Hindawi

Journal of Pregnancy
Volume 2020, Article ID 2139892, 8 pages
https://doi.org/10.1155/2020/2139892

Research Article
Knowledge of and Adherence to Anaemia Prevention
Strategies among Pregnant Women Attending Antenatal Care
Facilities in Juaboso District in Western-North Region, Ghana

Prince Kubi Appiah ,1 Daniel Nkuah,1 and Duut Abdulai Bonchel2

1
Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
2
Centre for Migration Studies, University of Ghana, Legon, Accra, Ghana

Correspondence should be addressed to Prince Kubi Appiah; [email protected]

Received 4 September 2019; Revised 27 May 2020; Accepted 23 July 2020; Published 1 August 2020

Academic Editor: Marco Scioscia

Copyright © 2020 Prince Kubi Appiah et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.

Background. Anaemia in pregnancy is a major problem in both developed and developing countries. The commonest source of
anaemia is nutritional deficiency of iron with evidence suggesting that up to 90% of maternal anaemia may be due to inadequate
consumption of dietary iron; however, there are other causes which include worm infestation, HIV infection, and genetic
disorders. There are some implemented approaches in Ghana including education and awareness creation, nutritional
supplements, and control and prevention of parasitic infections among others to prevent and control anaemia in pregnancy.
This study assessed pregnant women adherence to Ghana’s anaemia prevention strategies being implemented in the Juaboso
District. Method. A descriptive cross-sectional data on knowledge of and adherence to anaemia prevention strategies among
pregnant women was collected. Pearson’s chi-square and logistic regression models were used to assessed associations between
predictor and outcome variables. A p value <0.05 was considered as statistically significant. Findings. About 13.5% of the
pregnant women had high knowledge on anaemia, while 58.4% and 28.1% had moderate and low knowledge, respectively. Less
than half (39.1%) of the women adhered to anaemia prevention strategies. There were significant associations between
knowledge of anaemia and where pregnant woman resides in the district (AOR: 2.04, 95% CI: 2.16-9.83, p = 0:003), woman’s
educational (AOR: 10.43, 95% CI: 6.14-51.63, p = 0:002), and occupational status (AOR: 15.14, 95% CI: 13.57-18.43, p < 0:001).
Again, there were significant associations between adherence to anaemia prevention strategies and the woman’s ethnicity (AOR:
0.61, 95% CI: 0.04-0.92, p = 0:001) and her knowledge of anaemia (AOR: 3.88, 95% CI: 1.32-7.93, p = 0:001). Conclusions.
Pregnant women’s knowledge of anaemia and adherence to anaemia prevention strategies are not encouraging. However,
anaemia in pregnancy and its consequences could be devastating to all stakeholders if actions are not taken to reduce the
phenomenon. Therefore, we recommend that more education and sensitisation programs including good nutritional practices in
the diet of pregnant women be promoted to increase awareness and adherence to anaemia prevention strategies among
pregnant women in the Juaboso District.

1. Introduction children with the highest prevalence in South Asia and

Central and West Africa [3]. The commonest cause of anae-
Anaemia is one of the topmost causes of death globally and mia is iron deficiency with evidence suggesting that up to
has been of a grave public health worry for both developing 90% of maternal anaemia are due to inadequate intake of
and developed countries affecting people of different age dietary iron. However, worm infestations (hookworm and
groups [1]. However, it is more prevalent in pregnant schistosomiasis), bleeding haemorrhoids, vitamin B6 and
women, young children, and other women in reproductive B12 deficiencies, human immunodeficiency virus (HIV)
age [2]. Globally, anaemia prevalence is about 29% in non- infection, and genetic disorders such as sickle cell anaemia
pregnant women, 38% in pregnant women, and 43% in are other factors that cause anaemia in pregnancy [4, 5]. A
2 Journal of Pregnancy

cry of a baby immediately after birth gives joy to the mother. 2.4. Sample Size. Five hundred and ninety-eight (598) partic-
This means that a healthy mother and child after delivery is ipants were involved; this was determined using the formula:
the ultimate outcome that the pregnant mother, her family, n = z 2 × p ðqÞ ÷ d 2 [10]. Where n is the sample size to be
and the entire community expect. However, anaemia is asso- determined, z is the z-score (reliability coefficient) of 1.96
ciated with increased maternal and newborn health problems at 95% confidence level (C.L), p is the prevalence of anaemia
as well as death [6]. Ghana through the Ministry of Health among pregnant women in Ghana 44.6% [7], q is 1-p, and d
has been at the forefront with interventions and strategies is the degree of accuracy desired. With the extra implausibil-
to control anaemia in pregnancy. These strategies include ity about the true prevalence of anaemia among pregnant
education and awareness creation, nutrient (iron) supple- women due to a cluster sample survey design, design effect
mentation, and control and prevention of parasitic infections was considered in the sample size calculation. Therefore,
in pregnancy. Additionally, the use of insecticide-treated nets the sample size became n × design effect (which was 1.5 in
(ITNs) and intermittent preventive treatment (IPT) against this case) (379:68 × 1:5 = 569:52). For a 5% nonresponse rate
malaria, effective deworming, and provision of improved of 569.52, the sample size was upwardly adjusted and
water, sanitation, and hygiene services are also being imple- rounded to 598. This sample size ensured, with a probability
mented to prevent anaemia among pregnant women. These of 95%, that the estimated prevalence was within ±5% of the
strategies are meant to address common preventive causes true population coverage.
of anaemia such as iron deficiency, worm infestation, and
malaria control in the country. However, data available indi- 2.5. Sampling Method. Different (multistage) sampling tech-
cates that 44.6% of pregnant women in Ghana are anaemic niques were used to select respondents. The district was strat-
[7]. In view of this, the study examined pregnant women ified into the existing number (4) of subdistricts. A list of all
adherence to Ghana’s anaemia prevention strategies being ANC centres with registered pregnant women from each
implemented in the Juaboso District. stratum was obtained from the district health directorate. A
sample size was proportionately allocated to each stratum
2. Methods based on the list of pregnant women who have registered
and were attending ANC. For each stratum, 2 ANC centres
2.1. Study Site. The study was conducted in the Juaboso were randomly selected, and based on the sample size calcu-
District, which is located in the Western-North Region, lated for each stratum and the total population of pregnant
Ghana. The district has an estimated population of about women who have registered at each of the selected ANC
173,878 and annual population growth rate of 2%, with a centre, proportionate allocation was again used to allocate
landmass of 1,284 km with 99 communities [8]. The district sample size to each selected ANC centre. With reference to
has 25 health facilities including a hospital, 12 Community- the sample size for each ANC centre, special numbers were
based Health Planning and Services (CHPS) Compounds, 5 assigned to all registered women and randomly selected the
clinics, and 7 maternity homes providing health care services required respondents.
including information, education, and communication
(IE&C) to the people. Economic activities in the district 2.6. Data Collection Tool and Procedure. Data was collected
includes farming, trading, and rearing of livestock. The major through administration of a semistructured questionnaire
crops cultivated in the area include cocoa, rice, cassava, yam, using a face-to-face interview technique. The question-
and maize. Tomatoes, garden eggs, and pepper are the abun- naire was pretested on 20 pregnant women with similar
dant vegetables in the area. The district has two major mar- characteristics of the study participants from adjacent
kets for trading activities. The district also has 4 senior district for necessary modifications before being adminis-
secondary schools, 33 junior secondary schools, and 75 pri- tered to the study participants. Data collection tool was
mary schools providing formal education to people within a semistructured questionnaire comprised of demographic
and outside the district, with no tertiary institution [9]. characteristics of the participants, women’s knowledge of
anaemia (causes, signs and symptoms, and available
2.2. Study Population. The study population comprised preventive strategies), and adherence to anaemia preven-
pregnant women in the district. However, only those who tive strategies sections. Participants’ ages were accessed
have stayed in the district for three or more months, have using their birth certificates and ANC record cards. Par-
registered, and were attending antenatal clinics (ANC) were ticipants contact information obtained from the facilities
willing to be part of the study and agreed to sign the were used to trace to their homes and residence for data
informed consent forms that were included in the study. collection. Field assistants used these methods and tools
Non-Ghanaians, even if they had stayed up to the required to collect data from the pregnant women between May
period of time, as well as health professionals, and those and June 2019. Data collected from each participant aver-
who were severely ill were excluded. aged 20 minutes.
Knowledge of anaemia was assessed based on 22 ques-
2.3. Study Design. Descriptive cross-sectional study and tions with 22 scores; pregnant women who scored 0-7
quantitative method of data collection was used to collect points were considered as having low knowledge of anae-
data from pregnant women on adherence to Ghana’s mia; those who scored 8-15 point were also considered
anaemia prevention strategies being implemented in the as having fair knowledge of anaemia, while those who
Juaboso District. scored 16-22 points were classified as having high
Journal of Pregnancy 3

knowledge of anaemia. Seven questions with 7 points were Table 1: Demographic characteristics of participants.
used to assess adherence to anaemia prevention strategies;
pregnant women who scored 6 or less points were consid- Variable Frequency Percentage
ered as partially adhering, while those who scored all the 7 Juaboso 163 27.3
points were considered as completely adhering to anaemia Bonsu 152 25.4
preventive strategies. Subdistrict
Jato 139 23.2
Asempaneye 144 24.1
2.7. Ethical Issues. The study conformed to the required eth-
ical regulations regarding the use of humans and was 10–19 72 12.0
approved by the Ethical Review Committee of the Ghana 20–29 265 44.3
Age (years)
Health Services, Research and Development Division, Accra 30–39 194 32.5
with protocol number GHS-ERC 150/05/17. Participation ≥40 67 11.2
in the study was voluntary; consent and assent were sought None 109 18.2
from the participants and guardians after the study processes Basic (primary) 261 43.7
had been explained to them. Educational status
Secondary 155 25.9
2.8. Data Analysis. Double data entry was performed and Tertiary 73 12.2
checked for completeness and consistency using Epi data Legally married 470 78.6
Marital status
version 3.1. and Stata version 13 for data analysis, with illus- Cohabitation 128 21.4
trations in tables and graphs. In addition to descriptive statis- Christianity 411 68.7
tics, associations between dependent and independent Religion Islam 120 20.1
variables were analysed using Pearson’s chi2 and multiple
Traditionalist 67 11.2
(univariate and multivariate) logistic regression models. A p
value <0.05 was considered as statistically significant. Akan 336 56.2
Ewe 79 13.2
Ethnicity
3. Results Ga-Adangbe 63 10.5
Kussase 120 20.1
3.1. Demographic Characteristics of Participants. A total of Unemployed 119 19.9
598 pregnant women were involved in the study with mean
Occupation Nonformal jobs 406 67.9
age of 24.4 years (±2.6 sd), and most (44.3%) of them were
20-29 years old. A comparative majority (27.3%) of them Formal jobs 73 12.2
were from Juaboso subdistrict. About 18.2% of the women 1st trimester 146 24.4
Gestational age
never went to school. The majority (78.6%) of the pregnant 2nd trimester 267 44.7
of the pregnancy
women were legally married, 68.7% of them were Christians, 3rd trimester 185 30.9
while 56.2% were Akans. Again, the majority (67.9%) of the 0 51 8.5
pregnant women were involved in nonformal jobs, while 1 391 65.4
19.9% of them were unemployed. Most (44.7%) of the Parity
2 101 16.9
women were in 2nd trimester of gestational period, while
65.4% of them have had 1 pregnancy (parity 1) before the ≥3 55 9.2
current pregnancy (Table 1).

3.2. Knowledge of Anaemia among Pregnant Women. About

13.5% of the pregnant women had high knowledge of anae- were tested for confounding effects using multivariate
mia, while 58.4% and 28.1% of them had fair knowledge logistic regression analysis, it was confirmed that pregnant
and low knowledge, respectively, (Figure 1). women who were residing in the Bonsu (AOR: 0.21, 95%
CI: 2.31-8.81, p = 0:004), Jato (AOR: 3.06, 95% CI: 1.96-
3.3. Adherence to Anaemia Prevention Strategies among 7.18, p = 0:002) and Asempaneye subdistricts (AOR: 2.04,
Pregnant Women. The majority of the pregnant women were 95% CI: 2.16-9.83, p = 0:003) were less likely to have high
partially adhering to anaemia prevention strategies, 39.1% of knowledge of anaemia than those who were residing in the
them completely adhering to the preventive strategies Juaboso subdistrict. Also, pregnant women who attained
(Figure 2). basic (AOR: 1.78, 95% CI: 1.89-5.37, p = 0:001), secondary
(AOR: 4.22, 95% CI: 2.23-9.16, p = 0:002), and tertiary
3.4. Associations between Knowledge on Anaemia and education (AOR: 10.43, 95% CI: 6.14-15.63, p = 0:002)
General Characteristics. The study showed significant associ- were more likely to have high knowledge of anaemia than
ations between knowledge of anaemia and the subdistrict women who never went to school. Again, women who
where the pregnant woman resides (p = 0:003), the woman’s were engaged in nonformal (AOR: 2.18, 95% CI: 1.07-
educational status (p = 0:002), and occupational status 6.69, p = 0:001) and formal jobs (AOR: 15.14, 95% CI:
(p ≤ 0:001). 13.57-18.43, p < 0:001) were more likely to have high
Additionally, when the variable that showed associa- knowledge of anaemia than those who were unemployed
tions with knowledge of anaemia from univariate analysis (Table 2).
4 Journal of Pregnancy

4. Discussion
13.5%
This study showed that 18.2% of the pregnant women had
28.1% never been to school, while 19.9% of them were unemployed.
However, a study in Libya revealed that only 1.7% of preg-
nant women in the country were not educated; though, there
is a civil war in the country that might have affected the
educational system of the country [11], while about 19%
and 9.9% of pregnant women in Nigeria and Uyo State,
respectively, had never been to school [12, 13]. The findings
58.4% of this study are similar to what was reported (19.1%) in
the Ghana demographic and health survey [7]. The unem-
ployment status reported in this study is lower than what
High knowledge was reported in the Southern Ghana, Kenyan, and South
Fair knowledge African studies [14–16].
Low knowledge This study showed that 86.5% of the pregnant women
had insufficient (low/fair) knowledge of anaemia. This find-
Figure 1: Knowledge of anaemia among pregnant women. ing is in contrast with a study conducted among pregnant
women in Nepal, which revealed that 56% of the women
had insufficient knowledge of anaemia [17]. Also, a study to
assess the knowledge and risk factors of anaemia among
pregnant women in Libya revealed that all of the women
had moderate knowledge on anaemia [11]. Again, a study
conducted in the Brosankro in Ghana reported that less than
39.1% 30% of pregnant women knew signs and symptoms of anae-
mia [18]. The present study indicates that a significant num-
ber of the pregnant women knew that treatment of worm
60.9%
infestation can help prevent anaemia. This is in contrast to
the lower finding reported in the Nepal and Nigeria studies
[19, 20]. The reason for the differences in the treatment of
worm infestation as one of the anaemia prevention strategies
could be the sample size of the studies. The use of insecticide-
treated nets (ITNs) has been recommended as an integral
Complete adherence part of maternal and child health policies in Sub-Saharan
Partial adherence Africa where malaria infection is endemic and a major cause
of severe anaemia in pregnancy [21, 22]. Therefore, it is not
Figure 2: Adherence to anaemia prevention strategies among surprising that most of the pregnant women in the current
pregnant women. study knew that sleeping under ITNs prevents malaria and
is an anaemia prevent strategy, which agrees with the
Nigerian study [20]. Though, a good proportion of the preg-
3.5. Associations between Adherence to Anaemia Prevention nant women were aware that the use of ITNs is a strategy to
Strategies and General Characteristics and Knowledge on prevent anaemia in pregnancy; this awareness should be sus-
Anaemia. The study revealed significant associations tained, and efforts towards achieving 100% awareness should
between adherence to anaemia prevention strategies and eth- be enhanced.
nicity of the pregnant woman (p = 0:001) and woman’s Adherence to anaemia prevention strategies plays a
knowledge of anaemia (p = 0:001). major role in the prevention and treatment of anaemia
Additionally, when the variable that showed associations particularly among pregnant women whose iron require-
with adherence to anaemia prevention strategies from ment increases at the second trimester and progresses
univariate analysis were tested for confounding effects using until the third trimester [23, 24]. Generally, the current
multivariate logistic regression analysis, it was confirmed that study revealed that only 39.1% of the pregnant women
pregnant women who were Ewes (AOR: 0.68, 95% CI: 0.02- were fully adhering to anaemia prevention strategies. This
0.87, p = 0:001), Ga-Adangbe (AOR: 0.53, 95% CI: 0.09-0.90, finding is similar to a study conducted in Kathmandu,
p = 0:002), and Kussase (AOR: 0.61, 95% CI: 0.04-0.92, Nepal, which revealed that the majority of pregnant
p = 0:001) were less likely to adhere to anaemia prevention women did not adhere to practices required to prevent
strategies than women who were Akans. Also, pregnant anaemia in pregnancy [19]. However, the finding of the
women who had high knowledge of anaemia (AOR: 3.88, present study is in contrast with a study conducted among
95% CI: 1.32-7.93, p = 0:001) were more likely to adhere to pregnant women in Mecha district, Western Ethiopia [25].
anaemia prevention strategies than women who had low or This discrepancy could be that the Ethiopia study was
fair knowledge of anaemia prevention strategies (Table 3). based on pregnant women who took iron folate tablets
Journal of Pregnancy 5

Table 2: Associations between knowledge of anaemia and demographic characteristics.

Knowledge of anaemia
Variables OR (95% CI) p value AOR (95% CI) p value
Low/fair = 517 (86.5%) High = 81 (13.5%)
Subdistrict
Juaboso 136 (83.4) 27 (16.6) 1 1
Bonsu 134 (88.2) 18 (11.8) 0.49 (2.01-8.95) 0.41 (2.31-8.81) 0.004
0.003
Jato 116 (83.5) 23 (16.5) 0.71 (1.89-7.43) 0.76 (1.96-7.18) 0.002
Asempaneye 131 (91.0) 13 (9.0) 0.23 (2.15-9.30) 0.24 (2.16-9.83) 0.003
Age-group (years)
10–19 53 (73.6) 19 (26.4) 1
20–29 244 (92.1) 21 (7.9) 0.54 (0.04-7.10)
0.258
30–39 172 (88.7) 22 (11.3) 0.67 (0.11-6.88)
≥40 48 (71.6) 19 (28.4) 1.72 (0.02-3.48)
Educational status
None 105 (96.3) 4 (3.7) 1 1
Basic 240 (92.0) 21 (8.0) 2.34 (1.25-5.62) 1.78 (1.89-5.37) 0.001
0.002
Secondary 126 (81.3) 29 (18.7) 4.23 (2.33-9.89) 4.22 (2.23-9.16) 0.002
Tertiary 46 (63.0) 27 (37.0) 12.31 (10.24-17.98) 10.43 (6.14-15.63) 0.002
Marital status
Legally married 424 (90.2) 46 (9.8) 1
0.364
Cohabitation 93 (72.7) 35 (27.3) 3.59 (1.03-7.23)
Religion
Christianity 375 (91.2) 36 (8.8) 1
Muslim 94 (78.3) 26 (21.7) 5.23 (3.11-8.81) 0.347
Traditionalist 48 (71.6) 19 (28.4) 7.72 (4.30-11.33)
Ethnicity
Akan 311 (92.6) 25 (7.4) 1
Ewe 62 (78.5) 17 (21.5) 3.84 (0.51-6.61)
0.063
Ga-Adangbe 45 (71.4) 18 (28.6) 4.57 (0.33-8.15)
Kussase 99 (82.5) 21 (17.5) 2.46 (1.60-4.79)
Occupation
Unemployed 108 (90.8) 11 (9.2) 1 1
Nonformal jobs 359 (88.4) 47 (11.6) 2.48 (2.04-6.37) <0.001 2.18 (1.07-6.69) 0.001
Formal jobs 50 (68.5) 23 (31.5) 18.09 (5.42-25.28) 15.14 (13.57-18.43) <0.001
Gestational age of the pregnancy
1st trimester 133 (91.1) 13 (8.9) 1
2nd trimester 230 (86.1) 37 (13.9) 2.25 (0.84-6.17) 0.736
3rd trimester 154 (83.2) 31 (16.8) 2.62 (0.34-7.34)
Parity
0 47 (92.2) 4 (7.8) 1
1 360 (92.1) 31 (7.9) 1.67 (0.34-8.76)
0.682
2 74 (73.3) 27 (26.7) 3.74 (0.23-9.82)
≥3 36 (65.5) 19 (34.5) 6.93 (0.19-9.14)

for 90 or more days during the entire pregnancy, while woman’s knowledge of anaemia and showed that pregnant
this study was based on pregnant women who took iron women who had high knowledge were completely adhering
folate supplement within the entire duration of the preg- to anaemia prevention strategies as compared to those who
nancy. Moreover, the probable reason may be the differ- had poor knowledge. This association is an indication that
ence in geographical locations and accessibility of health the level of knowledge significantly contributed to the level
institutions in these countries. of adherence. What it means is that nonadherence occurs
There was a strong statistically significant association as a result of ignorance and inadequate knowledge a pregnant
between adherence to anaemia prevention strategies and woman has about anaemia. Consequently, sustained
6 Journal of Pregnancy

Table 3: Associations between adherence to anaemia prevention strategies and general characteristics and knowledge on anaemia.

Adherence to anaemia prevention strategies

Variables OR (95% CI) p value AOR (95% CI) p value
Partial adherence 364 (60.9) Complete adherence 234 (39.1)
Subdistrict
Juaboso 98 (60.1) 65 (39.9) 1
Bonsu 92 (60.5) 60 (39.5) 0.81 (0.03-8.76)
0.123
Jato 83 (59.7) 56 (40.3) 1.78 (0.04-5.84)
Asempaneye 91 (63.2) 53 (36.8) 0.65 (0.05-7.51)
Age-group (years)
10–19 61 (84.7) 11 (15.3) 1
20–29 160 (60.4) 105 (39.6) 4.73 (0.26-8.47)
0.237
30–39 101 (52.1) 93 (47.9) 6.65 (0.22-10.58)
≥40 42 (62.7) 25 (37.3) 4.54 (0.01-9.29)
Educational status
None 98 (89.9) 11 (10.1) 1
Basic 201 (77.0) 60 (23.0) 3.29 (0.23-7.67)
0.371
Secondary 58 (37.4) 97 (62.6) 7.57 (0.11-11.32)
Tertiary 7 (9.6) 66 (90.4) 8.24 (0.64-14.56)
Marital status
Legally married 262 (55.7) 208 (44.3) 1
0.421
Cohabitation 102 (79.7) 26 (20.3) 0.48 (0.07-11.43)
Religion
Christianity 248 (60.3) 163 (39.7) 1
Muslim 52 (43.3) 68 (56.7) 2.12 (0.03-4.45) 0.394
Traditionalist 64 (95.5) 3 (4.5) 0.32 (0.02-11.41)
Ethnicity
Akan 181 (53.9) 155 (46.1) 1 1
Ewe 51 (64.6) 28 (35.4) 0.69 (0.01-0.89) 0.68 (0.02-0.87) 0.001
0.001
Ga-Adangbe 53 (84.1) 10 (15.9) 0.51 (0.07-0.91) 0.53 (0.09-0.90) 0.002
Kussase 79 (65.8) 41 (34.2) 0.67 (0.06-0.92) 0.61 (0.04-0.92) 0.001
Occupation
Unemployed 76 (63.9) 43 (36.1) 1
Nonformal jobs 274 (67.5) 132 (32.5) 0.07 (0.13-2.43) 0.321
Formal jobs 14 (19.2) 59 (80.8) 3.21 (0.28-7.25)
Gestational age of the pregnancy
1st trimester 89 (61.0) 57 (39.0) 1
2nd trimester 169 (63.3) 98 (36.7) 0.72 (0.19-8.03) 0.408
3rd trimester 106 (57.3) 79 (42.7) 1.94 (0.21-3.67)
Parity
0 39 (76.5) 12 (23.5) 1
1 280 (71.6) 111 (28.4) 1.67 (0.17-3.92)
0.421
2 41 (40.6) 60 (59.4) 3.34 (0.62-4.27)
≥3 4 (7.3) 51 (92.7) 7.56 (0.41-9.18)
Knowledge of anaemia
Low/fair 355 (68.7) 162 (31.3) 1 1
0.001
High 9 (11.1) 72 (88.9) 4.12 (2.76-8.66) 3.88 (1.32-7.93) 0.001

education of pregnant women on anaemia and its preventive in Ethiopia [25]. Again, pregnant woman’s ethnicity was sig-
strategies are central to maximize adherence to anaemia nificantly associated with adherence to anaemia prevention
prevention strategies. Also, these findings are in harmony strategies. This finding agrees with Barroso et al. and the
with a study conducted in Mecha district, Western Amhara Belgium studies [26, 27].
Journal of Pregnancy 7

This study also revealed significant associations between Data Availability

where a pregnant woman resides in the district, woman’s
educational, and occupational status. The finding indicated Answer: Yes. Comment: The data used to support the
that pregnant women who went to school were more likely findings of this study can be made available from the corre-
to have high knowledge of anaemia than women who never sponding author upon request.
went to school. This revelation agrees with the studies in
India and Pakistan [28–30]. Again, the current study showed Conflicts of Interest
that pregnant women who had jobs were more likely to be
associated with high knowledge of anaemia as compared to The authors to this work declare that they have no conflict of
women who were not employed, with a study showing that interest regarding the study and the publication of this paper.
people who have low economic are more likely to suffer from
anaemia [31]. This could be due to the fact that education Acknowledgments
level attained is required in job seeking, which in turn
increases earning power of those employed and also increases The authors express their appreciations to the Juaboso
their number of ANC visits at the health facilities where edu- District Director of Health Service for granting us the per-
cation on anaemia prevention is always given. mission to carry out the study in his jurisdiction, and also
to the heads of antenatal clinics in the area, as well as all
participants. Funding for the study and its publication is per-
5. Conclusion sonal contributions from the authors.

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