Prevalence of Anemia among Pregnant Women and its Determinants in Northern Nigeria.

Objectives: We conducted a baseline survey in Northern Nigeria to determine the coverage, adherence, prevalence, barriers and facilitating factors affecting utilization of prenatal iron and folate supplementation (IFAS) from service delivery and recipient perspectives. Methods: The survey employed both quantitative and qualitative methods. Anemia (hemoglobin concentration Hb<110 g/L. g/L, Hemocues®) was measured among 1664 pregnant women 15-45 years. Results: The prevalence of anemia was high across all states surveyed (Jigawa 71.1%, Katsina 61.4%, Yobe 88.8%, Zamfara 62.2%). Although 70% of women from all states received some IFAS in their last pregnancy, <50% reported consuming IFAS ≥90 days. Utilization of IFAS among pregnant women was affected by such factors as misconception about IFAS, influences of male spouse and older women. Religion and cost were not found to constitute barriers to IFA utilization. Knowledge of health workers on how to track IFAS utilization was generally low. Most health facilities surveyed reported no IFA stock-out in the three-month preceding the survey. Over 55% of interviewed women knew the benefits of ANC in pregnancy from all the state and >60% knew the benefits of IFAS in pregnancy. Conclusions: This study has confirmed that anaemia is a problem among pregnant women in Nigeria. Despite awareness about ANC and IFAS and relatively high coverage of distribution of IFAS, utilization is relatively low. Neither the awareness of IFAS nor ANC attendance translates to IFA utilization. There is a need to address some misconceptions about IFAS resulting from cultures, beliefs and influence of male spouses and older women through Behaviour Change Communication (BCC) interventions.

Caregiver’s Knowledge, Attitudes and Practices on the Utilization of Zinc and lo-ORS for Diarrhea Treatment in Northern Nigeria.

Objectives: The caregiver’s knowledge, attitudes and practices on the utilization of Zinc and ORS for diarrhea treatment in Northern Nigeria call for concerns. We conducted a baseline in Northern Nigeria to determine the coverage, adherence, barriers and facilitating factors that affect utilization of Zinc and lo-ORS supplementation from service delivery and recipient perspectives. Methods: Qualitative and quantitative methods were used to collect data from eligible caregivers of under-five children between March-July 2013. Results: We found that awareness on use of zinc and lo-ORS in treating diarrhea is low among caregivers across surveyed states, awareness in Jigawa (44.5%) and Katsina (14.9%) states were higher than in Benue state (2.7%) while it was lower in Yobe (0.3%) and Zamfara states (0%). The percentage of caregivers of under-5 children with diarrhea using recommended dose of Zinc and Lo-ORS at home was also low (2.1% for Jigawa, while katsina, Yobe and Zamfara recorded 0%). In contradiction, the percentage of caregivers who seek any form of treatment for diarrhea ranges from 66.7% in Jigawa to 97.2 in Zamfara. Barriers to utilization of zinc and lo-ORS were similar across the surveyed states. They included non-availability, lack of adequate knowledge of the benefits and efficacy of zinc and lo-ORS and preference for herbal (traditional) medicine. Conclusions: The findings formed the basis for development of SBCC strategies, for each segment of the population with special focus on caregivers of children under-fives to address the gaps in knowledge, attitudes and practices on the utilization of zinc and ORS for diarrhea treatment.