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[1]                                                                                                                                                                                                                                         AJDHS.COM 

 

 

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Copyright  © 2023 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
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Prevalence of Anaemia and Associated Factors in Lactating Mothers 
Accessing Health Services at Ishaka Adventist Hospital, Bushenyi District 

Anslem Ajugwo1,2 , Robert Unzi Opigo2 and *Emmanuel Ifeanyi Obeagu2  

1 Department of Medical Laboratory Science, Madonna University, Elele Campus, Rivers State, Nigeria 

2 Department of Medical Laboratory Science, Kampala International University, Uganda 

Article Info: 
_______________________________________ 
Article History: 
Received 24 March 2022      
Reviewed  07 May 2023 
Accepted 23 May 2023 
Published 15 June 2023 

_______________________________________ 
Cite this article as:  

Ajugwo A, Opigo RU, Obeagu EI, Prevalence of 
Anaemia and Associated Factors in Lactating 
Mothers Accessing Health Services at Ishaka 
Adventist Hospital, Bushenyi District, Asian 
Journal of Dental and Health Sciences. 2023; 
3(2):1-6 

DOI: http://dx.doi.org/10.22270/ajdhs.v3i2.37      

_______________________________________
*Address for Correspondence:   

Emmanuel Ifeanyi Obeagu, Department of 
Medical Laboratory Science, Kampala 
International University, Uganda.  
Email: emmanuelobeagu@yahoo.com   

Abstract 
___________________________________________________________________________________________________________________ 

The study was done to determine the prevalence of anaemia and its associated factors in lactating 
mothers accessing health services at Ishaka Adventist Hospital, Bushenyi district. A cross-sectional 
study design was used. Structured questionnaires were used to obtain socio-demographic, obstetric and 
other related anemia factors while blood samples were obtained for hemoglobin determination. Data 
obtained were entered into excel and exported to SPSS Version 25.0 for analysis. Bivariate and 
multivariate analyses were performed to assess the factors associated with anaemia. The study results 
showed 11.7% prevalence of anaemia. Taking iron supplement during pregnancy was significantly 
associated with anaemia among lactating mothers. The prevalence of anaemia among lactating mothers 
accessing services at health services at Ishaka Adventist Hospital, Bushenyi district was low 
(11.7%).Taking iron supplement during pregnancy was significantly associated with anaemia among 
lactating mothers. 

Keywords: anaemia, lactating mothers, pregnancy, Ishaka Adventist Hospital 

 

 

INTRODUCTION 

Anaemia is the most common nutritional deficiency indicator 
and health status in the world affecting about one third of the 
global population 1-2. 

Anaemia is never a diagnosis but occurs secondary to an 
underlying disease process. Technically, anaemia is defined as  
a state in which an individual’s haemoglobin concentration 
(red cell mass) falls two standard deviations below the 
reference intervals in particular population (individuals of 
similar age, gender and geographical location) resulting into 
decreased oxygen-carrying capacity of red blood cells to the 
tissues 3.  

Globally, a study conducted in India among lactating mothers 
found out that the prevalence of anaemia was 66.0% 4. A study 
in Myanmar reported an anaemia prevalence rate of 60.3% in 
lactating mothers, with 20.3% of lactating mothers having 
severe anaemia 3. 

In Africa, studies conducted in Ethiopia in Lactating mothers 
from 2011-2015 found out that the prevalence was 22.1% 5. 
Another study in Kenya concluded that lactating mothers 
whose haemoglobin levels were less than 12g/dL had 
prevalence of 43.8% 6. 

Anaemia in lactating mother is common especially if the 
mother were anemic during their pregnancy. Lactating 
mothers are vulnerable to anaemia morbidity due to their 
susceptibility to iron depletion during pregnancy and lactation 
as well as due to bad consequences of blood loss during their 
childbirth 7-11. 

Anaemia in lactating mother has various adverse effects like 
decreased immunity which in turn results in delayed wound 
healing, and increased susceptibility to infections such as 
mastitis, ductitis and urinary tract infection and diminished 
quality or volume of the breast milk. It has also associated 
with reduction of global household income, cognitive 
impairment, impaired quality of life, and emotional instability 
as well as postpartum depression 12. These devastating 
impacts makeanaemiain lactating mothers to be one of the 
global health priority areas at the global level, especially in 
resource-limited areas 13. 

Studies have shown that, although breast milk is not a good 
source of iron, the concentration of iron in breast milk is 
independent of maternal iron status. This indicates that the 
quality of breast milk is maintained at the expense of maternal 
stores. Postpartum anaemia is highest in mothers who are 
anemic during pregnancy 14. 

                       Open Access                                                                                                                                                                                                         Research Article                                          

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Ajugwo et al                                                                                                                                     Asian Journal of Dental and Health Sciences. 2023; 3(2):1-6 

[2]                                                                                                                                                                                                                                         AJDHS.COM 

The study was done to determine the prevalence of anaemia 
and its associated factors in lactating mothers accessing health 
services at Ishaka Adventist Hospital, Bushenyi district 

METHODS AND MATERIALS 

Study design 

This was a hospital based cross-sectional study design which 
was conducted for a period of two months from 1st June 2022 
to 1stAugust 2022. 

Study area 

This study was carried out in Ishaka Adventist Hospital in 
Bushenyi district. 

Study population 

The study population included all lactating mothers accessing 
Ishaka Adventist Hospital in Ishaka, Bushenyi district during 
the given period of the study. 

Inclusion criteria 

This study included only lactating mothers accessing Ishaka 
Adventist Hospital in Ishaka, Bushenyi district during the 
given period of the study. 

Exclusion criteria 

This study excluded all non-lactating mothers, those who did 
not consent to take part in this study and those lactating 
mothers with history of illnesses and on iron supplementation. 

Sample size determination 

The Sample size of this study was determined using the 
formula by (Keish et al,1965). 

This is illustrated as shown below. 

From           
    

  
 

Where,  

n = sample size required 

P = prevalence of anaemiain lactating mothers among youths 
was 22.1% 5. 

Z = the score on normal standard curve corresponding to a 
95% (1.96) confidence level  

Q=(1-P), Proportion of those who do not have the disease. 

D = allowable error corresponding to 5%  

Therefore,  

n = [(1.96)2 ×0.221 × 0.779] 

(0.05)2 

n = 264.5 

Therefore 265samples were considered for the study 

Sampling method 

Simple random sampling technique was used to recruit until 
the required number is reached.  

Data collection methods/instruments 

After obtaining an informed written consent, pretested 
structured questionnaire was used which was written in two 
versions i.e. English version and Runyankole translated 
version for those who could not understand English. The 
questionnaire was validated and were used to collect 
information about variables that included demographic, 
obstetric factors and other anaemia related factors. Whereas 
the prevalence of anaemia was collected using the blood 
sample 

Sample collection for anaemia testing 

The venipuncture site was cleaned using a swab containing 
70% isopropyl alcohol and using aseptic techniques, an 
appropriate vein was identified and hypodermic needle 
introduced into the vein. About 3-4mls of blood samples was 
collected into syringe and then transferred into a sterile 
container containing EDTA and then transported to the 
hematology laboratory for analysis. 

Data analysis 

Data was coded, entered into Epi data version 7.2.4.0 and 
exported into SPSS version 25.0 for analysis. The data was 
computed to determine frequency and percentages and was 
presented inform of tables and figures at 95% confidence 
level. 

Ethical consideration 

An Introductory letter was sought from the Dean, School of 
Allied Health Sciences of Kampala International University-
Western Campus. This was taken to the Medical Director, 
Ishaka Adventist Hospital, to seek permission to carry out the 
study. The Medical Director,then introduced the researchers 
to the Medical Laboratory Scientists and who is also in charge 
of the Haematology Laboratory who allowed us to conduct the 
research. Informed consent was sought first from the 
participants. Participants were gotten from antenatal and 
postnatal clinic through the nursing officer in charge of 
antenatal and postnatal. 

Privacy was guaranteed by interviewing each participant 
separately and ensuring that information collected does not 
contain individual identity so as to avoid a breach of 
confidentiality. All information obtained was treated with 
confidentiality and only for the purpose of this study. 

RESULTS 

Table 1 shows that majority 128(48.3%) were aged 18-35 
years, 219(82.5%) were married, the maternal education level 
was secondary with132 (49.8%) was secondary, the paternal 
education level was also secondary with 138 (52.1%), 166 
(62.6%) were unemployed and lastly majority 143(54.0%) 
came from rural areas. 

  

 

 

 

 

 

 



Ajugwo et al                                                                                                                                     Asian Journal of Dental and Health Sciences. 2023; 3(2):1-6 

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Table 1: Demographic data of respondents 

Variables  Frequency Percent(%) 

Age   

18-25 years 128 48.3 

26-35 years 112 42.3 

≥ 36 years 25 9.4 

Marital status 

  Single 25 9.5 

Married 219 82.5 

Divorced 21 8.0 

Maternal level of education 

  Primary 80 30.2 

Secondary 132 49.8 

Tertiary 48 18.1 

Never attended school 5 1.9 

Paternal level of education   

Primary 60 22.6 

Secondary 138 52.1 

Tertiary 62 23.4 

Never attended school 5 1.9 

Occupation  

  Employed 99 37.4 

Unemployed 166 62.6 

Residence  

  Urban 122 46.0 

Rural 143 54.0 

 

 

According to Figure 1, 31 (11.7%) were anemic while 234 
(87.9%) were not anemic. Thus, the prevalence of anaemia 
among study participants is11.7%. 

 

Figure 1: Severity of anaemia in lactating mothers 
accessing health services at Ishaka Adventist Hospital, 
Bushenyi district 

 

Of the 31 anaemic mothers, many 16(51.6%) had anaemia 
classified as moderate, 11(35.5 had anaemia classified as Mild 
(10-10.9 g/dl) and lastly 4(12.9%) had anaemia classified as 
severe. 

Table 2: Severity of anaemia in lactating mothers 
attending health services at Ishaka Adventist Hospital, 
Bushenyi district 

Severity of anaemia 
Frequency 

(n=31) Percent (%) 

Mild (10-10.9 g/dl) 11 35.5 

Moderate (7.0-9.9 g/dl) 16 51.6 

Severe (<7.9 g/dl) 4 12.9 

 

 

 

31 

234 

11.7 

87.9 

0

50

100

150

200

250

Anemic Not anemic/normal
Frequency Percent



Ajugwo et al                                                                                                                                     Asian Journal of Dental and Health Sciences. 2023; 3(2):1-6 

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Table 3: Bivariate analysis of socio-demographic factors associated with anaemia in lactating mothers accessing health 
services at Ishaka Adventist Hospital, Bushenyi district  

 

Anaemia aOR(95%CI) p-value 

Anaemic Not anaemic 

Age 18-25 years 9 119 0.30(0.09-0.99) 0.049 

26-35 years 17 94 0.72(0.23-2.19) 0.567 

≥ 36 years 5 20 1.00  

Marital status Single 0 25 N/A  

Married 31 185 N/A  

Divorced 0 21 1.00  

Maternal level of education Primary 10 70 0.57(0.06-5.64) 0.632 

Secondary 12 120 0.40(0.04-3.87) 0.429 

Tertiary 8 39 0.82(0.08-8.34) 0.87 

Never attended school 1 4 1.00  

Paternal level of education primary 9 46 0.78(0.08-7.84) 0.84 

Secondary 14 124 0.45(0.05-4.33) 0.49 

Tertiary 7 54 0.52(0.05-5.32) 0.58 

never attended school 1 4 1.00  

Occupation Employed 11 85 0.91(0.41-1.98) 0.803 

Unemployed 20 140 1.00  

Sex Urban 13 108 0.84(0.39-1.79) 0.643 

Rural 18 125 1.00  

 

 

Table 4: Bivariate analysis of Obstetric factors associated with anaemia in lactating mothers accessing health services at 
Ishaka Adventist Hospital, Bushenyi district 

 

Anaemia  

aOR(95%CI) 

 

P-value Anaemic Not anaemic 

Number of pregnancies have you ever 

carried 

One  12 81 0.79(0.31-2.01) 0.621 

Two  4 35 0.61(0.17-2.14) 0.440 

Three  6 69 0.46(0.16-1.39)  0.170 

More than three 9 48 1.00  

Took iron supplement during 

pregnancy 

Yes 19 186 0.40(0.18-0.88) 0.023 

No 12 47 1.00  

Number of times  you  attend ANC 

during your previous pregnancy 

No visit 1 13 0.47(0.06-3.77) 0.480 

1-3 4 52 0.47(0.16-1.42) 0.182 

4 and above 26 160 1.00  

Currently using contraceptive method Yes 9 102 0.53(0.23-1.19)  0.123 

No 22 131 1.00  

Period of  breast feeding < 3 months 12 68 0.35(0.57-3.19) 0.491 

≥ 1 year 6 73 0.63(0.23-1.76) 0.378 

3-9 months 13 92 1.00  

Number of  birth ever had in the last 

five  years 

Once 17 118 0.89(0.33-2.42) 0.817 

Two 8 78 0.63(0.21-1.96) 0.426 

Three - four 6 37 1.00  

HIV status Positive 1 31 0.21(0.03-1.63) 0.136 

Negative 30 199 1.00  

Are you pregnant Yes 1 8 0.94(0.11-7.76) 0.952 

No 30 225 1.00  

 



Ajugwo et al                                                                                                                                     Asian Journal of Dental and Health Sciences. 2023; 3(2):1-6 

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Table 5: Multivariate analysis of factors associated with anaemiain lactating mothers accessing health services at Ishaka 
Adventist Hospital, Bushenyi district  

  
Anaemia  

aOR(95%CI) 

 

p-value Anaemic Not anaemic 

Age 

18-25 years 9 119 0.27(0.07-1.09) 0.066 

26-35 years 17 94 0.79(0.23-2.69) 0.707 

≥ 36 years 5 20 1   

Number of pregnancies have you 
ever carried 

One  12 81 0.45(0.47-4.52) 0.517 

Two  4 35 1.01(0.218-4.69) 0.99 

Three  6 69 0.69(0.20-2.39) 0.56 

More than three 9 48 1   

Took iron supplement during 
pregnancy 

Yes  19 186 0.16(0.05-0.46) 0.001 

No  12 47 1   

Number of times did you attend 
ANC during your previous 
pregnancy 

No visit 1 13 0.19(0.02-2.11) 0.179 

1-3 4 52 0.18(0.05-1.17) 0.055 

4 and above 26 160 1   

Currently using contraceptive 
method 

Yes  9 102 0.59(0.23-1.53) 0.284 

No 22 131 1   

HIV status 
Positive  1 31 0.16(0.02-1.37) 0.095 

Negative  30 199 1   

 

DISCUSSION 

In this study, the prevalence of anaemia among lactating 
mothers attending health services at Ishaka Adventist 
Hospital, Bushenyi district was 11.7%. This was low compared 
to 66.0% lactating mothers with anaemia according to a study 
done in India by [4], and anaemia prevalence rate of 60.3% in 
lactating mothers according to a study done in Myanmar by 
(Zhao et al.,2014).It was also low compared to 28.3% among 
4658 Ethiopian lactating mothers (Liyew et al., 2020), rate of 
43.8% among Kenyan lactating mothers [6], a prevalence of 
(53.08%) in Mozambique, (46.28%) in Tanzania, and 
(19.33%) in Rwanda. 

According Lakew and colleagues, the lower prevalence of 
anaemia among lactating mothers may be due to the cultural 
norms of providing nutritional care to lactating mothers 
during the postpartum period. Lactating mothers are 
encouraged to rest for 3–6 months and to eat a variety of foods 
5. Considerably, in Ishaka and in communities surrounding it, 
cultural norms are almost extinct following the abolishment of 
kings in Uganda. For over decades, Ankole has no king and as 
result women in this region can now eat fish, chicken among 
other foods that were previously prohibited by culture. 
Therefore, adoption of such foods that contain lots of iron 
could be the reason for low prevalence of anaemia among 
lactating mothers attending health services at Ishaka 
Adventist Hospital, Bushenyi district.  

Regarding the severity of anaemia among lactating mothers, 
51.6% had moderate form of anemia, 35.5% had Mild form of 
anaemia and lastly 12.9% had severe form of anemia. 

In this study, taking iron supplement during pregnancy were 
significantly related to anaemia in lactating mothers. 
Participants who took iron supplement during pregnancy 

were 84% less likely to be anaemic as compared to those who 
didn’t take iron supplement during pregnancy.   

This is supported by a study in Bahir Dar- Ethiopia 15, which 
showed that iron supplementation during pregnancy is 
negatively associated with having anaemia both for pregnant 
and lactating women. The possible explanation could be that, 
iron is the most important nutrient which is used for the 
formation of red blood cells and when it was taken during 
pregnancy it can have a probability of preventing anaemia 
during the lactation period as well. 

A study by carried out in Ethiopia also revealed that lactating 
mothers who were taking modern contraceptives had a lower 
risk of having anaemia 5. 

CONCLUSION  

In conclusion, the prevalence lactating mothers attending 
health services at Ishaka Adventist Hospital, Bushenyi district 
was low and its severity was commonly in moderate form. The 
risk of lactating mothers was seen to be significantly reduced 
with intake of iron supplement during pregnancy.  

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