Determinant of Non-pregnant Women's Anemia in Banggai Regency
Abstract
This study purpose is to seek the determinant factors of anemia in non-pregnant women in Banggai Regency. With a cross-sectional design, we collect data from 308 non-pregnant women through non-probability sampling. Variables collected were age, Body Mass Index (BMI), Middle Upper Arm Circumference (MUAC), abdominal circumference, education, ownership of a healthy latrine, water source for cooking, and daily consumption of iron-source food such as legumes, green vegetables, also fish or meat. Bivariate and logistic regression was used to identify variables that correlate with anemia. The mean age and hemoglobin levels were 30±6.2 years and 12.7±1.5 g/dL, respectively. About 80 (25.97%) of the subjects were anemic. Bivariate analysis shows that water from standardized sources/facilities for cooking, ownership of a healthy latrine, MUAC, daily consumption of legumes, and daily consumption of fish or meat were variables that significantly correlated with anemia (p<0.05). Moreover, after we performed logistic regression, non-pregnant women who did not use standardized clean water for cooking (OR 2.19; p=0.09) and did not consume fish or meat daily (OR 2.28; p=0.02) were at higher risk of having anemia. Determinant factors that significantly correlate with anemia in Banggai Regency's non-pregnant women were water utilization from not-standardized sources/facilities for cooking and not consuming of fish or meat daily. Local governments should include these variables in their new reformulated and innovative stunting-reducing programs. Thus, perhaps they can achieve their expected targets, such as non-anemic pregnant women, which, in the long run, can reduce stunting.
References
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Britton LE, Alspaugh A, Greene MZ, McLemore MR. 2020. An evidence-based update on Contraception: A detailed review of hormonal and nonhormonal methods. Am J Nurs 120(2):22–33. https://doi.org/10.1097/01.NAJ.0000654304.29632.a7
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Fiandari YR, Surachman S, Rohman F, Hussein AS. 2019. Perceived value dimension in repetitive fish consumption in Indonesia by using an extended theory of planned behavior. Br Food J 121(6):1220–1235. https://doi.org/10.1108/BFJ-07-2018-0429
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Girum T, Wasie A. 2018. Return of fertility after discontinuation of contraception: A systematic review and meta-analysis. Contracept Reprod Med 8(29):1‒1. https://doi.org/10.1186/s40834-023-00226-y
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Jeong J, Cho Y, Cho IY, Ahn J. 2022. Association between obesity and anemia in a nationally representative sample of South Korean adolescents: A cross- sectional study. Healthcare 10(6):1055. https://doi.org/10.3390/healthcare10061055
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Manikam NRM. 2021. Known facts. Iron deficiency in Indonesia. World Nutr J 5(S1):1–9. https://doi.org/10.25220/WNJ.V05.S1.0001
Nainggolan O, Hapsari D, Titaley CR, Indrawati L, Dharmayanti I, Kristanto AY. 2022. The relationship of body mass index and mid-upper arm circumference with anemia in non-pregnant women aged 19–49 years in Indonesia: Analysis of 2018 Basic Health Research data. Plos One 17(3):e0264685. https://doi.org/10.1371/journal.pone.0264685
Naoko K, Anne CL, Joanne K. 2012. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. J Nutr 142(2):358–362. https://doi.org/10.3945/jn.111.149237
Owais A, Merritt C, Lee C, Bhutta ZA. 2021. Anemia among women of reproductive age: An overview of global burden, trends, determinants, and drivers of progress in low- and middle-income countries. Nutrients 13(8):2745. https://doi.org/10.3390/nu13082745
Peraturan Presiden Republik Indonesia. 2020. Peraturan Presiden Republik Indonesia. Nomor 18 Tahun 2020 tentang Rencana Pembangunan Jangka Menengah Nasional Tahun 2020–2024. Jakarta (ID): Kementerian Hukum dan HAM RI.
Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. 2022. Iron absorption: Factors, limitations, and improvement methods. ACS Omega 7(24):20441–20456.https://doi.org/10.1021/acsomega.2c01833
Qin Y, Melse-Boonstra A, Pan X, Yuan B, Dai Y, Zhao J, Zimmermann MB, Kok FJ, Zhou M, Shi Z. 2013. Anemia in relation to body mass index and waist circumference among chinese women. Nutr J 12(1):10. https://doi.org/10.1186/1475-2891-12-10
Regassa R, Duguma M, Belachew T, Tamiru D. 2023. Environmental enteropathy and anaemia status among under-five children, in Slum Areas of Jimma Town, Ethiopia. Pediatric Health Med Ther 14:33–43. https://doi.org/10.2147/PHMT.S387747
Renyoet BS, Martianto D, Sukandar D. 2016. Economic losses potential due to stunting in toddlers in Indonesia year 2013. J Gizi Pangan 11(3):247–254. https://journal.ipb.ac.id/index.php/jgizipangan/article/view/16461
Roberts N, Mengge B, Oaks B, Sari N, Irsan, Humphries A. 2022. Fish consumption pathways and food security in an Indonesian fishing community. Food Secur 15(1):1–19. https://doi.org/10.1007/s12571-022-01323-7
Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. 2022. Anemia among adolescent girls in West Java, Indonesia: Related factors and consequences on the quality of life. Nutrients 14(18):3777. https://doi.org/10.3390/nu14183777
Shah T, Khaskheli MS, Ansari S, Lakhan H, Shaikh F, Zardari AA, Warsi J, Rind NA, Rind KH, Shar AH. 2022. Gestational anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan. Saudi J Biol Sci 29(1):83–87. https://doi.org/10.1016/j.sjbs.2021.08.053
Soliman A, De Sanctis V, Alaaraj N, Ahmed S, Alyafei F, Hamed N. 2021. Early and long-term consequences of nutritional stunting: From childhood to adulthood. Acta Biomed 92(1). https://doi.org/10.23750/abm.v92i1.11346
Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M et al. 2018. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet 391(10132):1830–1841. https://doi.org/10.1016/S0140-6736(18)30311-8
Sungkar A, Bardosono S, Irwinda R, Manikam NRM, Sekartini R, Medise BE, Nasar SS, Helmyati S, Ariani AS, Nurihsan J et al. 2022. A life course approach to the prevention of iron deficiency anemia in Indonesia. Nutrients 14(2):277. https://doi.org/10.3390/nu14020277
[TP2AK] Tim Percepatan Pencegahan Anak Kerdil (Stunting). 2021. Peta jalan percepatan pencegahan stunting Indonesia 2018‒2024. https://stunting.go.id/peta-jalan-percepatan-pencegahan-stunting-indonesia-2018-2024/ [Accessed at 27th May 2023].
Talukder A, Paul N, Khan ZI, Ahammed B, Haq I, Ali M. 2022. Risk factors associated with anemia among women of reproductive age (15–49) in Albania: A quantile regression analysis. Clin Epidemiol Glob Health 13:100948. https://doi.org/10.1016/j.cegh.2021.100948
Teshale AB, Tesema GA, Worku MG, Yeshaw Y, Tessema ZT. 2020. Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model. Plos One 15(9): e0238957. https://doi.org/10.1371/journal.pone.0238957
Utami PS, Ani LS, Lubis DS, Wirawan DN. 2020. Determinants of anemia in women of reproductive age in Indonesia: Secondary data analysis of the 2018 Indonesia Basic Health Research. Public health Prev Med Arch 8(2):86–91. https://doi.org/10.15562/phpma.v8i2.301
Virginia DM, Fenty F. 2017. Correlation between anthropometric measurements and risk of anemia among rural community in Cangkringan, Sleman. J Pharm Sci Community 14(2):112–119. https://doi.org/10.24071/jpsc.142712
[WHO] World Health Organization. 2015. The global prevalence of anaemia in 2011. https://apps.who.int/iris/handle/10665/177094 [Accessed 16th June 2023].
[WHO] World Health Organization. 2020. Global anaemia reduction efforts among women of reproductive age: Impact, achievement of targets, and the way forward for optimizing efforts. https://www.who.int/publications/i/item/9789240012202 [Accessed 5th July 2023].
[WHO] World Health Organization. 2023. Accelerating anaemia reduction: A comprehensive framework for action. https://www.who.int/publications/i/item/9789240074033 [Accessed 5th July 2023].
[WHO/USAID/UNICEF] World Health Organization, United States Agency for International Development, United Nations Children's Fund. 2015. Improving nutrition outcomes with better water, sanitation and hygiene: Practical solutions for policies and programmes. https://apps.who.int/iris/handle/10665/193991 [Accessed 11th July 2023].
Alshwaiyat N, Ahmad A, Hassan WMRW, Al-Jamal HAN. 2021. Association between obesity and iron deficiency. Exp Ther Med 22(5):1‒7. https://doi.org/10.3892/etm.2021.10703
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. 2018. A review of child stunting determinants in Indonesia. Matern Child Nutr 14(4):e12617. https://doi.org/10.1111/mcn.12617
BPS-Statistic of Banggai Regency. 2018. Kabupaten Banggai dalam angka 2018. https://banggaikab.bps.go.id/publication/2018/08/16/800106c7760c03a900e342db/kabupaten-banggai-dalam-angka-2018.html [Accessed 15th July 2023]
BPS-Statistic of Banggai Regency. 2020. Konsumsi kalori dan protein penduduk kabupaten Banggai 2020. https://banggaikab.bps.go.id/publication/2021/12/30/621ea81d677098ff68a765c8/konsumsi-kalori-dan-protein-penduduk-kabupaten-banggai-2020.html [Accessed at 18th July 2023]
Brittenham GM, Moir-Meyer G, Abuga KM, Datta-Mitra A, Cerami C, Green R, Pasricha SR, Atkinson SH. 2023. Biology of anemia: A public health perspective. J Nutr 153(1):S7‒S28. https://doi.org/10.1016/j.tjnut.2023.07.018
Britton LE, Alspaugh A, Greene MZ, McLemore MR. 2020. An evidence-based update on Contraception: A detailed review of hormonal and nonhormonal methods. Am J Nurs 120(2):22–33. https://doi.org/10.1097/01.NAJ.0000654304.29632.a7
Cepeda-Lopez AC, Baye, K. 2020. Obesity, iron deficiency and anaemia: A complex relationship. Public Health Nutr 23(10):1703–1704. https://doi.org/10.1017/S1368980019004981
Choma SSR, Alberts M, Modjadji SEP. 2015. Conflicting effects of BMI and waist circumference on iron status. J Trace Elem Med Biol 32:73–78. https://doi.org/10.1016/j.jtemb.2015.06.003
Fiandari YR, Surachman S, Rohman F, Hussein AS. 2019. Perceived value dimension in repetitive fish consumption in Indonesia by using an extended theory of planned behavior. Br Food J 121(6):1220–1235. https://doi.org/10.1108/BFJ-07-2018-0429
Finkelstein JL, Herman HS, Plenty A, Mehta S, Natureeba P, Clark TD, Kamya MR, Ruel T, Charlebois ED, Cohan D et al. 2020. Anemia and micronutrient status during pregnancy, and their associations with obstetric and infant outcomes among HIV-Infected Ugandan women receiving antiretroviral therapy. Curr Dev Nutr 4(5):nzaa075. https://doi.org/10.1093/cdn/nzaa075
Ganju S. 2020. Maternal anaemia, intra uterine growth restriction and neonatal outcomes. Int J Clin Obstet Gynaecol 4(4):152–155. https://doi.org/10.33545/gynae.2020.v4.i4c.638
Girum T, Wasie A. 2018. Return of fertility after discontinuation of contraception: A systematic review and meta-analysis. Contracept Reprod Med 8(29):1‒1. https://doi.org/10.1186/s40834-023-00226-y
Imai E, Nakade M. 2019. Fish and meat intakes and prevalence of anemia among the Japanese elderly. Asia Pac J Clin Nutr 28(2):276–284. https://doi.org/10.6133/apjcn.201906_28(2).0010
[IFPRI] International Food Policy Research Institute. 2016. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington DC (USA): IFPRI.
Jeng SS, Chen YH. 2022. Association of zinc with anemia. Nutrients 14(22):4918. https://doi.org/10.3390/nu14224918
Jeong J, Cho Y, Cho IY, Ahn J. 2022. Association between obesity and anemia in a nationally representative sample of South Korean adolescents: A cross- sectional study. Healthcare 10(6):1055. https://doi.org/10.3390/healthcare10061055
Kerkadi A, Mohsen Ali R, AH Shehada A, Abdelnasser AbouHassanein E, Moawad J, Bawadi H, Shi Z. 2021. Association between central obesity indices and iron status indicators among Qatari adults. Plos One 16(4):e0250759. https://doi.org/10.1371/journal.pone.0250759
Kothari MT, Coile A, Huestis A, Pullum T, Garrett D, Engmann C. 2019 Exploring associations between water, sanitation, and anemia through 47 nationally representative demographic and health surveys. Ann N Y Acad Sci 1450(1):249‒267. https://doi.org/10.1111/nyas.14109
Manikam NRM. 2021. Known facts. Iron deficiency in Indonesia. World Nutr J 5(S1):1–9. https://doi.org/10.25220/WNJ.V05.S1.0001
Nainggolan O, Hapsari D, Titaley CR, Indrawati L, Dharmayanti I, Kristanto AY. 2022. The relationship of body mass index and mid-upper arm circumference with anemia in non-pregnant women aged 19–49 years in Indonesia: Analysis of 2018 Basic Health Research data. Plos One 17(3):e0264685. https://doi.org/10.1371/journal.pone.0264685
Naoko K, Anne CL, Joanne K. 2012. Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes. J Nutr 142(2):358–362. https://doi.org/10.3945/jn.111.149237
Owais A, Merritt C, Lee C, Bhutta ZA. 2021. Anemia among women of reproductive age: An overview of global burden, trends, determinants, and drivers of progress in low- and middle-income countries. Nutrients 13(8):2745. https://doi.org/10.3390/nu13082745
Peraturan Presiden Republik Indonesia. 2020. Peraturan Presiden Republik Indonesia. Nomor 18 Tahun 2020 tentang Rencana Pembangunan Jangka Menengah Nasional Tahun 2020–2024. Jakarta (ID): Kementerian Hukum dan HAM RI.
Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. 2022. Iron absorption: Factors, limitations, and improvement methods. ACS Omega 7(24):20441–20456.https://doi.org/10.1021/acsomega.2c01833
Qin Y, Melse-Boonstra A, Pan X, Yuan B, Dai Y, Zhao J, Zimmermann MB, Kok FJ, Zhou M, Shi Z. 2013. Anemia in relation to body mass index and waist circumference among chinese women. Nutr J 12(1):10. https://doi.org/10.1186/1475-2891-12-10
Regassa R, Duguma M, Belachew T, Tamiru D. 2023. Environmental enteropathy and anaemia status among under-five children, in Slum Areas of Jimma Town, Ethiopia. Pediatric Health Med Ther 14:33–43. https://doi.org/10.2147/PHMT.S387747
Renyoet BS, Martianto D, Sukandar D. 2016. Economic losses potential due to stunting in toddlers in Indonesia year 2013. J Gizi Pangan 11(3):247–254. https://journal.ipb.ac.id/index.php/jgizipangan/article/view/16461
Roberts N, Mengge B, Oaks B, Sari N, Irsan, Humphries A. 2022. Fish consumption pathways and food security in an Indonesian fishing community. Food Secur 15(1):1–19. https://doi.org/10.1007/s12571-022-01323-7
Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. 2022. Anemia among adolescent girls in West Java, Indonesia: Related factors and consequences on the quality of life. Nutrients 14(18):3777. https://doi.org/10.3390/nu14183777
Shah T, Khaskheli MS, Ansari S, Lakhan H, Shaikh F, Zardari AA, Warsi J, Rind NA, Rind KH, Shar AH. 2022. Gestational anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan. Saudi J Biol Sci 29(1):83–87. https://doi.org/10.1016/j.sjbs.2021.08.053
Soliman A, De Sanctis V, Alaaraj N, Ahmed S, Alyafei F, Hamed N. 2021. Early and long-term consequences of nutritional stunting: From childhood to adulthood. Acta Biomed 92(1). https://doi.org/10.23750/abm.v92i1.11346
Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M et al. 2018. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet 391(10132):1830–1841. https://doi.org/10.1016/S0140-6736(18)30311-8
Sungkar A, Bardosono S, Irwinda R, Manikam NRM, Sekartini R, Medise BE, Nasar SS, Helmyati S, Ariani AS, Nurihsan J et al. 2022. A life course approach to the prevention of iron deficiency anemia in Indonesia. Nutrients 14(2):277. https://doi.org/10.3390/nu14020277
[TP2AK] Tim Percepatan Pencegahan Anak Kerdil (Stunting). 2021. Peta jalan percepatan pencegahan stunting Indonesia 2018‒2024. https://stunting.go.id/peta-jalan-percepatan-pencegahan-stunting-indonesia-2018-2024/ [Accessed at 27th May 2023].
Talukder A, Paul N, Khan ZI, Ahammed B, Haq I, Ali M. 2022. Risk factors associated with anemia among women of reproductive age (15–49) in Albania: A quantile regression analysis. Clin Epidemiol Glob Health 13:100948. https://doi.org/10.1016/j.cegh.2021.100948
Teshale AB, Tesema GA, Worku MG, Yeshaw Y, Tessema ZT. 2020. Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model. Plos One 15(9): e0238957. https://doi.org/10.1371/journal.pone.0238957
Utami PS, Ani LS, Lubis DS, Wirawan DN. 2020. Determinants of anemia in women of reproductive age in Indonesia: Secondary data analysis of the 2018 Indonesia Basic Health Research. Public health Prev Med Arch 8(2):86–91. https://doi.org/10.15562/phpma.v8i2.301
Virginia DM, Fenty F. 2017. Correlation between anthropometric measurements and risk of anemia among rural community in Cangkringan, Sleman. J Pharm Sci Community 14(2):112–119. https://doi.org/10.24071/jpsc.142712
[WHO] World Health Organization. 2015. The global prevalence of anaemia in 2011. https://apps.who.int/iris/handle/10665/177094 [Accessed 16th June 2023].
[WHO] World Health Organization. 2020. Global anaemia reduction efforts among women of reproductive age: Impact, achievement of targets, and the way forward for optimizing efforts. https://www.who.int/publications/i/item/9789240012202 [Accessed 5th July 2023].
[WHO] World Health Organization. 2023. Accelerating anaemia reduction: A comprehensive framework for action. https://www.who.int/publications/i/item/9789240074033 [Accessed 5th July 2023].
[WHO/USAID/UNICEF] World Health Organization, United States Agency for International Development, United Nations Children's Fund. 2015. Improving nutrition outcomes with better water, sanitation and hygiene: Practical solutions for policies and programmes. https://apps.who.int/iris/handle/10665/193991 [Accessed 11th July 2023].
Authors
YuwonoD. K. (2024). Determinant of Non-pregnant Women’s Anemia in Banggai Regency. Jurnal Gizi Dan Pangan, 19(Supp.2), 304-313. https://doi.org/10.25182/jgp.2024.19.Supp.2.304-313
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