Association between Antenatal Care Service Utilization and Anaemia Status among Pregnant Women Attending Selected Health Facilities in West B Region, Zanzibar

Abstract

Anaemia during pregnancy remains a major public health concern in many low- and middle-income countries, including Tanzania, where it contributes significantly to maternal and neonatal morbidity and mortality. Although antenatal care (ANC) services provide important opportunities for screening, prevention, and treatment of anaemia, inadequate utilisation of these services may limit their effectiveness. This study aimed to examine the association between antenatal care service utilisation and anaemia status among pregnant women attending selected health facilities in the West B Region of Zanzibar. A facility-based cross-sectional study was conducted among pregnant women attending antenatal clinics in selected public and private health facilities in the West B Region. A sample size of 339 participants was determined using the Kish and Leslie formula and selected through stratified and systematic random sampling techniques. Data were collected using structured questionnaires and haemoglobin measurements obtained from ANC records. Data were analysed using descriptive statistics, Chi-square tests, and multivariable logistic regression to determine the relationship between ANC service utilisation and anaemia status. The study found that anaemia was highly prevalent among pregnant women in the study area, with 62.2% of participants classified as anaemic. Several factors were associated with increased risk of anaemia, including limited knowledge about anaemia, unemployment, consumption of non-food substances (pica), and short pregnancy intervals. Inadequate utilization of ANC services, such as delayed initiation of visits and poor adherence to recommended maternal health practices was also associated with higher odds of anaemia among pregnant women. The study was limited to selected health facilities in the West B Region and employed a crosssectional design, which restricts causal interpretation. Further research using longitudinal or multi-regional studies is recommended to better understand the causal pathways linking ANC utilization and maternal anaemia. Strengthening ANC utilization through early booking, improved maternal health education, and increased adherence to iron and folic acid supplementation could significantly reduce the burden of anaemia among pregnant women in Zanzibar.