Search

Background: The estimated burden of maternal morbidities in lower-income countries, such as Madagascar, is high. However, there is still a lack of data on maternal morbidities, in part due to an absence of standardized assessment tools. This cross-sectional study aims to report maternal morbidities among 1015 women in the district of Ambanja, Madagascar, and to describe the advantages and limitations of a mHealth system. Methods: Data were collected using the PANDA (pregnancy and newborn diagnosis assessment) system, an mHealth device that incorporates the WHO recommendations for antenatal care (ANC). Data, including personal and medical information, but also clinical data such as hypertension, anemia or HIV were collected from more than 1000 women attending ANC. Results: A total of 1015 pregnant women were recruited from January 2015 to August 2018. The average age was 24.6 years old, and most women were married (82.3%). The majority lived in urban areas and were unemployed. Prevalence of hypertension and gestational diabetes was relatively low (4% vs 2.2%). Malaria infection was diagnosed in 2.2% and HIV was diagnosed in 1.2% of pregnant women. The most common morbidity was anemia (68.4%) and the only significant factor associated was being single compared to being married (OR 1.68, 95% CI 1.05– 2.70, p-value 0.032). Discussion: The prevalence of anemia in our study population was much higher than previously reported in Sub-Saharan Africa. This finding highlights the need for regular iron supplementation during pregnancy, especially in vulnerable (eg, single) women. The PANDA mHealth system provides unique opportunities due to its standardization of ANC and creation of a digital database accessible from a distance. However, one of the main challenges was that even a mHealth system such as the PANDA remains dependent on the local procurement chain. Therefore, future studies need to access opportunities of mHealth systems to support health service delivery. Trial Registration: Registered on ISRCTN on 14th October 2015, number ISRCTN18270380. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby. Objective: To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia. Methods: An institution-based unmatched case–control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p< 0.05. Results: Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1– 2 times a month [AOR=7.245; 95% CI=(2.007– 26.151)] or not at all [AOR=8.690; 95% CI=(1.795– 42.072)]), and insufficient consumption of green vegetables (i.e. 1– 2 times a week [AOR=2.970; 95% CI=(1.012– 8.716)] or 1– 2 times a month [AOR=8.057; 95% CI=(2.358– 27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240– 51.526)] with anemia. Conclusion: This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries. [ABSTRACT FROM AUTHOR]