INTRODUCTION

Background of the Study

Pregnancy as a condition which is peculiar only to a woman it is a

state of being pregnant; being pregnant is the act of a woman having a

child developing in her womb. Some of the problems encountered by

pregnant women are much but some of them are: hypertensive

disorder asthma heart diseases diabetes mellitus epilepsy thyroid

dysfunction and anaemia which can be induced by pregnancy.

Anaemia in pregnancy is a topic which the researcher is looking

into the strategies of reducing it’s occurrence among the pregnant

women who attends antenatal clinic at Dr. Gwamna Awan General

Hospital Kakuri. Anaemia is the most common medical disorder of

pregnancy. Anaemia result as a reduction of the oxygen carrying

capacity of the blood when it occurs the heart tries to compensate by

increasing the cardiac output this effect increases the workload of the

heart and stresses ventricular function therefore anaemia occurs (for

example pre-eclampsia may result in congestive heart failure).

Anaemia can be defined as a reduction below normal in the

number of red blood corpuscles per cubic millimeter the quantity of

haemoglobin and the volume of packed red cell per 100ml of blood. The

average female patient in health has a heamoglobin of 14.5 grams per

100ml of blood (cent per cent Hb) 450000 RBC per cubic millimeter of

blood and packed cell volume of 45 percent. Sometimes these values

are considerably reduced during pregnancy and the condition of

anaemia in pregnancy result.

Folic acid deficiency is the most important cause of non

heamorrhagic anaemia in pregnancy. Approximately 90 percent of cases

of anaemia in pregnancy are of the iron deficiency type; the remaining

10 percent of cases embrace a considerably variety of acquired and

hereditary anaemia including folic acid deficiency sickle cell anaemia and

thalassemia.

In pregnancy anaemia can also be caused as a result of increase

demands of iron diminished intake of iron disturbed metabolism

pre-pregnant healthy status excess demand in multiple pregnancy

women with rapidly reoccurring pregnancy teenage pregnancy

polymorphism and loss of blood due to bleeding from haemorrhoids

(pile) or stomach ulcer.

Anaemia can be classified into two major groups namely

physiological anaemia of pregnancy and pathological anaemia.

The pathological anaemia is divided into six groups namely:

deficiency anaemia which comprises of iron deficiency folic acid

deficiency vitamin B12 deficiency and protein deficiency the second

group is haemorrhagic anaemia which could be due to acute

(antepartum haemorrhage) chronic (hook worm infestation bleeding

and piles etc). The third group is hereditary which could be

thalassemia sickle cell anaemia haemoglobinopathies. Fourth group is

bone marrow insufficiency (Aplasia due to radiation drugs e.g. asprin).

The fifth group is anaemia of infection (malaria tuberculosis) and the

sixth group which is the last under pathological anaemia is chronic

diseases or neoplasm.

The physiological anaemia – There is disproportional increase of

plasma volume during pregnancy leading to apparent reduction of red

blood cell haemoglobin and haemotocrit level. The onset of anaemia in

pregnancy depends on the state of the stored iron in the body before

pregnancy which largely determine whether or not how soon a pregnant

woman will become anaemic.

According to World Health Organization (WHO) anaemia ranges

from mild moderate to severe and WHO pegs the heamoglobin level for

each type of anaemia in pregnancy at 10.0 – 10.9g/dL (mild anaemia)

7-9.9g/dL (moderate anaemia) and< 7g/dL (severe anaemia).

The prevalence of anaemia according to WHO estimated that

about 40% of the world population (more than 2 billion individuals)

suffer from anaemia. The group with the highest prevalence are

pregnant women and the elderly about 50%; infant and children of 1-2

years 48% school children 40% non-pregnant women 35% adolescent

30-55% and preschool children 25% it is apparent that the prevalence

of anaemia in developing countries which Nigeria (where the researcher

is located) is about four times that of developed countries with high

incidence and security occurring among primigravida living in malaria

endemic areas.

Table 1: Below is a Table Showing Limit used to Define

Anaemic Based on WHO/UNCEF/UNU (1996)

Recommendation

Age or Gender Group Hb Below (g/L Haematocrit Below

Children 6 months – 5 years

Children 5 – 11 years

Children 12 – 13 years

Non-pregnant women

Pregnant women

Men

110

115

120

120

110

130

33

34

36

36

33

39

The current strategic measures employed to reduce anaemia in

pregnancy are as follows:

● Early identification by the midwife

● Proper history taking

● Dietary advice mostly proteinous food

● Health education on food rich in iron. NB (coffee and tea inhibit

absorption of iron)

● Prevent malaria which is the major cause in haemolytic anaemia

● Advice to cook vegetables well and administration of iron drugs

with vitamin B complex during and after pregnancy.

Statement of the Problem

In the hospital where this study is carried out it has been

observed that between years 2008-2010 the number of recorded cases

of anaemic pregnant women has increased by 30%. This has increase

the risk of intrauterine growth retardation perinatal morbidity and

mortality to the child and reduces resistance to infection post partum

haemorrhage and heart failure a potential threat to life of the mother

and at the end it may lead to maternal mortality leaving he child to the

fate of motherless baby. If actions and preventive measures are not

employed it will lead to increase fetal/maternal morbidity and mortality

which will have adverse effect on the child family and the nation at

large. Therefore there is need for this study.

Purpose of the Study

The general purpose of this study is to determine the strategies for

reducing anaemia among pregnant women attending antenatal clinic in

Dr. Gwamna Awan General Hospital Kakuri Kaduna state. Specifically

the study will find out

● Awareness of the women on common causes of anaemia in

pregnancy among women attending antenatal clinic in Dr. Gwamna

Awan General Hospital Kakuri Kaduna state.

● Adequacy of the present effort to reduce anaemia in pregnancy in

the above hospital.

● Strategies for eradicating anaemia in pregnancy

Significance of the Study

The findings of this study will be beneficial to the following.

Firstly the women (pregnant women) what adequate care health

education are giving on food adequate haematinics and close

monitoring or follow up on pregnant women there will be reduction in

the rate of anaemia in pregnancy thereby reducing maternal

morbidity/mortality. Secondly the child will benefit right from the utero

because the stages of development will not be interrupted there will no

growth retardation and so congenital abnormalities such as spinal cord

defect (spinal bifida) which occur as a result of lack of folic acid thirdly

to the nation at large the rate at which men become widower will be

reduce some women are breadwinner if we safeguard them from dying

as a result of anaemia it will help the family and it will increase the

manpower for a healthy nation.

Scope of the Study

This study will be limited to: what anaemia is the brief anatomy

and physiology of red blood cells and how hemodilution occur during

pregnancy. It will also state the causes of anaemia the clinical

manifestation of an anaemic pregnant woman some overviews of

related literatures investigations that needed to be carried out

management of anaemia in pregnancy and in conclusion it will also tell

us the complications and prognosis of anaemia in pregnancy.

Research Questions

The research questions for this stated problem are as follows:

● What are the common causes of anaemia in pregnancy among

women attending antenatal clinic in Dr. Gwamna Awan General

Hospital Kakuri Kaduna state.

● How adequate are the present effort designed to reduce anaemia

in pregnancy in the above hospital.

● What are the strategies for eradicating anaemia in pregnancy.