Anemia Among Women Using Family Planning at Public Health Facilities in Ambo Town, Central Ethiopia: Multi-Center Cross-Sectional Study

Abstract

Background

Anemia affects more than a quarter of non-pregnant women over the globe, with Sub-Saharan Africa bearing a disproportionate share. Although the use of family planning is beneficial in reducing anemia, lack of scientific study on anemia among family planning users of reproductive-age women is notable, particularly in the study setting. The purpose of this study was to determine the extent of anemia and associated factors in women who used family planning.

Methods

A cross-sectional multi-centered study was conducted from March 3 to 29, 2019, among 443 non-pregnant reproductive age (15 to 49 years) women receiving family planning services in Ambo town. Sample size was calculated using Epi-info version 7 software. Participants were selected by systematic random sampling technique. Trained data collectors collected data using a structured pretested questionnaire, as well as venous blood and stool samples. Epi-Data and SPSS were used to enter and analyze data. The effect of independent variables on the outcome variable was determined by binary logistic regression analysis with adjusted odds ratio at 95% confidence interval and 5% margin of error. P-value <0.05 was used to declare statistical significance.

Results

This study revealed 28% (95% CI:23.9%, 32.3%) magnitude of anemia. Age of 25–35 years [AOR:2.84, 95% CI:1.74, 4.64], implantable family planning method [AOR: 0.34, 95% CI: 0.12, 0.96], no previous use of family planning [AOR:2.62, 95% CI: 1.62, 4.24], household food insecurity [AOR: 2.04, 95% CI: 1.06, 3.93], parasite infestations [AOR:2.01, 95% CI: 1.12, 3.63], and regular intake of coffee/tea within 30 minutes post meal [AOR:3.85, 95% CI:1.24, 11.92] were independently associated with anemia.

Conclusion

Anemia is a moderate public health concern among reproductive-age women receiving family planning services in the study area. There are missed opportunities to address the anemia burden during family planning services. This study emphasizes the importance of nutritional screening for early detection and targeted interventions for healthcare workers in reducing missed opportunities to prevent and control anemia in vulnerable populations.

Keywords:

• anemia
• family planning
• reproductive age women
• Ambo
• Ethiopia

Abbreviations

AOR, Adjusted Odds Ratio; CI, Confidence Interval; COR, Crude Odds Ratio; EDHS, Ethiopian Demographic Health Survey; FANTA, Food and Nutrition Technical Assistance Project; FAO, Food and Agriculture Organization of the United Nations; FCS, Food Consumption Score; FP, Family planning; HDDS, Household Dietary Diversity Score; HFIAS, Household Food Insecurity Access Scale; IUCD, Intra Uterine Contraceptive Device; LMICs, Low and middle-income countries; MDD, Minimum Dietary Diversity; MDD-W, Minimum Dietary Diversity for Women of Reproductive Age; MOH, Ministry of Health; NPW, Non-pregnant women; OCP, Oral Contraceptive Pills; WDDS, Women Dietary diversity score; WRA, Women of Reproductive Age.

Data Sharing Statement

All datasets pertinent to the work are included within the article. Detailed raw data analyzed for the work reported can be available from the corresponding author upon reasonable request.

Ethical Approval and Consent to Participate

This research was carried out in accordance with the Helsinki Declaration. Haramaya University’s Institutional Health Research and Ethics Review Committee granted ethical approval. All study participants aged 18-49 years provided written, voluntarily signed consent and parental informed consent was obtained for study participants aged 15–18-year-old after being informed about the study’s goal, risks, and benefits. No personal identifiers used throughout the execution of the study. Standard safety measures were implemented strictly during the data collection process.

Acknowledgments

The authors expressed their heartfelt gratitude and humble appreciation to Haramaya University for giving ethical permission and financially supporting data collection. All study respondents, data collectors, and supervisors who made this study feasible were also grateful. Finally, all cooperative staffs of the Ambo town health bureau and public health facilities, as well as all individuals who contributed directly or indirectly to the accomplishment of the study were thankful.

Author Contributions

All authors made substantial intellectual contributions to the work reported, whether in the conception, study design, execution and acquisition of data, analysis, and interpretation, or in all of these parts; participated in drafting the manuscript, critical review or revision of the article; have read and approved the final version; selected and settled the journal to which the article submitted; and approved accountability in all aspects of the work reported.

Disclosure

The authors declare that there is no financial or other competing interest that can be constructed as a potential conflict of interest in the work reported.

Additional information

Funding

This work was financially supported by Haramaya University. The funder had no role in the study selection, data collection, analysis, conclusion, interpretation and manuscript writing.