Anemia among pregnant women in internally displaced camps in Mogadishu, Somalia: a cross-sectional study on prevalence, severity and associated risk factors.

BACKGROUND: Anemia in pregnancy is a serious global public health problem in most developing countries and a major cause of maternal morbidity and mortality. Somalia which already had very high maternal mortality ratio of 829 per 100,000 live births, pregnant women in internally displaced camps (IDPs) remain at most exposed. The aim of the study was to determine the prevalence, severity and associated risk factors of anemia among pregnant women in internally displaced camps in Mogadishu, Somalia. METHODS: A community based cross-sectional study was conducted among 383 households in the most IDP settled districts in Mogadishu. Every pregnant mother in these sampled households who was voluntarily consented was targeted. A sample of blood was also taken by pricking the fingertip and inserted into hemoglobin meter. Those with Hb < 11 g/dl from hemoglobin meter had been taken another sample of 3 cc blood and put into EDTA tube for CBC analysis to identify the type of anemia. Data on risk factors were collected using structured pretested questionnaire via an interview. Collected data was coded and entered in SPSS- Version 22 for analysis. Descriptive analysis, bivariate chi-square and multivariate logistic regression were done. RESULTS: The overall prevalence of anemia among study participants was 44.4% (95%CI: 39.5-49.3%), where severe and moderate anemia were 11.8 and 47.0% respectively. In addition all anaemic cases were microcytic hypochromic anemia. Young maternal age, low Family income, fewer/zero parity, being at third or second trimesters, lack of ANC attendance during pregnancy, lack of iron supplementation during pregnancy, taking tea immediately after meal during pregnancy, lower/zero frequency of daily meat and vegetables consumption during pregnancy were associated risk factors of anemia. CONCLUSION: The anemia prevalence from this study was severe public health problem. Several factors were found to be associated with anemia during pregnancy. Measures has to be taken to curb the problem by including them mass iron supplementation and health education towards identified risk factors.

Determinants of modern contraceptive use among married Somali women living in Kampala; a cross sectional survey.

BACKGROUND: Low contraceptive uptake exposes women to unintended pregnancies and often the resultant obstetric complications. The immigrant communities especially from countries with low contraceptive use present a unique challenge. The main objective of the study was to describe modern contraceptive use and associated factors among married Somali women living in Kampala. METHODS: A community based cross sectional survey was conducted among Somali women living in Kampala from August to November 2016. Using consecutive sampling, 341 respondents were recruited after informed consent. Data was collected using interviewer administered questionnaires on contraceptives use and factors associated. Data was entered in Epidata 3.1 and analyzed using STATA 11.0. Logistic regression analysis was used to determine the factors associated with use of modern contraceptives. RESULTS: Majority of the participants were refugees 317/341(94%), with a mean age of 30.4 (±6.7) years and 136/341 (40%) had no formal education. More than 325/341 (95%) of respondents desired to have five or more children (Average 9 + 3) and 164/341 (45%) had five or more living children. Only 29% of women were using modern contraceptives, of which 51% used oral pills, 15% condoms and 15% injectables. Having tertiary education, one who had ever used modern contraceptives and desire for spacing of more than two years were independently associated with current of use modern contraceptives. CONCLUSIONS: The Contraceptive prevalence rate among married Somali women in Kampala was (29%). A majority of the respondents were using short acting contraceptive methods. Attaining tertiary education, ever use of modern contraceptives, those whose source of contraceptive information was health worker and desire to space for more than two years were associated with current use of modern contraceptives. There is a need for improvement of girl child education, contraceptive awareness and male involvement to increase contraceptive uptake in this community. Research looking at attitude of this community towards use of long term contraception is recommended.