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Background Anaemia during pregnancy is a major public health problem in developing countries. It is important to regularly monitor haemoglobin level in pregnancy and factors associated with it to inform clinical and preventive services. The aim of this study was to assess the prevalence and determinants of anaemia in pregnant women attending antenatal clinic (ANC) of a tertiary referral hospital in Northern Ghana. Methods An analytical cross-sectional study involving 400 pregnant women receiving antenatal care in Tamale Teaching Hospital was conducted. Using a semi-structured questionnaire and 24-h dietary recall, data were collected on socio-demographic characteristics, health practices, dietary diversity, anaemia knowledge and haemoglobin level of the women. Anaemia was defined as haemoglobin concentration less than 11 g/dl. Chi-square test and logistic regression analysis were used to identify the independent determinants of pregnancy anaemia. Results The mean age and haemoglobin of the women were 28.3 (±4.5) years and 10.81 (±1.41) g/dl respectively. About half of the women 50.8% [95% Confidence Interval (CI): 45.8–55.7] were anaemic and the prevalence of anaemia increased with pregnancy trimester. Among a host of socio-demographic, dietary, and preventive health service factors evaluated, the women’s knowledge on anaemia and pregnancy trimester at interview were the independent determinants of anaemia in pregnancy. Compared to women of the highest anaemia knowledge tertile, women belonging to the lowest (AOR = 2.63, 95% CI: 1.50–4.61) and middle (AOR = 1.92, 95% CI: 1.12–3.27) anaemia knowledge tertiles were about 3 and 2 times more likely to be anaemic respectively. Similarly, women in third trimester of pregnancy were about 4 times more likely to be anaemic compared to those in first trimester at the time of interview (AOR = 3.57, 95% CI: 1.91–6.67). Conclusions There is a high prevalence of anaemia, which increases with pregnancy trimester, in pregnant women attending ANC in a tertiary referral hospital in Northern Ghana. The women’s knowledge on anaemia and pregnancy trimester at the time of interview are associated with their anaemia status. The high prevalence of anaemia in pregnancy needs urgent intervention to prevent the occurrence of adverse maternal and neonatal outcomes. Education on anaemia should be intensified at ANCs.

Folate is a vitamin B-related substance needed by expectant mothers during the period right before and after conception (peri-conceptional period) to help protect foetuses against neural tube defects (NTDs). Despite efforts to promote the peri-conceptional uptake of folic acid (FA), adherence remains low. The aim of this study was to assess the prevalence and determinants of peri-conceptional FA uptake among childbearing women in northern Ghana. In a cross-sectional study, data from 303 women accessing antenatal care services in the Upper East Region of Ghana between February and July 2017 were collected and analysed in Stata (Version 12.1). Chi-square and logistic regression analysis were used to identify the independent determinants of peri-conceptional uptake of FA. The mean age of the study population was 27.4 (±5.73) years. The prevalence of uptake of peri-conceptional FA was 28.7% (95% confidence interval: 26.7%-34.2%); 66% of the women were aware of FA and 52% had acceptable knowledge about FA. Initiating ANC after 3 months of pregnancy was associated with 91% less chance of peri-conceptional FA use [adjusted odds ratio (AOR) 0.09; 95% confidence interval (CI) 0.04-0.22; P

Background Unmet need for contraception contributes to the burden of unwanted pregnancies, which are correlated with a host of adverse maternal and child outcomes. The aim of this study was to determine the prevalence and identify the determinants of unmet need for contraception in North Gonja District, Ghana. Methods A cross-sectional survey involving 386 randomly selected women of childbearing age was conducted in North Gonja district, Ghana, with the use of a questionnaire in household interviews. Women were classified as having unmet need for contraception if they were fecund, sexually active and wished to postpone the next birth or halt childbearing completely but were not using any form of contraception. Chi-square/Fisher’s exact test and logistic regression analysis were used to identify the determinants of unmet need. Results The mean age of the study population was 26.1 (±8.4) years and awareness on contraception was almost universal in the district (95.9%). The overall prevalence of unmet need for contraception was 38.9%, with 27.5% having unmet need for limiting and 12.2% unmet need for spacing. In multivariate analysis, compared to women aged 25–29 years, those aged 20–24 years [Adjusted Odds Ratio (AOR) 0.26; 95% Confidence Interval (CI) 0.11–0.58] and 30 years and above (AOR 0.25; 95% CI 0.09–0.73) were less likely to have unmet need for contraception. However, uneducated women (AOR 5.06; 95% CI 1.07–24.01) compared with those educated to tertiary level; those unaware of family planning (AOR 3.93; 95% CI 1.12–13.80) compared to those aware; and those who had not previously practised contraception (AOR 1.81; 95% CI 1.09–3.00) compared to those who did were more likely to have unmet need. Conclusions The present study found high prevalence of both awareness on and unmet need for contraception among the study population. Unmet need for contraception is associated with age, educational status, awareness on family planning and previous contraception practice. Educational campaigns to promote contraception should prioritize women of middle age and low educational status. Further studies are needed to understand the low correlation between awareness on and unmet need for contraception.

Supplementation with iron and folic acid (IFA) is recommended to prevent anaemia in pregnancy. However, the effectiveness of the supplementation in improving haemoglobin level depends on the degree of compliance. It is therefore necessary to periodically assess level of compliance with IFA supplementation. The aim of this study was to assess the prevalence and factors associated with compliance to IFA supplementation in pregnancy in Tamale Metropolis, Ghana. A health facility–based cross-sectional study was conducted among 403 pregnant women who accessed antenatal clinic (ANC) services in three health facilities in Tamale Metropolis, Ghana. Simple random sampling was used to select study health facilities and participants. Compliance to IFA was defined as use of IFA supplement in 4 of the last 7 days. Logistic regression analysis was used to identify the determinants of IFA supplementation compliance. The mean age of the study population was 26.7 (± 4.18) years. The prevalence of compliance to IFA supplementation was 58.8% (215/403) and the main reason the women gave for non-compliance was forgetting to take the supplements (40.9%). Following multivariate analysis, factors that were significantly associated with compliance were pregnancy trimester at interview, educational level, IFA knowledge, sex of household head and household wealth index. About 3 out of 5 women seeking ANC services in Tamale Metropolis are compliant with IFA supplementation with some of their socio-demographic and household characteristics predicting compliance. Efforts to increase compliance to IFA supplementation must focus on education on its benefits and improvement of socio-economic status of women.

Objective Malnutrition is a common cause of morbidity and mortality in children. The aim of this study was to compare the nutritional status of children under 5 years of teenage and adult mothers in Tamale Metropolis, Ghana. A case–control study involving 300 (150 cases, 150 controls) mother–child pairs was carried out. A questionnaire was used to collect data on socio-demographic characteristics of mothers and children and anthropometry was used to assess the nutritional status of children. Anthropometric z-scores derived based on WHO Child Growth Standards were used to determine stunting, wasting and underweight statuses of children. Logistic regression analysis was used to compare the nutritional status of children of teenage and adult mothers. Results Children of teenage mothers, compared to those of adult mothers, were 8 times more likely to be stunted [Adjusted Odds Ratio (AOR) = 7.56; 95% confidence interval (CI) 4.20–13.63], 3 times more likely to be wasted (AOR = 2.90; 95% CI 1.04–8.04), and 13 times more likely to be underweight (AOR = 12.78; 95% CI 4.69–34.81) after adjusting for potential confounders. The risk of child malnutrition increases with young maternal age; interventions should be targeted at teenage mothers and their children to reduce the risk of malnutrition. Electronic supplementary material The online version of this article (10.1186/s13104-018-3980-7) contains supplementary material, which is available to authorized users.

Background Childhood immunization is one of the most cost effective health interventions but its rate has been declining recently in Ghana. Information on immunization coverage and determinants is needed to improve immunization programmes. The objective of this study was to determine the prevalence and factors associated with incomplete immunization of children (12–23 months) in Kwabre East District, Ghana. Methods A cross-sectional, community-based survey involving 322 children and their mothers was carried out. Data were collected on socio-demographic characteristics of mothers, childhood immunization history and mothers’ knowledge and practices of immunization using a structured questionnaire. Children were classified as incompletely immunized if they failed to receive at least one of 8 vaccine doses: - one dose of Bacillus Calmette–Guérin (BCG), 3 doses each of pentavalent, 3 doses of polio and one dose of measles per WHO/UNICEF definition. Chi-square and logistic regression analyses were used to identify the factors associated with incomplete immunisation. Results The prevalence of incomplete immunization was low (15.5%) suggesting high immunisation coverage but the coverage of the second measles dose, taken at 18 months of age, was the lowest (23.9%). Most of the mothers knew the importance of immunisation (95.7%) and at least one vaccine-preventable disease or symptom (84.9%). Two factors associated with incomplete immunisation in bivariate analyses (community of residence, and mother’s knowledge of number of oral polio vaccines given to children) were no longer significant in a logistic regression model. Compared to children in Aboaso, children in Gyamfi Wonoo (AOR = 1.81, 95% CI = 0.80–4.08), Mamponteng (Bonwunu) (AOR = 0.59, 95% CI = 0.24–1.48) and Mamponteng (Town) (AOR = 0.63, 95% CI = 0.26–1.55) had similar odds of incomplete immunisation. Similarly, mother’s lack of knowledge of the number of doses of polio vaccine given to children had no effect on the odds of incomplete immunisation (AOR = 0.53, 95% CI = 0.22–1.26). Conclusions Immunization coverage is high in the Kwabre East district but very few children received the second measles dose. None of the maternal and child factors assessed is associated with immunisation coverage. Further research is needed to identify the determinants of immunisation coverage and the reasons for the low uptake of second measles dose in the study area. Electronic supplementary material The online version of this article (10.1186/s13690-018-0315-z) contains supplementary material, which is available to authorized users.

Objective Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6–23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother–child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. Results The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children’s risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children. Electronic supplementary material The online version of this article (10.1186/s13104-018-3528-x) contains supplementary material, which is available to authorized users.

This study sought to assess maternal growth monitoring knowledge and its effect on stunting, wasting and underweight among children 0-18 months in the Tamale Metropolis. An analytical cross-sectional study design, involving 340 mother-child pairs randomly selected from 4 health facilities in the Tamale Metropolis, was used. A structured questionnaire was used to collect information on socio-demographic characteristics and maternal growth monitoring knowledge. Weight and length of children were taken to assess nutritional status (stunting, underweight and wasting). Chi-square/Fisher’s exact test was used to determine the association between maternal growth monitoring knowledge level and child nutritional status.This study sought to assess maternal growth monitoring knowledge and its effect on stunting, wasting and underweight among children 0-18 months in the Tamale Metropolis. An analytical cross-sectional study design, involving 340 mother-child pairs randomly selected from 4 health facilities in the Tamale Metropolis, was used. A structured questionnaire was used to collect information on socio-demographic characteristics and maternal growth monitoring knowledge. Weight and length of children were taken to assess nutritional status (stunting, underweight and wasting). Chi-square/Fisher’s exact test was used to determine the association between maternal growth monitoring knowledge level and child nutritional status.

Objective Depression in mothers is a risk factor for poor health, and pregnancy and child outcomes. The objective of the present study was to determine the prevalence of depression and identify its determinants in mothers of children under 5 years in Bole District, Ghana. Results We conducted an analytical cross-sectional study consisting of 244 mothers (mean age 28.7 ± 6.29 years) in Bole District, Ghana. Edinburgh Postnatal Depression Scale was used to screen for depression and the determinants of depression were identified using logistic regression analysis. The prevalence of depression in this study population was 16.8% (95% confidence interval 12.1–22.0%). The independent determinants of depression were marital status, occupation, lighting source and type of cooking fuel. Being currently unmarried (p

Background One in five Ghanaian children is chronically malnourished. Childhood undernutrition remains a public health concern in Ghana; therefore, research is needed to identify modifiable risk factors to inform health programming. This study evaluated household dietary diversity (HDD) as a determinant of nutritional status of pre-school children in Wenchi Municipality, Ghana. Methods An analytical cross-sectional study involving 590 mother-child pairs was conducted in Wenchi Municipality. A two-stage cluster sampling procedure was used; clusters were first selected followed by the selection of children using simple random sampling. Socio-demographic, dietary, and anthropometric data were collected in face-to-face interviews. HDD scores were calculated using data from 24-h dietary recalls based on 12 standard food groups consumed by the households in the past 24 h preceding the survey and categorised into low (1–5 food groups) and high (6–12 food groups) HDD categories using the mean HDD score. Anthropometric indices (stunting, wasting, and underweight) were defined as anthropometric z-scores Results The mean age of the respondents was 27.3 [95% confidence interval = 26.8–27.8] years, and majority of them (58.3%) were within the age group 20–29 years. The prevalence rates of stunting, wasting, and underweight in the children were 38.6%, 11.0%, and 13.1%, respectively, while 36.4% of the households had low dietary diversity. There was no association between HDD categories and stunting (adjusted OR = 1.18, 95% confidence interval [CI] = 0.79–1.76, p = 0.409) or wasting (adjusted OR = 0.97, 95% CI = 0.54–1.73, p = 0.910). Conclusions There was a high prevalence of stunting in children and many households consumed less diverse diet in Wenchi Municipality. There is a lack of evidence of an association between HDD and stunting or wasting in the population studied. Interventions to improve child growth and HDD are needed to promote and protect child health.

Background. Coinfections are becoming common risk factors that may contribute to the increased burden of morbidity in pregnancy. The aim of this study was to assess the seroprevalence of coinfections of malaria, hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among pregnant women attending antenatal clinics (ANC) in the Tamale Metropolis. Methods. By means of rapid diagnostic tests (RDTs), pregnant women attending the Tamale Teaching Hospital (TTH) were screened for malaria, HBV infection, HIV infection, and syphilis from March 2013 to February 2015. Haemoglobin (Hb) values, sickling, and glucose-6-phosphate dehydrogenase deficiency (G6PDd) statuses were also assessed using full blood count (FBC), sodium metabisulphite, and methaemoglobin reduction tests, respectively. Logistic regression analysis was performed to estimate the risks/odds ratios (ORs) for the coinfections and other variables (age, gravidity, and time of the first ANC visit) with 95% confidence intervals (CIs) and set p values for accepting any differences at Results. Within the two-year study period, data were collected from 3,127 pregnant women. The mean age (SD) of the pregnant women was 28.5 (±5.0) years. Of the total number, seroprevalence was high for malaria (11.6%) and HBV infection (4.2%) and low for HIV infection (1.0%) and syphilis (0.4%) monoinfections. Mal/HBV coinfection was higher (0.7%) when compared with Mal/HIV (0.1%), Mal/syphilis (0.0%), HBV/HIV (0.0%), HBV/syphilis (0.1%), and HIV/syphilis (0.0%) coinfections. The mean Hb (g/dl) for the women with the four monoinfections was significantly different from one another (p=0.009). Pregnant women with malaria infection were about 2 times more likely to be coinfected with HBV even after adjusting for potential confounders (adjusted odds ratio (AOR) = 1.66, 95% CI = 1.04–2.65, p=0.031). Those in their third trimester and visiting the ANC for the first time were significantly less likely to be infected with HBV (AOR = 0.45, 95% CI = 0.28–0.73, p=0.001), with malaria/HBV coinfection (AOR = 0.09, 95% CI = 0.01–0.68, p=0.020), and with any coinfection (AOR = 0.19, 95% CI = 0.06–0.63, p=0.007). Conclusion. A comparatively high seroprevalence of malaria and its coinfection with HBV in pregnant women was observed in this study. Considering the effects that both malaria and HBV have on the liver, it would be expedient to conduct further studies to assess liver function among malaria/HBV-infected individuals, while interventions to prevent coinfections among pregnant women are intensified.