MUHIMBILI 5 HYPERLINK l _Toc516999766 1.4. Research questions

MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCIES SCHOOL OF NURSING TITLE ASSESS KNOWLEDGE AND PERCEPTION AMONG PREGNANT WOMEN ON UNDERSTANDING IRON RICH FOOD AT MNAZI MMOJA HOSPITAL IN TANZANIA NAME DAMIAN GREGORY REG NO 2015-04-08378 DEGREE PROGRAM BSC-MIDWIFERY SUPERVISOR RASHID HERI FACILITATOR Dr. L. MSELLE/Dr. A.

OUTWATER. 18 JUNE 2018 TABLE OF CONTENT Contents TOC o 1-3 h z u HYPERLINK l _Toc516999759 TITLE PAGEREF _Toc516999759 h 1 HYPERLINK l _Toc516999760 Chapter one introduction PAGEREF _Toc516999760 h 3 HYPERLINK l _Toc516999761 1.1. Background PAGEREF _Toc516999761 h 3 HYPERLINK l _Toc516999762 1.

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2. Problem statement PAGEREF _Toc516999762 h 4 HYPERLINK l _Toc516999763 1.3. Objectives PAGEREF _Toc516999763 h 5 HYPERLINK l _Toc516999764 1.3.1. Broad objective PAGEREF _Toc516999764 h 5 HYPERLINK l _Toc516999765 1.

3.2. Specific objectives PAGEREF _Toc516999765 h 5 HYPERLINK l _Toc516999766 1.

4. Research questions PAGEREF _Toc516999766 h 6 HYPERLINK l _Toc516999767 1.5. Hypothesis PAGEREF _Toc516999767 h 6 HYPERLINK l _Toc516999768 1.6. Conceptual framework PAGEREF _Toc516999768 h 7 HYPERLINK l _Toc516999769 Chapter two literature review PAGEREF _Toc516999769 h 8 HYPERLINK l _Toc516999770 References PAGEREF _Toc516999770 h 10 Chapter one introduction Background Women often become anemic during pregnancy because the demand for iron and other vitamins is increased due to pregnancy. The inability to meet the required level for these substances either as a result of dietary deficiencies or infection gives rise to anemia. Anemia ranges from mild, moderate to severe and the rates of haemoglobin level for each of these types of anemia in pregnancy at 10.

0 10.9g/dl (mild anemia) 7 9.9g/dl (moderate anemia) and 7g/dl (severe anemia) ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Mgonja, given Neema, non-dropping-particle , parse-names false, suffix , container-title International Nutrirional Anemia, id ITEM-1, issue 1, issued date-parts 2014 , page 3-4, title Perception and understanding of pregnant women towards the use of folic acid supliment, type article-journal, volume 14 , uris http//www.mendeley.com/documents/uuid37700c4b-6818-404c-8e1c-54b785c35acd , mendeley formattedCitation (Mgonja, 2014), plainTextFormattedCitation (Mgonja, 2014), previouslyFormattedCitation (Mgonja, 2014) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.

json (Mgonja, 2014). Iron deficiency anemia occurs when iron stores are exhausted and the supply of iron to the tissues is compromised. Iron deficiency anemia is a severe stage of iron deficiency in which hemoglobin (or hematocrit) falls below the above cutoffs. Iron deficiency anemia is defined as anemia with biochemical evidence of iron deficiency. Serum ferritin, transferrin saturation, transferrin receptor, and erythrocyte protoporphyrin are indicators used as biochemical evidence of iron deficiency ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3390/nu6125915, ISBN 1541-6100 (Electronic)n0022-3166 (Linking), ISSN 1205-7088, PMID 24913257, abstract Iron deficiency anemia and child mortality are public health problems requiring urgent attention. However, the degree to which iron deficiency anemia contributes to child mortality is unknown.

Here, we utilized an exhaustive article search and screening process to identify articles containing both anemia and mortality data for children aged 28 days to 12 years. We then estimated the reduction in risk of mortality associated with a 1-g/dL increase in hemoglobin (Hb). Our meta-analysis of nearly 12,000 children from six African countries revealed a combined odds ratio of 0.76 (0.62-0.

93), indicating that for each 1-g/dL increase in Hb, the risk of death falls by 24. The feasibility of a 1-g/dL increase in Hb has been demonstrated via simple iron supplementation strategies. Our finding suggests that 1.

8 million deaths in children aged 28 days to five years could be avoided each year by increasing Hb in these children by 1 g/dL., author dropping-particle , family Stoltzfus, given Rebbeca J., non-dropping-particle , parse-names false, suffix , dropping-particle , family Dreyfuss, given Michele L, non-dropping-particle , parse-names false, suffix , container-title International Nutrirional Anemia Consultative Group CINACG), id ITEM-1, issue 1, issued date-parts 2013 , page 2-8, title Prevention of Iron Deficiency Anaemia in Adolescents Role of Weekly Iron Acid Supplementation, type article-journal, volume 138 , uris http//www.

mendeley.com/documents/uuidb4f7bb74-2fde-4235-850e-c6b7b5bde08e , mendeley formattedCitation (Stoltzfus Dreyfuss, 2013), plainTextFormattedCitation (Stoltzfus Dreyfuss, 2013), previouslyFormattedCitation (Stoltzfus Dreyfuss, 2013) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Stoltzfus Dreyfuss, 2013). Problem statement Knowledge deficit among pregnant women on understanding iron rich food has been common problem among Tanzania societies. This Knowledge deficit lead to prevalence of Iron deficiency among pregnant women.

Iron deficiency among pregnant women is due to physiological changes occurred during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.9734/BJMMR/2016/23427, author dropping-particle , family Adesuyi, given E O, non-dropping-particle , parse-names false, suffix , container-title British Journal of Medicine Medical Research, id ITEM-1, issue 12, issued date-parts 2016 , page 1-10, title Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo, type article-journal, volume 14 , uris http//www.mendeley.com/documents/uuid45aaba87-f823-424a-8813-04cb9fac8932 , mendeley formattedCitation (Adesuyi, 2016), plainTextFormattedCitation (Adesuyi, 2016), previouslyFormattedCitation (Adesuyi, 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.

json (Adesuyi, 2016). Fetal growth demand iron that derived from mother, this cause depletion of iron in maternal blood circulation and iron stores (hemosiderin and ferritin). This result to a contributory factor for anemia during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family N, given Fatima Shanthini, non-dropping-particle , parse-names false, suffix , dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family Contracept, given J Reprod, non-dropping-particle , parse-names false, suffix , dropping-particle , family Gynecol, given Obstet, non-dropping-particle , parse-names false, suffix , container-title International Journal of Reproduction, Contraception, Obstretics and Gynecology, id ITEM-1, issue 2, issued date-parts 2016 , page 425-431, title Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels, type article-journal, volume 5 , uris http//www.mendeley.com/documents/uuidffd6eaeb-ba14-4b36-a6c7-79dbb2635475 , mendeley formattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016), plainTextFormattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016), previouslyFormattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Nivedita, N, Nivedita, Contracept, Gynecol, 2016).

Anemia lead to increase maternal morbidity rate, mortality rate and increase congenital fetal anomalies. During gestational period large number of women suffering from iron deficiency, so need to understand the food rich in iron, in order to reduce incidence of iron deficiency and iron supplementation among pregnant women during antenatal clinic visit. Other literature studies focused on physiological changes of pregnancy (fetal growth iron demand), hookworms infection and malaria (hemolytic anemia) ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3923/ajcn.2017.

51.56, author dropping-particle , family Jalambo, given Marwan O, non-dropping-particle , parse-names false, suffix , dropping-particle , family Norimah, given Abdul Karim, non-dropping-particle , parse-names false, suffix , container-title Asian Journal of Clinical Nutrition, id ITEM-1, issue 1, issued date-parts 2017 , page 51-56, title Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine, type article-journal, volume 9 , uris http//www.mendeley.com/documents/uuid5141ba32-718f-48b1-ad88-ea603f64b659 , mendeley formattedCitation (Jalambo Norimah, 2017), plainTextFormattedCitation (Jalambo Norimah, 2017), previouslyFormattedCitation (Jalambo Norimah, 2017) , properties noteIndex 0 , schema https//github.

com/citation-style-language/schema/raw/master/csl-citation.json (Jalambo Norimah, 2017), but yet many studies has been done on this field in a specific studying area. This research project we focus on knowledge and perception of pregnant women on understanding these food rich iron. If women have this knowledge possibly will decrease prevalence of iron deficiency and iron deficiency anemia among pregnant women and simultaneously decrease the need of Ferrous Sulfate and Folic Acid during antenatal clinic visit. Due to decreasing adherence to ferrous sulfate and folic acid supplementation among pregnant women, had potentiated to anemia during gestational period.

Knowledge on understanding food rich Iron will enable women on reducing Iron deficiency and Iron deficiency anemia. Objectives Broad objective Explore knowledge and perception in pregnant women on understanding iron rich food.at Mnazi Mmoja from December 2018 to March 2019. Specific objectives To explore pregnant women perception and understanding towards the use iron rich food. To assess pregnant women understanding toward the effect of anemia. 1.4.

Research questions What are the knowledge needed to pregnant women on food rich in iron What are pregnant women perceive on food rich in iron Does pregnant women come to antenatal visit have knowledge on understanding food rich in iron 1.5. Hypothesis Reduction of Ferrous sulfate and Folic acid supplementation among pregnant women may relate with knowledge and good perception on Iron rich food. 1.6. Conceptual framework The conceptual framework implies the use various methods in gathering information about the knowledge and perception pregnant women on understanding food rich in iron at Mnazi Mmoja hospital. In order to know the factors that cause Iron Deficiency Anemia among pregnant women in a studying area, hence to improve awareness and providing knowledge on these iron rich foods.

This conceptual framework implies multiple sources in gathering valuable and potential information Chapter two literature review INTRODUCTION Attitude and practices of pregnant women regarding anemia, Iron rich food and iron supplements and also to assess the impact of these factors and other socio demographic variables on the hemoglobin levels of these vulnerable groups of women. The study done by Nivedita K, Fatima Shanthini in 2016 on Knowledge about food rich in iron was poor among the participants. At least 1/5th of the participants have not received educational information regarding anemia from any source. The conclusion was, the present study indicated the lack of knowledge regarding anemia, iron rich foods and the importance of iron supplementation during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family N, given Fatima Shanthini, non-dropping-particle , parse-names false, suffix , dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family Contracept, given J Reprod, non-dropping-particle , parse-names false, suffix , dropping-particle , family Gynecol, given Obstet, non-dropping-particle , parse-names false, suffix , container-title International Journal of Reproduction, Contraception, Obstretics and Gynecology, id ITEM-1, issue 2, issued date-parts 2016 , page 425-431, title Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels, type article-journal, volume 5 , uris http//www.

mendeley.com/documents/uuidffd6eaeb-ba14-4b36-a6c7-79dbb2635475 , mendeley formattedCitation (Nivedita et al., 2016), plainTextFormattedCitation (Nivedita et al., 2016), previouslyFormattedCitation (Nivedita et al., 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Nivedita et al.

, 2016). The study conducted by Fredanna A. D. MCormack and Judy C. Drolet in 2012, about Forty-five percent of participants out of 68 did not provide correct information about anemia causes. General responses for anemia causes or that lacked elaboration were considered erroneous. Only about a third of participants were able to correctly identify particular food items and cite specific food rich iron and cite examplesADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Cormack, given Fredanna A D M, non-dropping-particle , parse-names false, suffix , dropping-particle , family Drolet, given Judy C, non-dropping-particle , parse-names false, suffix , container-title Continuing Education Contact Hour Opportunit, id ITEM-1, issue 2, issued date-parts 2011 , page 2012, title Continuing Education Contact Hour Opportunity Assessment of Anemia Knowledge , Attitudes and Behaviors Among Pregnant Women in Sierra Leone, type article-journal, volume 44 , uris http//www.mendeley.

com/documents/uuid5520d422-c317-4c45-845b-55a39633ab04 , mendeley formattedCitation (Cormack Drolet, 2011), plainTextFormattedCitation (Cormack Drolet, 2011), previouslyFormattedCitation (Cormack Drolet, 2011) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Cormack Drolet, 2011). The study conducted by J Clin Diagn Res. 2015 in India on evaluation of Dietary Choices, majority of the participants (87) reported regular antenatal care visits and intake of iron and folic acid tablets. Eighty two percent of the participants were acquainted with standardized marks on food items and 64 of them reported checking of these marks before purchasing. Thirty two percent of the participants did not know about balanced diet and iron rich food. The study conducted by Edward J.

Pavlik et al. in Nigeria on Attitude of pregnant Women Attending Ante-natal Clinic Adequate Diet in the Prevention of Anemia in Selected Hospital. Showed that significant difference in knowledge among pregnant women that believe that anemia could be cured with drugs alone and those that do not while the other believe that adequate diet in prevention of anemia ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.9734/BJMMR/2016/23427, author dropping-particle , family Adesuyi, given E O, non-dropping-particle , parse-names false, suffix , container-title British Journal of Medicine Medical Research, id ITEM-1, issue 12, issued date-parts 2016 , page 1-10, title Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo, type article-journal, volume 14 , uris http//www.

mendeley.com/documents/uuid45aaba87-f823-424a-8813-04cb9fac8932 , mendeley formattedCitation (Adesuyi, 2016), plainTextFormattedCitation (Adesuyi, 2016), previouslyFormattedCitation (Adesuyi, 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Adesuyi, 2016). The study conducted by Marwan O.

jalambo et al. on Short Communication Knowledge, Attitude and Practices of Iron Deficient and Iron Deficient Anemia among Adolescents in the Gaza Strip, Palestine in 2017 showed that, 84 of the adolescents could not tell if a person was having anemia. About 81.

3 of them were not aware of the consequences of Iron Deficiency Anemia among pregnant women and 91.6 had no knowledge of the causes of Iron Deficiency Anemia. Also, 89 did not know which iron-rich foods can be easily absorbed, while 74.

8 did not know which foods reduce iron absorptionADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3923/ajcn.2017.51.56, author dropping-particle , family Jalambo, given Marwan O, non-dropping-particle , parse-names false, suffix , dropping-particle , family Norimah, given Abdul Karim, non-dropping-particle , parse-names false, suffix , container-title Asian Journal of Clinical Nutrition, id ITEM-1, issue 1, issued date-parts 2017 , page 51-56, title Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine, type article-journal, volume 9 , uris http//www.mendeley.com/documents/uuid5141ba32-718f-48b1-ad88-ea603f64b659 , mendeley formattedCitation (Jalambo Norimah, 2017), plainTextFormattedCitation (Jalambo Norimah, 2017), previouslyFormattedCitation (Jalambo Norimah, 2017) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.

json (Jalambo Norimah, 2017). References ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Adesuyi, E. O.

(2016). Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo. British Journal of Medicine Medical Research, 14(12), 110. https//doi.org/10.

9734/BJMMR/2016/23427 Cormack, F. A. D. M., Drolet, J.

C. (2011). Continuing Education Contact Hour Opportunity Assessment of Anemia Knowledge , Attitudes and Behaviors Among Pregnant Women in Sierra Leone. Continuing Education Contact Hour Opportunit, 44(2), 2012. Jalambo, M. O., Norimah, A. K.

(2017). Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine. Asian Journal of Clinical Nutrition, 9(1), 5156. https//doi.org/10.

3923/ajcn.2017.51.56 Makola, D., Ash, D. M.

, Tatala, S. R., Latham, M. C., Ndossi, G., Mehansho, H. (2003). A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women.

The Journal of Nutrition, 133(5), 13391346. Mgonja, N. (2014). Perception and understanding of pregnant women towards the use of folic acid supliment. International Nutrirional Anemia, 14(1), 34. Nivedita, K.

, N, F. S., Nivedita, K., Contracept, J.

R., Gynecol, O. (2016).

Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels. International Journal of Reproduction, Contraception, Obstretics and Gynecology, 5(2), 425431. Stoltzfus, R. J., Dreyfuss, M.

L. (2013). Prevention of Iron Deficiency Anaemia in Adolescents Role of Weekly Iron Acid Supplementation. International Nutrirional Anemia Consultative Group CINACG), 138(1), 28. https//doi.org/10.3390/nu6125915 PAGE MERGEFORMAT 10 Availability of food rich iron Educational level Religious beliefs Cultural beliefs Poverty Environmental factors Behavior toward iron rich food. Iron deficiency among pregnant women oXNi8/6v_ fO7S4W__ h6lpTN/Aojy,[email protected] xnFWzq_1Ki_ MyLWkqjx5Dm 7c(NTWlo4SPsR1On37R9Kj(f95XVkXfOmTunr-di4AMnoxwTf4waA/X 9LyEP8U 0 1 U5XMP5jXXoH24wkfhgtWIY WMjQsxy _rLSTYQ_,1CyYO9TKJW so(C58L9SEGS4OY5A5 gFu9u_KrIiLdJyU FQqPikkZvWJ/2JQSJjRrse rL2Lg3GPj2O.

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MUHIMBILI l _Toc516999764 1.3.1. Broad objective PAGEREF _Toc516999764

MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCIES SCHOOL OF NURSING TITLE ASSESS KNOWLEDGE AND PERCEPTION AMONG PREGNANT WOMEN ON UNDERSTANDING IRON RICH FOOD AT MNAZI MMOJA HOSPITAL IN TANZANIA NAME DAMIAN GREGORY REG NO 2015-04-08378 DEGREE PROGRAM BSC-MIDWIFERY SUPERVISOR RASHID HERI FACILITATOR Dr.

L. MSELLE/Dr. A.OUTWATER. 18 JUNE 2018 TABLE OF CONTENT Contents TOC o 1-3 h z u HYPERLINK l _Toc516999759 TITLE PAGEREF _Toc516999759 h 1 HYPERLINK l _Toc516999760 Chapter one introduction PAGEREF _Toc516999760 h 3 HYPERLINK l _Toc516999761 1.1. Background PAGEREF _Toc516999761 h 3 HYPERLINK l _Toc516999762 1.

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2. Problem statement PAGEREF _Toc516999762 h 4 HYPERLINK l _Toc516999763 1.3. Objectives PAGEREF _Toc516999763 h 5 HYPERLINK l _Toc516999764 1.3.1. Broad objective PAGEREF _Toc516999764 h 5 HYPERLINK l _Toc516999765 1.3.

2. Specific objectives PAGEREF _Toc516999765 h 5 HYPERLINK l _Toc516999766 1.4.

Research questions PAGEREF _Toc516999766 h 6 HYPERLINK l _Toc516999767 1.5. Hypothesis PAGEREF _Toc516999767 h 6 HYPERLINK l _Toc516999768 1.6. Conceptual framework PAGEREF _Toc516999768 h 7 HYPERLINK l _Toc516999769 Chapter two literature review PAGEREF _Toc516999769 h 8 HYPERLINK l _Toc516999770 References PAGEREF _Toc516999770 h 10 Chapter one introduction Background Women often become anemic during pregnancy because the demand for iron and other vitamins is increased due to pregnancy.

The inability to meet the required level for these substances either as a result of dietary deficiencies or infection gives rise to anemia. Anemia ranges from mild, moderate to severe and the rates of haemoglobin level for each of these types of anemia in pregnancy at 10.0 10.

9g/dl (mild anemia) 7 9.9g/dl (moderate anemia) and 7g/dl (severe anemia) ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Mgonja, given Neema, non-dropping-particle , parse-names false, suffix , container-title International Nutrirional Anemia, id ITEM-1, issue 1, issued date-parts 2014 , page 3-4, title Perception and understanding of pregnant women towards the use of folic acid supliment, type article-journal, volume 14 , uris http//www.mendeley.com/documents/uuid37700c4b-6818-404c-8e1c-54b785c35acd , mendeley formattedCitation (Mgonja, 2014), plainTextFormattedCitation (Mgonja, 2014), previouslyFormattedCitation (Mgonja, 2014) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Mgonja, 2014). Iron deficiency anemia occurs when iron stores are exhausted and the supply of iron to the tissues is compromised.

Iron deficiency anemia is a severe stage of iron deficiency in which hemoglobin (or hematocrit) falls below the above cutoffs. Iron deficiency anemia is defined as anemia with biochemical evidence of iron deficiency. Serum ferritin, transferrin saturation, transferrin receptor, and erythrocyte protoporphyrin are indicators used as biochemical evidence of iron deficiency ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3390/nu6125915, ISBN 1541-6100 (Electronic)n0022-3166 (Linking), ISSN 1205-7088, PMID 24913257, abstract Iron deficiency anemia and child mortality are public health problems requiring urgent attention. However, the degree to which iron deficiency anemia contributes to child mortality is unknown. Here, we utilized an exhaustive article search and screening process to identify articles containing both anemia and mortality data for children aged 28 days to 12 years. We then estimated the reduction in risk of mortality associated with a 1-g/dL increase in hemoglobin (Hb).

Our meta-analysis of nearly 12,000 children from six African countries revealed a combined odds ratio of 0.76 (0.62-0.93), indicating that for each 1-g/dL increase in Hb, the risk of death falls by 24. The feasibility of a 1-g/dL increase in Hb has been demonstrated via simple iron supplementation strategies. Our finding suggests that 1.

8 million deaths in children aged 28 days to five years could be avoided each year by increasing Hb in these children by 1 g/dL., author dropping-particle , family Stoltzfus, given Rebbeca J., non-dropping-particle , parse-names false, suffix , dropping-particle , family Dreyfuss, given Michele L, non-dropping-particle , parse-names false, suffix , container-title International Nutrirional Anemia Consultative Group CINACG), id ITEM-1, issue 1, issued date-parts 2013 , page 2-8, title Prevention of Iron Deficiency Anaemia in Adolescents Role of Weekly Iron Acid Supplementation, type article-journal, volume 138 , uris http//www.

mendeley.com/documents/uuidb4f7bb74-2fde-4235-850e-c6b7b5bde08e , mendeley formattedCitation (Stoltzfus Dreyfuss, 2013), plainTextFormattedCitation (Stoltzfus Dreyfuss, 2013), previouslyFormattedCitation (Stoltzfus Dreyfuss, 2013) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Stoltzfus Dreyfuss, 2013). Problem statement Knowledge deficit among pregnant women on understanding iron rich food has been common problem among Tanzania societies.

This Knowledge deficit lead to prevalence of Iron deficiency among pregnant women. Iron deficiency among pregnant women is due to physiological changes occurred during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.9734/BJMMR/2016/23427, author dropping-particle , family Adesuyi, given E O, non-dropping-particle , parse-names false, suffix , container-title British Journal of Medicine Medical Research, id ITEM-1, issue 12, issued date-parts 2016 , page 1-10, title Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo, type article-journal, volume 14 , uris http//www.

mendeley.com/documents/uuid45aaba87-f823-424a-8813-04cb9fac8932 , mendeley formattedCitation (Adesuyi, 2016), plainTextFormattedCitation (Adesuyi, 2016), previouslyFormattedCitation (Adesuyi, 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Adesuyi, 2016). Fetal growth demand iron that derived from mother, this cause depletion of iron in maternal blood circulation and iron stores (hemosiderin and ferritin). This result to a contributory factor for anemia during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family N, given Fatima Shanthini, non-dropping-particle , parse-names false, suffix , dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family Contracept, given J Reprod, non-dropping-particle , parse-names false, suffix , dropping-particle , family Gynecol, given Obstet, non-dropping-particle , parse-names false, suffix , container-title International Journal of Reproduction, Contraception, Obstretics and Gynecology, id ITEM-1, issue 2, issued date-parts 2016 , page 425-431, title Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels, type article-journal, volume 5 , uris http//www.mendeley.

com/documents/uuidffd6eaeb-ba14-4b36-a6c7-79dbb2635475 , mendeley formattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016), plainTextFormattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016), previouslyFormattedCitation (Nivedita, N, Nivedita, Contracept, Gynecol, 2016) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Nivedita, N, Nivedita, Contracept, Gynecol, 2016). Anemia lead to increase maternal morbidity rate, mortality rate and increase congenital fetal anomalies. During gestational period large number of women suffering from iron deficiency, so need to understand the food rich in iron, in order to reduce incidence of iron deficiency and iron supplementation among pregnant women during antenatal clinic visit. Other literature studies focused on physiological changes of pregnancy (fetal growth iron demand), hookworms infection and malaria (hemolytic anemia) ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3923/ajcn.2017.

51.56, author dropping-particle , family Jalambo, given Marwan O, non-dropping-particle , parse-names false, suffix , dropping-particle , family Norimah, given Abdul Karim, non-dropping-particle , parse-names false, suffix , container-title Asian Journal of Clinical Nutrition, id ITEM-1, issue 1, issued date-parts 2017 , page 51-56, title Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine, type article-journal, volume 9 , uris http//www.mendeley.com/documents/uuid5141ba32-718f-48b1-ad88-ea603f64b659 , mendeley formattedCitation (Jalambo Norimah, 2017), plainTextFormattedCitation (Jalambo Norimah, 2017), previouslyFormattedCitation (Jalambo Norimah, 2017) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.

json (Jalambo Norimah, 2017), but yet many studies has been done on this field in a specific studying area. This research project we focus on knowledge and perception of pregnant women on understanding these food rich iron. If women have this knowledge possibly will decrease prevalence of iron deficiency and iron deficiency anemia among pregnant women and simultaneously decrease the need of Ferrous Sulfate and Folic Acid during antenatal clinic visit. Due to decreasing adherence to ferrous sulfate and folic acid supplementation among pregnant women, had potentiated to anemia during gestational period.

Knowledge on understanding food rich Iron will enable women on reducing Iron deficiency and Iron deficiency anemia. Objectives Broad objective Explore knowledge and perception in pregnant women on understanding iron rich food.at Mnazi Mmoja from December 2018 to March 2019. Specific objectives To explore pregnant women perception and understanding towards the use iron rich food. To assess pregnant women understanding toward the effect of anemia. 1.4.

Research questions What are the knowledge needed to pregnant women on food rich in iron What are pregnant women perceive on food rich in iron Does pregnant women come to antenatal visit have knowledge on understanding food rich in iron 1.5. Hypothesis Reduction of Ferrous sulfate and Folic acid supplementation among pregnant women may relate with knowledge and good perception on Iron rich food. 1.6.

Conceptual framework The conceptual framework implies the use various methods in gathering information about the knowledge and perception pregnant women on understanding food rich in iron at Mnazi Mmoja hospital. In order to know the factors that cause Iron Deficiency Anemia among pregnant women in a studying area, hence to improve awareness and providing knowledge on these iron rich foods. This conceptual framework implies multiple sources in gathering valuable and potential information Chapter two literature review INTRODUCTION Attitude and practices of pregnant women regarding anemia, Iron rich food and iron supplements and also to assess the impact of these factors and other socio demographic variables on the hemoglobin levels of these vulnerable groups of women. The study done by Nivedita K, Fatima Shanthini in 2016 on Knowledge about food rich in iron was poor among the participants.

At least 1/5th of the participants have not received educational information regarding anemia from any source. The conclusion was, the present study indicated the lack of knowledge regarding anemia, iron rich foods and the importance of iron supplementation during pregnancy ADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family N, given Fatima Shanthini, non-dropping-particle , parse-names false, suffix , dropping-particle , family Nivedita, given K, non-dropping-particle , parse-names false, suffix , dropping-particle , family Contracept, given J Reprod, non-dropping-particle , parse-names false, suffix , dropping-particle , family Gynecol, given Obstet, non-dropping-particle , parse-names false, suffix , container-title International Journal of Reproduction, Contraception, Obstretics and Gynecology, id ITEM-1, issue 2, issued date-parts 2016 , page 425-431, title Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels, type article-journal, volume 5 , uris http//www.mendeley.com/documents/uuidffd6eaeb-ba14-4b36-a6c7-79dbb2635475 , mendeley formattedCitation (Nivedita et al.

, 2016), plainTextFormattedCitation (Nivedita et al., 2016), previouslyFormattedCitation (Nivedita et al., 2016) , properties noteIndex 0 , schema https//github.

com/citation-style-language/schema/raw/master/csl-citation.json (Nivedita et al., 2016). The study conducted by Fredanna A. D. MCormack and Judy C. Drolet in 2012, about Forty-five percent of participants out of 68 did not provide correct information about anemia causes. General responses for anemia causes or that lacked elaboration were considered erroneous.

Only about a third of participants were able to correctly identify particular food items and cite specific food rich iron and cite examplesADDIN CSL_CITATION citationItems id ITEM-1, itemData author dropping-particle , family Cormack, given Fredanna A D M, non-dropping-particle , parse-names false, suffix , dropping-particle , family Drolet, given Judy C, non-dropping-particle , parse-names false, suffix , container-title Continuing Education Contact Hour Opportunit, id ITEM-1, issue 2, issued date-parts 2011 , page 2012, title Continuing Education Contact Hour Opportunity Assessment of Anemia Knowledge , Attitudes and Behaviors Among Pregnant Women in Sierra Leone, type article-journal, volume 44 , uris http//www.mendeley.com/documents/uuid5520d422-c317-4c45-845b-55a39633ab04 , mendeley formattedCitation (Cormack Drolet, 2011), plainTextFormattedCitation (Cormack Drolet, 2011), previouslyFormattedCitation (Cormack Drolet, 2011) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.json (Cormack Drolet, 2011). The study conducted by J Clin Diagn Res. 2015 in India on evaluation of Dietary Choices, majority of the participants (87) reported regular antenatal care visits and intake of iron and folic acid tablets. Eighty two percent of the participants were acquainted with standardized marks on food items and 64 of them reported checking of these marks before purchasing.

Thirty two percent of the participants did not know about balanced diet and iron rich food. The study conducted by Edward J. Pavlik et al. in Nigeria on Attitude of pregnant Women Attending Ante-natal Clinic Adequate Diet in the Prevention of Anemia in Selected Hospital. Showed that significant difference in knowledge among pregnant women that believe that anemia could be cured with drugs alone and those that do not while the other believe that adequate diet in prevention of anemia ADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.9734/BJMMR/2016/23427, author dropping-particle , family Adesuyi, given E O, non-dropping-particle , parse-names false, suffix , container-title British Journal of Medicine Medical Research, id ITEM-1, issue 12, issued date-parts 2016 , page 1-10, title Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo, type article-journal, volume 14 , uris http//www.mendeley.com/documents/uuid45aaba87-f823-424a-8813-04cb9fac8932 , mendeley formattedCitation (Adesuyi, 2016), plainTextFormattedCitation (Adesuyi, 2016), previouslyFormattedCitation (Adesuyi, 2016) , properties noteIndex 0 , schema https//github.

com/citation-style-language/schema/raw/master/csl-citation.json (Adesuyi, 2016). The study conducted by Marwan O. jalambo et al. on Short Communication Knowledge, Attitude and Practices of Iron Deficient and Iron Deficient Anemia among Adolescents in the Gaza Strip, Palestine in 2017 showed that, 84 of the adolescents could not tell if a person was having anemia. About 81.3 of them were not aware of the consequences of Iron Deficiency Anemia among pregnant women and 91.6 had no knowledge of the causes of Iron Deficiency Anemia.

Also, 89 did not know which iron-rich foods can be easily absorbed, while 74.8 did not know which foods reduce iron absorptionADDIN CSL_CITATION citationItems id ITEM-1, itemData DOI 10.3923/ajcn.2017.

51.56, author dropping-particle , family Jalambo, given Marwan O, non-dropping-particle , parse-names false, suffix , dropping-particle , family Norimah, given Abdul Karim, non-dropping-particle , parse-names false, suffix , container-title Asian Journal of Clinical Nutrition, id ITEM-1, issue 1, issued date-parts 2017 , page 51-56, title Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine, type article-journal, volume 9 , uris http//www.mendeley.com/documents/uuid5141ba32-718f-48b1-ad88-ea603f64b659 , mendeley formattedCitation (Jalambo Norimah, 2017), plainTextFormattedCitation (Jalambo Norimah, 2017), previouslyFormattedCitation (Jalambo Norimah, 2017) , properties noteIndex 0 , schema https//github.com/citation-style-language/schema/raw/master/csl-citation.

json (Jalambo Norimah, 2017). References ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Adesuyi, E. O. (2016). Attitude of Pregnant Women Attending Ante-natal Clinic towards Adequate Diet in the Prevention of Anaemia in Selected Hospitals in Osogbo. British Journal of Medicine Medical Research, 14(12), 110. https//doi.

org/10.9734/BJMMR/2016/23427 Cormack, F. A. D. M., Drolet, J. C.

(2011). Continuing Education Contact Hour Opportunity Assessment of Anemia Knowledge , Attitudes and Behaviors Among Pregnant Women in Sierra Leone. Continuing Education Contact Hour Opportunit, 44(2), 2012. Jalambo, M. O., Norimah, A. K.

(2017). Knowledge , Attitude and Practices of Iron Deficient and Iron Deficient Anaemic Adolescents in the Gaza Strip , Palestine. Asian Journal of Clinical Nutrition, 9(1), 5156. https//doi.

org/10.3923/ajcn.2017.51.56 Makola, D., Ash, D. M.

, Tatala, S. R., Latham, M. C., Ndossi, G., Mehansho, H. (2003). A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women.

The Journal of Nutrition, 133(5), 13391346. Mgonja, N. (2014). Perception and understanding of pregnant women towards the use of folic acid supliment.

International Nutrirional Anemia, 14(1), 34. Nivedita, K., N, F. S., Nivedita, K., Contracept, J. R., Gynecol, O.

(2016). Knowledge , attitude and practices of pregnant women regarding anemia , iron rich diet and iron supplements and its impact on their hemoglobin levels. International Journal of Reproduction, Contraception, Obstretics and Gynecology, 5(2), 425431. Stoltzfus, R. J., Dreyfuss, M. L.

(2013). Prevention of Iron Deficiency Anaemia in Adolescents Role of Weekly Iron Acid Supplementation. International Nutrirional Anemia Consultative Group CINACG), 138(1), 28. https//doi.org/10.3390/nu6125915 PAGE MERGEFORMAT 10 Availability of food rich iron Educational level Religious beliefs Cultural beliefs Poverty Environmental factors Behavior toward iron rich food. Iron deficiency among pregnant women oXNi8/6v_ fO7S4W__ h6lpTN/Aojy,[email protected] xnFWzq_1Ki_ MyLWkqjx5Dm 7c(NTWlo4SPsR1On37R9Kj(f95XVkXfOmTunr-di4AMnoxwTf4waA/X 9LyEP8U 0 1 U5XMP5jXXoH24wkfhgtWIY WMjQsxy _rLSTYQ_,1CyYO9TKJW so(C58L9SEGS4OY5A5 gFu9u_KrIiLdJyU FQqPikkZvWJ/2JQSJjRrse rL2Lg3GPj2O.

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