Perceptions and practices of midwives toward the detection of anemia during first antenatal care visits at Hoima Regional Referral Hospital: a cross-sectional study.
DOI:
https://doi.org/10.51168/m2nr4p82Keywords:
Anaemia, Haemoglobin, Ferritin, Macrocytic anaemia, Pallor, Ferrous SulphateAbstract
Background:
Anemia in pregnancy is a major cause of maternal and perinatal morbidity, yet early detection at the first antenatal care (ANC) visit is often sub-optimal. This study assessed midwives’ knowledge, perceptions, and practices regarding the detection of anemia during first ANC visits at Hoima Regional Referral Hospital, Uganda.
Methodology:
A descriptive cross-sectional study was conducted among 56 purposively selected midwives. Data were collected using a structured interviewer-administered questionnaire. The collected data were analyzed using descriptive statistics in Microsoft Excel and presented as tables and figures.
Results:
Overall, 14 (25.0%) midwives were aged 25–29 years, followed by 12 (21.4%) aged 30-34 years. Half of the midwives (28; 50.0%) held a diploma qualification, while 18 (32.1%) held a certificate.38 (67.9%) midwives correctly identified the WHO hemoglobin cutoff of 11 g/dL, 48 (85.7%) recognized hemoglobin estimation as the primary diagnostic test, and 32 (57.1%) correctly classified anemia severity. Most (45; 80.4%) knew that hemoglobin testing should be performed at the first ANC visit. Perceptions were highly positive: 50 (89.3%) believed first-visit screening is essential, and 46 (82.1%) supported mandatory testing, while workload and stock-outs were perceived as major barriers by 41 (73.2%) and 45 (80.4%), respectively. In practice, 43 (76.8%) routinely requested or performed hemoglobin tests, 48 (85.7%) assessed pallor, 46 (82.1%) provided iron–folate counseling, and 40 (71.4%) documented results; 44 (78.6%) referred severe anemia.
Conclusion:
Midwives generally demonstrated good knowledge and positive perceptions, but systemic constraints and practice gaps limited optimal detection of anemia at the first ANC visit.
Recommendations:
Strengthening supplies, staffing, refresher training, supervision, and documentation will improve screening and follow-up, with potential to reduce preventable maternal and perinatal complications and enhance the quality of antenatal care in similar low-resource settings.
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Copyright (c) 2026 Lillian Najjuko, Jimmy Okwany, Frank Ssemuwemba, Hasifah Nansereko, Jane Frank Nalubega, Immaculate Prosperia Naggulu (Author)
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