Patterns in the Effect of Iron Supplementation, Deworming Medication, and Antimalarial Drug Intake on Anemia in Women of Reproductive Age in Sub-Saharan Africa: Review of Demographic and Health Survey Data Open Access

Julius, Samantha (Summer 2018)

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Objective: Approximately 528.7 million women of reproductive age (WRA) are considered to be anemic globally; 38% of pregnant women are anemic, and 29% of WRA are anemic (1). There are a variety of factors attributed to causing anemia such as iron deficiency, helminths, vitamin B12 deficiency, malaria, vitamin a. The purpose of this paper was to examine patterns in anemia and iron tablet/syrup supplementation, deworming medication, and antimalarial drug intake over time in (WRA) in Sub-Saharan Africa. This report examined existing nutrition policies in Sub-Saharan Africa and how Demographic and Health Surveys (DHS) could enhance the data it already provides in order to inform programs on how to enhance/implement nutrition protocol in terms of iron supplementation, deworming medication, and antimalarial drugs availability to WRA.

Methods: We considered all 48 Sub-Saharan African Countries for this analysis. The inclusion criteria to be included in this report were: 1) report must be for a country located within Sub-Saharan Africa, 2) DHS report must be available in English, 3) DHS report must have been published no earlier than 2003, 4) anemia prevalence in WRA must be present in at least two reports for each country in order to analyze trends, and 5) percentage of women who reported they consumed iron tablets/syrup during their last pregnancy must have been available in all chosen DHS reports. The DHS indicates that WRA are between the ages of 15-49. The countries included were: Rwanda, Ethiopia, Lesotho, Ghana, Malawi, Sierra Leone, Tanzania, and Zimbabwe. Trends were assessed over time by looking at absolute percent differences, but a statistical analysis was not conducted. These patterns were analyzed based on DHS data that had been published as early as 2003.

Results: There were 21 total surveys examined in this report. Overall, 6 of the 8 countries indicated an overall decrease in anemia prevalence from the first report to the last report of 1.72 percentage points. However, iron tablet/syrup intake among pregnant WRA increased in all eight countries of 10.03 percentage points. Only three of the 8 countries indicated patterns suggestive of decrease in anemia in WRA and both deworming medication and antimalarial drugs over time. Additionally, 2 of the 8 countries indicated patterns suggestive of decrease in anemia in WRA and deworming medication.

Conclusion: The decrease in anemia prevalence among WRA is not fully explained by the data that the DHS provides on iron supplementation, deworming medication, and antimalarial drugs. The DHS needs to improve the data that is provided to make more accurate associations on factors attributed to anemia. This would allow for stronger data provided to countries that could aid in enhancing their nutrition policies.

Table of Contents

Chapter 1-Introduction                                                                                                       

1.1-        Global Burden of Anemia and Current Targets                                                             1

1.2-        Nutritional and Non-Nutritional Causes of Anemia                                                      2

1.3-        Anemia Determination                                                                                                    4

1.4-        National Nutrition Policies                                                                                             4

1.5-        Objective                                                                                                                       5

Chapter 2-Methods                                                                                                             

2.1-     Inclusion Criteria                                                                                                         6

2.2-     Data Extraction                                                                                                              7

2.3-     Analysis                                                                                                                        9

Chapter 3-Results    

3.1-     Anemia Prevalence                                                                                                      13

3.2-     Iron Coverage                                                                                                               14

3.3-     Antimalarial Coverage                                                                                                14

3.4-     Deworming Coverage                                                                                                  15

3.5-     Overall Patterns Observed                                                                                          15

Chapter 4-Discussion

4.1-     Main Findings                                                                                                              22

4.2-     National Nutrition Policies                                                                                          24

4.3-     Limitations and Strengths                                                                                           25

4.4-     Implications                                                                                                                  27

Chapter 5-Conclusion and Future Recommendations                                                 28

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