A study done in sindh Pakistan

support this study where 65% participants were from rural area while 35% were from urban

areas29.

The result of this study shows that 40% of participants were taking egg during pregnancy, 61.9%

of the participants were taking meat/fish during pregnancy, 97% of the respondents were using

green leafy vegetable during pregnancy. In support to this study done in Palestine 65% of the

participants were using egg, meat, and green leafy vegetable during pregnancy to prevent

anemia.3 Majority of the respondent in this study proportion 90.3% were using iron

supplementation during pregnancy. A study done in rural area of Kalyobia support this study

where 83% of the participants were using iron suplimentation.6 Current study shows that

Majority of the participant 71.6 % of participants visit during 1-10 weeks of pregnancy, 26.1 %

of participant visit 11-30 weeks while 2.2% of the total participants visit antenatal care center

during 31 and above weeks of pregnancy. In support of this study a study done in Palestine result

shows that 76.6% of the participant visit ANC in 1st trimester while 18.4% in second and third

trimester visit ANC26. This study shows that a proportion of 62.7% have 1-3 children, 26.1%

have 4-6, 9.7% have 7-9 and 1.5% of the participants have 10 and above children. A study done

in India support this study shows 39.8% have primary parity while 60.12% have multi parity.20
 27

The result shows that among participants proportion 7.5%, Hb % at first ANC were 5-7 while

55.2%, 37.3% were 8-10, and 11 and above respectively. A study done in Peshawar Pakistan

favor this study shows 0.3% have HB less than 7 and 98% of the participants have HB 7-10

while 0.2 have HB more than 10.24

CONCLUSION AND RECOMMENDATION

This study concluded that over all assessment and knowledge of the pregnant women was

satisfactory but there was some misunderstanding regarding to manage anemia. Majority of the

women HB% was less to normal. It is recommended that iron rich diet should take women

during pregnancy and possible ANC continuously during pregnancy in all trimester.
 28

REFERENCES
1. Abu-Hasira AWM. Iron Deficiency Anemia among Pregnant Women in Nablus District;
Prevalence, Knowledge, Attitude and Practices. :72.

2. Baig-Ansari N, Badruddin SH, Karmaliani R, Harris H, Jehan I, Pasha O, et al. Anemia

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