Testing and treating anaemia in pregnant women in Bangladesh: a cross-sectional survey.

INTRODUCTION

Anaemia during pregnancy is a significant public health problem, disproportionately affecting women in low-and middle-income countries. In Bangladesh, anaemia affects 38.6% of pregnant women. Although much is known about the prevention of anaemia in pregnancy, it is unknown how women are tested and treated. This study therefore aimed to describe how pregnant women in Bangladesh are tested for anaemia, including variations by social and equity dimensions. We also aimed to explore how women are treated for anaemia and use of intravenous iron in pregnancy.

METHODS

An interviewer-administered cross-sectional survey was conducted in Narayanganj district, Bangladesh, with analysis limited to women who had previously been pregnant (n=1000). Outcomes of interest were anaemia testing, anaemia treatment, and intravenous iron use. We undertook descriptive analyses and derived estimates and 95% confidence intervals of the percentage of pregnant women tested for anaemia stratified by education, wealth, and person making decisions around women's healthcare.

RESULTS

Approximately half of women were tested for anaemia in their previous pregnancy (505/963, 52.4%), with lower testing in women with no education (15.8%, 95% CI: 6.0 to 31.3), whose husband had no education (25.6%, 95% CI: 18.2 to 34.2), or in the poorest wealth quintile (34.0%, 95% CI: 27.4 to 41.2). Pregnant women were most commonly tested for anaemia at a private health facility (393/505, 77.8%), by a medical technologist (350/505, 69.3%), using venous full blood count (484/505, 95.8%). Most women diagnosed with anaemia in their previous pregnancy received treatment (135/142, 95.1%). In any prior pregnancies, a small number of women received intravenous iron (33/985, 3.4%).

CONCLUSION

Our study reveals the need for substantial investments to ensure all women in Bangladesh are tested for anaemia in pregnancy. This could be achieved through increasing point-of-care testing in antenatal care. However, health facilities and health workers may need to be prepared for an increase in women diagnosed with anaemia.