Background: Anaemia in pregnancy (AIP) is a public health concern due to its devastating effects on women and their unborn babies, resulting in increased maternal and neonatal deaths in developing countries. Despite several Ghanaian health policies to combat AIP, AIP is still on the rise. It becomes imperative to identify geographic-specific factors for developing appropriate interventions for the management of AIP. However, Kassena Nankana West District (KNWD) in the Upper East Region of Ghana lacks a study on anaemia risk factors, therefore, this study estimated the prevalence and risk factors for anaemia among pregnant women in the district.   Methods: A household-based cross-sectional study was conducted on 376 pregnant women in their third trimester from February to March 2023. Anthropometric, obstetric, sociodemographic, and health facility resource characteristics were collected using structured questionnaires and antenatal records. Mixed-effect logistic regression was used to identify independent factors of anaemia at 95% confidence interval.   Results: Prevalence of AIP was 53.9%. Mild, moderate, and severe anaemia prevalence was 16.9%, 35.3%, and 1.7% respectively. Malaria infection during pregnancy (aOR=1.563; 95%CI:1.087 – 2.475) and accessing health facilities without trained laboratory personnel (aOR=5.271; 95%CI:1.641 – 16.93) were associated with increased odds of AIP. Belonging to the major ethnic group (aOR=0.431; 95%CI:0.280 – 0.675), accessing health facilities without laboratory services (aOR=0.151; 95%CI:0.047 – 0.487), and accessing health facilities without sulphadoxine-pyrimethamine drugs (aOR=0.234; 95%CI:0.061 – 0.897) in KNWD were also associated with decreased odds of AIP.   Conclusion: AIP prevalence remains high in the KNWD. Maternal and health facility-related factors were responsible for anaemia in the district. These factors are preventable. Therefore, health facility strengthening and enhanced strategies for malaria prevention are recommended for anaemia control in the district.

The authors have declared no competing interest.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study obtained ethical clearance from the Nagasaki University School of Tropical Medicine and Global Health (TMGH) Institutional Review Board (approval number:NU_TMGH_2022_225_1), and the Ghana Health Service Ethics Review Committee (approval number: GHS-ERC:023/12/22). Permission was obtained from the UER Health Directorate, KNWD Health Directorate, and Heads of the health facilities before the data was collected. Written informed consent was obtained from all respondents and/or their parents/guardians after they were given information on the purpose of the study and what was required of them as study participants.

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