Prevalence and associated factors of anemia among postpartum mothers in public health facilities in Ethiopia, 2024: a systematic review and meta-analysis

Abstract

Background: Postpartum anemia, characterized by hematocrit or hemoglobin levels below the defined cutoff point (< 11gm/dl or hematocrit < 33%), is a prevalent global issue. It serves as an indirect contributor to maternal mortality and morbidity. Mothers in the postpartum period experience diminished quality of life, impaired cognitive function, emotional instability, and an increased risk of postpartum depression due to anemia. Additionally, infants of affected mothers may face challenges such as insufficient breast milk supply and a lack of proper care. Examining the combined prevalence and factors associated with postpartum anemia is crucial for addressing maternal health risks and complications during the postnatal phase attributed to anemia.

Objective: The study aimed to synthesize the existing literature on the prevalence and associated factors of postpartum anemia in public health facilities of Ethiopia, in 2024.

Methods: The study was conducted by searching through the Google Scholar, PubMed, and Cochrane Library search engines. The search utilized keywords and MeSH terms such as anemia, low hemoglobin, postpartum, postnatal women, and Ethiopia. The collected data underwent analysis and comparison with the WHO criteria to determine if it met the threshold for declaring a public health concern. Heterogeneity was evaluated through the Cochran Q test and I2 statistics. Prevalence and odds ratio estimations were performed using a random-effects model with a 95% confidence interval.

Result: Four studies were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among postpartum women in Ethiopia was 69% (95% CI: 60- 77%).Lack of formal education(OR = 3.5;CI:2.639,4.408),Low Pre-delivery hemoglobin (OR = 4.2;CI: 1.768-6.668), Postpartum women < 4 ANC visit (OR = 2.72; 95% CI:2.14,3.3 ),history of post partum hemorrhage (OR = 2.49; CI: 1.075-3.978),history of Forceps/vacuum delivery(OR = 3.96; CI:2.986-4.947), Poor iron and folic acid adherence (OR = 2.8;95% CI:2.311,3.297), C/S (OR = 4.04; 95% CI: 3.426,4.671),lower dietary diversity (OR = 4.295% CI:1.768,6.668) were significantly associated postpartum anemia.

Conclusion: Postpartum women in Ethiopia continue to face a considerable public health challenge in the form of anemia. Consequently, there is a pressing need for the government to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the substantial regional disparities influenced by interconnected factors, with the aim of reducing the prevalence of anemia among postpartum women in Ethiopia.

Keywords: Anemia; Ethiopia; Hemoglobin; Postpartum women.

Fig. 1

PRISMA flow chart diagram describing selection of studies for systematic review and meta-analysis on the prevalence of Anemia among postpartum women in Ethiopia, 2024

Fig. 2

Forest plots of four studies on the prevalence of anemia among postpartum women in Ethiopia, 2024

Fig. 3

A Funnel plot of studies conducted on prevalence of anemia among post partum women in Ethiopia, 2024

Fig. 4

Sub group analysis based on place of study on prevalence of postpartum anemia in Ethiopia, 2024 Fig A: sub group analysis of western Ethiopia on postpartum anemia in Ethiopia Fig B: sub group analysis of eastern Ethiopia among postpartum anemia in Ethiopia

Fig. 5

Leave-one-out sensitivity analysis of prevalence of postpartum women in Ethiopia, 2024