Published in PLOS One on 2026-07-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Abdirisak Nur Yusuf, Adisu Birhanu, Alemayehu Tesfaye, Birhanu Shegene, Obsan Kassa, Tadesse Gure Eticha, Dawit Firdisa, Berhe Gebremichael
Source: PLOS One • DOI 10.1371/journal.pone.0354666
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Anemia is a prevalent global public health issue, especially among pregnant women in developing countries. Limited research exists on anemia in pregnant women in Somalia, particularly in Garowe City. This study aims to determine the prevalence of anemia and its associated factors among pregnant women attending antenatal care in public health facilities in Garowe City, Puntland, Somalia, from December 1, 2023, to January 1, 2024.
An institution-based cross-sectional study was conducted with 422 randomly selected pregnant women in public health facilities. Data were collected using EpiData version 4.6 and analyzed with SPSS version 25. Bivariate and multivariable logistic regression analyses identified factors associated with anemia, with statistical significance set at P < 0.05.
The prevalence of anemia among pregnant women was 38.6% (95% CI: 33.9%, 43.6%). Significant associated factors included: rural residence (AOR = 2.58, 95% CI: 1.18–5.64), multigravidity (AOR = 2.01, 95% CI: 1.03–3.89), lack of nutritional counseling (AOR = 1.65, 95% CI: 1.09–2.52), positive malaria test (AOR = 3.58, 95% CI: 1.08–11.98), and not consuming one extra meal (AOR = 2.19, 95% CI: 1.15–4.19).
Anemia in pregnant women in Garowe City is a moderate public health concern according to WHO standards. Factors such as residence, gravidity, nutritional counseling, malaria status, and dietary habits significantly correlate with anemia. Public health measures should focus on enhancing nutritional counseling, promoting extra meal consumption, and preventing malaria during pregnancy.
Introduction
Anemia is characterized by a reduction in the concentration of red blood cells in circulation or a decrease in hemoglobin/hematocrit concentration, leading to an impaired capacity to transport oxygen. It measures the ratio of red cell concentration to blood volume, which is traditionally used to quantify the decline [1]. According to the WHO definition, hemoglobin (Hb) <11 g/dL or a hematocrit <33% at any time during pregnancy is considered anemia of pregnancy. It is classified as mild (10.0–10.9 g/dL), moderate (7.0–9.9 g/dL), and severe (lower than 7.0 g/dL) anemia based on the level of hemoglobin concentration [2]. Iron deficiency can be diagnosed by serum ferritin-level measurement, with a threshold value of <30 μg/L. Routine hemoglobin testing, at least once per trimester, and blood ferritin-level testing in the first trimester are the recommended methods for screening for anemia caused by iron deficiency in all pregnant women [3]. The recommended daily iron intake for pregnant women is 27 mg, and proper nutrition can help prevent iron deficiency anemia during pregnancy. Dietary sources of iron include fish, chicken, and lean red meat, as well as dry beans, peas, dark green leafy vegetables, and iron-enriched breakfast cereals [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Abdirisak Nur Yusuf, Adisu Birhanu, Alemayehu Tesfaye, Birhanu Shegene, Obsan Kassa, Tadesse Gure Eticha, Dawit Firdisa, Berhe Gebremichael. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Prevalence of undernutrition and its associated factors among pregnant women attending antenatal care service in public hospitals in Mogadishu, Somalia
- Evidence brief: Hematological parameters and associated factors among adult patients with type 2 diabetes mellitus attending selected hospitals in Garowe, Puntland, Somalia: A comparative cross-sectional study
- Evidence brief: Integrated malaria service delivery and its determinants among pregnant women in Ethiopia: Multi level analysis of 2021/22 National Service Provision Assessment Survey
