Improving management of anemia among pregnant women: Tested changes and guidance from East Central Uganda
Anemia in pregnancy is a global problem. The World Health Organization (WHO) estimated the incidence of anemia in pregnancy in 2011 at 38.2% globally, 46.3% in the African region, and 34% in Uganda (WHO 2015). In Uganda, the prevalence of anemia among pregnant women who attended antenatal care was estimated at 22.1% (Obai et al. 2016). Most cases of anemia in pregnant women are a result of insufficient iron levels to meet the increased requirements of pregnancy. Severe iron-deficiency anemia has been associated with an increased risk of stillbirths, low birthweight babies, intrauterine growth restriction, neonatal sepsis, infant and maternal mortality. Moderate anemia has been found to restrict the ability of mothers to work and care for their children.
From June 2015 through March 2017, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project worked with the Ministry of Health (MOH) of Uganda to implement an improvement activity in a “slice” of the health care system in Jinja District, Uganda to improve the quality of primary antenatal care services through implementation of an integrated package of antenatal care best practices.
This activity generated important learning about effective models for improving delivery of quality antenatal care to address anemia. The changes implemented by QI teams that are discussed in this document demonstrate effective ways to overcome common gaps in anemia care in a low-resource environment, improve the quality of antenatal care for pregnant women, and reduce maternal and newborn mortality.