Maternal knowledge and practices related to anaemia and iron supplementation in rural Malawi: A cross-sectional study

Abstract

Anaemia is a leading cause of maternal morbidity, mortality and poor birth outcomes
in developing countries. In Malawi, education on anaemia and provision of
prophylaxis iron supplements during pregnancy are key strategies that are used to
reduce the high prevalence of anaemia in this population. Therefore, as part of
Surveillance of Micronutrient Programmes in Malawi, a cross-sectional study was
done to assess maternal knowledge and practices related to anaemia and iron
supplementation in rural areas. A total of 629 (mean age 27.9 years) randomly
selected women were interviewed in the Northern, Central and Southern regions using
a pre-tested questionnaire. The data were entered in EpiInfo 6.04d and analyzed in
SPSS 9.0 for Windows. The results showed that 96.6% of the women were aware of
anaemia, with at least two thirds knowing its causes, ways of prevention, and
treatment. As expected, health facilities are the primary source of iron supplements
(97.1%). On whether or not pregnant women actually take the supplements, the study
found that 22.5%, 29% and 33.8% of women from the Central, Northern and Southern
regions, respectively reported taking the supplements for one month only during their
most recent pregnancy (χ2=6.79, p=0.009). Overall, about 9% reported taking the
supplements throughout pregnancy, but the proportion was higher (22.5%) in the
Central than the Southern (2.5%) and Northern (0.5%) regions. The single most
important reason for non-compliance was nausea (43.6%), with 34.9% of those
reporting nausea resorting to withdrawal. On a positive note, 47.4% of women from
the Southern region reported taking the supplements with nsima (stiff maize gruel) to
overcome nausea. Therefore, this study shows that Malawi's efforts to increase
awareness on anaemia in women of reproductive age in rural areas are largely
effective. However, non-compliance with iron supplementation is a big challenge
which requires strategic planning and implementation of ways to ensure that pregnant
women consistently take iron supplements throughout pregnancy.

Keywords: anaemia, knowledge, iron, Malawi, pregnancy.

AJFAND Vol. 9 (1) 2009: pp. 551-564