Anaemia Among Pregnant Women in Hospitals in Nigeria

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Anaemia during pregnancy is a significant health issue that impacts the well-being of both pregnant women and their fetuses. It is a state where there is less haemoglobin in the blood than what the body needs to satisfy its oxygen demand. In pregnancy, anaemia is usually measured through blood haemoglobin concentration and, in general, anything below 110g/L is a cut-off point for the diagnosis of anaemia. This can occur due to various factors including nutritional factors infections hereditary blood disorders, illnesses, and other medical issues. Iron deficiency is one of the most significant factors that contribute to anaemia, mostly for pregnant women (World Health Organization [WHO], 2025a).

However, there are many people with anaemia in the world. According to the global estimates from WHO on 2023, in 2023, about 35.5% of women during pregnancy aged (1549 years) had anaemia in the world. WHO believes that there is insufficient progress towards the global goal for the reduction of anaemia in women in reproductive age (WHO, 2025a). This explains why there is still a need to prevent and diagnose and treat anaemia particularly in the countries where there are nutritional deficiencies in women during pregnancy..

Anaemia in pregnancy is of serious concern in Nigeria due to the increased risk of nutritional deficiency, multiple pregnancies, malaria, and other infections, and challenges encountered by pregnant women in accessing timely antenatal care. The magnitude of these issues varies with different regions and different socioeconomic groups. Studies based on hospitals are so crucial in measuring the burden of anaemia among women attending antenatal clinics..

Recent data from Nigeria also sheds light on this issue. Saliu et al. (2025) explored iron deficiency anaemia and related risk factors in pregnant women visiting the antenatal clinic at Aminu Kano Teaching Hospital in Kano State. In their longitudinal study conducted among 112 pregnant women in the second and third trimesters, they evaluated iron status indicators, characteristics of the mother, dietary practices, as well as iron and folic acid supplementations..

Anaemia can develop or deteriorate in pregnancy, from an increased blood volume in the mother, and increasing requirement of iron and other nutrients. While a degree of haemoglobin fall can be a normal physiological occurrence in pregnancy, in cases of clinical anaemia it helps to evaluate the case to confirm the cause and its severity. Symptoms like fatigue, weakness, dizziness, headaches, and shortness of breath may occur. Some women with anaemia may have no symptoms at all, so regular antenatal checks are important.

However, there are other consequences beyond the well-being of mothers when anaemia remains unattended. When severe, anaemia reduces the tolerance of blood loss at childbirth and might cause more risks to mothers. Anaemia, particularly that caused by iron deficiency, has been associated with negative outcomes of pregnancy such as premature birth and low birth weight. "Maternal health care and iron and folic acid supplementation are recognized as essential prevention and management techniques for anaemia during pregnancy" according to WHO (2025b). Maternity healthcare is a vital part of this process that entails regular measurement of haemoglobin levels, delivery instruction, consultation with a dietitian, identification of the underlying causes, and treatment of the problem. Nevertheless, proper management of anaemia will be contingent upon early detection of the condition, compliance with additional therapies, and overall maternal care during pregnancy. Studies conducted on anaemia among pregnant women attending hospitals in Nigeria will be highly beneficial for improving antenatal care services. Therefore, this study focuses on the prevalence, possible factors, and consequences of anaemia in pregnant women attending hospitals in Nigeria.

1.2 Statement of the Problem

Pregnant anaemia continues to be a significant issue for maternal health and one that requires constant consideration by the health care providers. This is despite the existence of antenatal screening, dietary information, iron and folic acid tablets as interventions for pregnant women. Pregnant anaemia may occur as some women may have anaemia when pregnant as a result of late antenatal booking, poor dieting, non-compliance to prescribed treatment, infections and unavailability of diagnostic services.

The question is not only about having anaemia, but rather whether the hospitals can screen, diagnose and manage these women in the early stages of their pregnancies. The findings from one hospital may not be generalisable throughout the country of Nigeria because of the variability of the prevalence and factors associated with it..

In addition, evidence from hospital studies in Nigeria, for example the one conducted by Saliu et al. (2025) show that it helps to investigate iron levels and other related factors in pregnant women attending for antenatal care. Importantly results from one health facility should not be extrapolated to every hospital in Nigeria.

As a result of this a study of anaemia in pregnant women attending the hospital is needed to estimate the burden of anaemia in the hospital setting, identify appropriate risk factors and generate evidence to inform potential interventions for screening, prevention, and treatment.

1.3 Aim and Objectives of the Study

The aim of this study is to assess anaemia among pregnant women attending antenatal care in a selected hospital in Nigeria.

The specific objectives are to:

1.         Investigate the prevalence of anaemia in the pregnant population visiting the chosen hospital.

2.         Ascertain the possible socio-demographic and obstetric determinants of anaemia.

3.         Study the association between anaemia and the identified maternal variables such as age, gestational age and parity.

4.         Ascertain pregnant women’s knowledge about the prevention and treatment of anaemia.

5.         Ascertain the possible barriers to the prevention and management of anaemia in pregnancy.

1.4 Research Questions

1. How common is anaemia in pregnant women attending the hospital?

2. What sociodemographic and obstetric factors are tied to anaemia among these women?

3. Are anaemic and the maternal features like age, gestational age and parity associated?

4. What do pregnant women know about the prevention and management of anaemia?

5. What challenges affect the prevention and management of anaemia among pregnant women?

1.5 Significance of the Study

The findings suggest that expecting mothers could be helped by improving awareness about early pregnancy care nutrition screening as well as compliance to treatment. The healthcare personnel might use these findings to emphasize patient education, screen-out women in need of evaluation and boost follow-up.

The findings could also be of help to hospital administrators and public health decision makers in the formulation of maternal health interventions and in directing resources towards laboratory testing, nutritional counselling and antenatal care services. The study may act as a benchmark for future research on maternal anaemia in Nigeria.

1.6 Scope of the Study

The study will be conducted among pregnant women attending the antenatal clinic of a designated hospital in Nigeria. This will be explored: occurrence of anaemia, selected sociodemographic and obstetric characteristics, awareness of the prevention and other potential factors linked to the illness. Data collection may entail the use of questionnaires, medical records and haemoglobin findings, as stipulated by the approved research design and available facilities.

The conclusion of this study will be limited to the hospital selected and should not be generalized to ALL pregnant women in Nigeria.

Most recently, a 2026 systematic review and meta-analysis on self-medication in Nigeria included 86 studies and found a pooled prevalence of 67.8% for all of Nigeria and significant mix (Muoka et al., 2026). This is a Nigeria-wide estimate, not a prevalence for the North.