Prevalence and obstetric factors associated with anaemia among pregnant women, attending antenatal care in Unguja island, Tanzania

Mwanaisha M. Ali, Agatha F. Ngowi, Nyasiro S. Gibore


Background: Anaemia in pregnancy remains a major health problem with adverse maternal and fetal outcome worldwide, especially in developing countries such as Tanzania. The study aimed to establish prevalence and obstetric factors associated with anaemia among pregnant women attending antenatal care visits in Unguja Island, Tanzania.

Methods: This cross sectional survey used systemic random sampling in three hospitals of Unguja Island to select 388 pregnant women. Demographic and obstetric characteristics of respondents were collected using a structured questionnaire. Hemoglobin levels were measured by using Hemocue machine. Multivariate logistic regression analysis was carried out in SPSS version 21.0 to measure obstetric factors associated with anaemia among pregnant women.

Results: The overall prevalence of anaemia among pregnant women was 80.8%, whereby 68.64% of respondents had mild anaemia, 11.24% had moderate anaemia and 0.89% had severe anaemia. The factors associated with anaemia in pregnancy were gravidity, (AOR= 1.185, 95% CI=0.317-4.338, p<0.001), irregular taking of iron tablets (AOR=0.288, 95% CI=0.149-0.556, p<0.001) and age of the child <2 years, (AOR 3.635, 95% CI= 1.103-11.882, p<0.034).

Conclusions: The prevalence of anaemia among pregnant women in Unguja is high. Timely and regular intake of iron tablets during pregnancy, child spacing as well as having children within the capacity of parents to raise them up may significantly reduce the prevalence of anaemia in pregnancy. Therefore health education on family planning and the importance of taking of iron tablet is critical.


Anaemia, Maternal anaemia, Obstetric factors, Tanzania, Unguja

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World Health Organization. Guideline: Daily iron and folic acid supplementation in pregnant women, 2012. Available at publications/micronutrients/guidelines/daily_ifa_supp_pregnant_women/en/. Accessed 9 August 2018.

Barooti E, Rezazadehkermani M, Sadeghirad B, Motaghipisheh S, Arabi M, Salahi S, et al. Prevalence of iron deficiency anemia among Iranian pregnant women; a systematic review and meta-analysis. J Reprod Infertil. 2010;11(1):17.

Ghimire N, Pandey N. Knowledge and practice of mother regarding the prevention of anaemia during pregnancy, in teaching hospital, Kathmandu. J Chitwan Med Coll. 2013; 3(5):14-7.

Gebre A, Mulugeta A. Prevalence of anemia and associated factors among pregnant women in North Western zone of Tigray, Northern Ethiopia: a cross-sectional study. J Nutr Metab. 2015;2015:165430.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), [Tanzania Mainland, Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) and ICF. 2015-16 Tanzania Demographic and Health Survey-Malaria Indicator Survey Key Findings. Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF. 2016.

Rahmati SH, Delpisheh A, Parizad N, Sayehmiri K. Maternal Anemia and Pregnancy outcomes: a Systematic Review and Meta-Analysis. International J Pediatrics. 2016;4(8):3323-42.

World Health Organization. Haemoglobin Concentrations for the diagnosis of anaemia and assessment of severity. Available at: Accessed on 04 Feb, 2018.

Sharma JB, Shankar M. Anemia in Pregnancy. JIMSA. 2010;23(4):253-60.

Hassan AA, Mamman AI, Adaji S, Musa B, Kene S. Anemia and iron deficiency in pregnant women in Zaria, Nigeria. Sub-Saharan Afr J Med. 2014;1:36-9.

Dutta DC. Anaemia in pregnancy. Text book of Obstetrics including Perinatology & Contraception, 8th edition ISBN: 978-93-5152-723-7. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd; 2015.

Haniff J, Das A, Onn LT, Sun CW, Nordin NM. Anaemia in pregnancy in Malaysia: A cross-sectional survey. Asia Pac J Clin Nutr. 2007;16:527-36.

Noronha JA, Bhaduri A, Vinod Bhat H, Kamath A. Maternal risk factors and anaemia in pregnancy: A prospective retrospective cohort study. J Obstet Gynaecol. 2010;30:132-6.

National Bureau of Statistics. The 2012 population and housing census for the United Republic of Tanzania. September, 2013.

Loy SL, Marhazlina M, Nor Azwany Y, Hamid Jan JM. Development , Validity and Reproducibility of a Food Frequency Questionnaire in Pregnancy for the Universiti Sains Malaysia Birth Cohort Study. Mal J Nutr. 2011;17(1):1-18.

Hinderaker SG, Olsen BE, Bergsjø P, Lie RT, Gasheka P, Kvåle G. Anemia in pregnancy in the highlands of Tanzania. Acta Obstet Gynecol Scand. 2001;80(1):21.

WHO, UNICEF, UNU. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. Geneva: World Health Organization; 2001. Available at: Accessed on 13 April, 2018.

Getahun W, Belachew T, Wolide AD. Burden and associated factors of anemia among pregnant women attending antenatal care in southern Ethiopia : cross sectional study. BMC Res Notes. 2017;10:276.

Abiselvi A, Gopalakrishnan S, Umedevi R, Rama R. Socio-demographic and obstetric risk factors of anaemia among pregnant women in rural Tamil Nandu. Int J community Med Public Health. 2018;5:721-7.

Hasswane N, Bouziane A, Mrabet M, Laamiri FZ, Aguenaou H, Barkat A. Preva-lence and Factors Associated with Anemia Pregnancy in a Group of Moroccan Pregnant Women. J Biosci Med. 2015;3:88-97.

Ministry of Health, Community Development, Gender, Elderly and Children: 2015-16 TDHS-MIS Key Findings. [Tanzania Mainland, Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) and ICF. 2016. Rockville, Maryland, USA, 2016.

Msuya SE, Hussein TH, Uriyo J, Sam NE, Stray-Pedersen B. Anaemia among pregnant women in northern Tanzania: prevalence, risk factors and effect on perinatal outcomes. Tanzan J Health Res. 2011;3(1):33-9.

Belghith N, Belhaj H, De Boisseson, Pierre-Marie A. Zanzibar poverty assessment. 2017. Washington, D.C.: World Bank Group. Available at: Accessed on 22 February 2018.

Stoltzfus RJ, Chwaya HM, Montresor A, Albonico M, Savioli L, Tielsch JM. Malaria, hookworms and recent fever are related to anemia and iron status indicators in 0- to 5-years old Zanzibari children and these relationships change with age. J Nutr. 2000;130:1724-33.

Mirzaie F, Eftekhari N, Goldozeian S, Mahdavinia J. Prevalence of anemia risk factors in pregnant women in Kerman, Iran. IJRM. 2010;8(2):66–9.

Bizuneh A, Befekadu A. Assessment of Prevalence and Risk Factors for Anemia Among Pregnant Mothers Attending Anc Clinic at Adama Hospital Medical Collage, Adama, Ethiopia, 2017. J Gynecology Obstetrics. 2018;6(3):31-39.

Bekele A, Tilahun M, Mekuria A. Prevalence of Anemia and Its Associated Factors among Pregnant Women Attending Antenatal Care in Health Institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia: A Cross-Sectional Study. Anemia. 2016;1-9.

Abel G, Afework M. Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study. J Nutr Metab. 2015;2015:1-7.

Sam O, Oona C, Florence M. Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda. BMC Res Notes. 2014;7:712.

Nwizu EN, Iliyasu Z, Ibrahim SA, Galadanci HS. Socio-Demographic and Maternal Factors in Anaemia in Pregnancy at Booking in Kano, Northern Nigeria. Afr J Reprod Health. 2011;15(4):33-41.

Vivek RG, Halappanavar AB, Vivek PR, Halki SB, Maled VS, Deshpande PS. Prevalence of Anaemia and its epidemiological Determinants in Pregnant Women. AJMS. 2012;5(3):216–23.

Khan DA, Fatima S, Imran R, Khan FA. Iron, folate and cobalamin deficiency in anaemic pregnant females in tertiary care centre at Rawalpindi. J Ayub Med College Abbottabad. 2010;22(1):17–21.

Anuragamayi Y, Kumari K. Prevalence and Risk Factors of Anemia among Pregnant Women Attending a High-Volume Tertiary Care Center for Delivery. IOSR J Dental and Med Sci. 2017;16(12):56–60.

Mangla M, Singla D. Prevalence of anaemia among pregnant women in rural India : a longitudinal observational study. IJRCOG. 2016;5(10):3500–5.

Bereka SG, Gudeta AN, Reta MA, Ayana LA. Prevalence and Associated Risk Factors of Anemia among Pregnant Women in Rural Part of JigJiga City , Eastern Ethiopia : A Cross Sectional Study. J Pregnancy Child Health. 2017;4(337).

Lubeya M K, Walika B V. Anaemia in Pregnancy among Pregnant Women in Lusaka District, Zambia. Medical J Zambia. 2017;44(4):238–43.

Chikwendu MC, Nkemena B, Udigwe GO, Obiechina NJA, Nnaji GA. Risk factors for anaemia in pregnancy at the first antenatal clinic visit at Nnamdi Azikiwe university teaching hospital, Nnewi. Tropical J Obstetrics Gynaecol. 2015;32(1).

Tomar GS, Singhal S, Shukla Al. Anemia in pregnancy : Epidemiology and it’s determinants. Int J Med Health Res. 2017;3(1):5-9.

Kassa GM, Muche AA, Berhe AK, Fekadu G A. Prevalence and determinants of anemia among pregnant women in Ethiopia ; a systematic review and meta-analysis. BMC Hematol. 2017;17(17).

Abdelhafez AM, El-Soadaa SS. Prevalence and risk factors of anemia among a sample of pregnant females attending primary health care centers in Makkah, Saudi Arabia. Pak J Nutr. 2012;11(12):1113–20.