Anemia and Associated Factors Among Lactating Women in Sierra Leone: An Analysis of the Sierra Leone Demographic and Health Survey 2019

Ivan Kato Arinda; Quraish Sserwanja; Kassim Kamara; David Mukunya; Napyo Agnes; Nsubuga Edirisa Juniour; Nuwahereza Christinah; Anitah Kagali; Seungwon Lee

doi:10.1177/11786388221105732

Anemia and Associated Factors Among Lactating Women in Sierra Leone: An Analysis of the Sierra Leone Demographic and Health Survey 2019

Nutr Metab Insights. 2022 Jun 16:15:11786388221105732. doi: 10.1177/11786388221105732. eCollection 2022.

Authors

Ivan Kato Arinda¹, Quraish Sserwanja², Kassim Kamara³, David Mukunya⁴, Napyo Agnes⁴, Nsubuga Edirisa Juniour⁵, Nuwahereza Christinah⁶, Anitah Kagali⁴, Seungwon Lee⁷

Affiliations

¹ Department of Nutrition Research, Nutri-worth International, Kampala, Uganda.
² Programmes Department, GOAL, Khartoum, Sudan.
³ Directorate of Health Security and Emergencies, Applied Epidemiology and Disease control, Ministry of Health and Sanitation, Sierra Leone, Freetown, Sierra Leone.
⁴ Department of Public Health, Busitema University, Mbale, Uganda.
⁵ Field Epidemiology, Ministry of Health, Uganda.
⁶ Department of Community Health and Behavioural Sciences, Makerere School of Public Health, Kampala, Uganda.
⁷ Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA.

Abstract

Background: Anemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual's physiological needs. The prevalence of anemia among women of reproductive age is high in Sub-Saharan Africa (SSA), including Sierra Leone. However, data on anemia among lactating women in Sierra Leone are scarce. Therefore, this study was conducted to estimate the prevalence of anemia and determine its associated factors among lactating women in Sierra Leone.

Methods: The 2019 Sierra Leone Demographic and Health Survey (SLDH) data were used of which 1543 lactating women aged 15 to 49 years old had hemoglobin measurements. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariate binary logistic regression was used to determine factors associated with anemia among lactating women in Sierra Leone.

Results: The general prevalence of anemia among lactating women in Sierra Leone was 52.9% (95% CI = 50.9-55.8). Almost a quarter, 23.8% (95% CI = 22.1-26.3) of the lactating women had mild anemia, 27.4% (95% CI = 25.3-29.7) had moderate anemia and 1.7% (95% CI = 1.1-2.5) had severe anemia. The use of modern contraceptives (aOR = 1.64, 95% CI = 1.09-2.47), not being visited by a field worker in the past year (aOR = 1.51, 95% CI = 1.12-2.03) and being Muslim (aOR = 1.46, 95% CI = 1.11-1.91), were associated with higher odds of being anemic. Being given and having bought iron supplements during pregnancy (aOR = 0.46, 95% CI = 0.25-0.87) was associated with less odds of being anemic.

Conclusion: More than half of the lactating mothers in our study were anemic. The risk factors for anemia in our study included: use of modern contraceptives, not being visited by a field worker in the past year and being Muslim. Receiving iron supplements during pregnancy was protective against anemia. According to the results from this study, the recommendation for lactating women was to maintain routine interface with the healthcare system which includes being visited by a field worker who should prescribe and issue iron supplements to them. Lactating women especially Muslims should receive routine nutrition education by the health workers at the health facilities during antenatal care visits or postnatal care in regard to anemia and means of prevention and treatment. Community stakeholders should also work in collaboration to establish scalable methods to correctly identify pregnant women with risk factors, inform them about anemia with caution, and apply appropriate measures as trained or instructed.

Keywords: Anemia; lactating women and Sierra Leone.