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

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