地域および公衆衛生看護学ジャーナル

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Factors and Perspectives on Childhood Anemia in Haiti: A Mixed-Methods Study

Jeongyoung Park, Mayri Leslie, Joyce Pulcini, Carol S Lang, Yeoun Joo Lee

Abstract Objective: The prevalence of childhood anemia in Haiti is among the highest in the world. This study investigated factors associated with childhood anemia, explored knowledge of anemia and perspectives for solutions from community members in the area around Caracol, Haiti. Methods: We used a mixed-methods design. Participants were children aged 6 months to 14 years, their families, and any community members attending the free clinic between November 12-17, 2017. Quantitative data were collected via a complete record of a patient’s key clinical data and medical history taken during a clinic visit, and a subsequent verbal survey with their mothers. We identified risk factors for childhood anemia based on a multi-sectoral framework by USAID, which included biophysical, socioeconomic and environmental factors found in this population. Hemoglobin levels of children were measured using the HemoCue System. Through focus groups, qualitative data on the knowledge of anemia and perspectives of parents and community members were gathered. Results: This study found a high prevalence of childhood anemia (n=149, 67%-17% mild, 49% moderate, and 1% severe) and an overall low level of understanding of the multiple causes of anemia. Neither children nor maternal factors result in a significant association with childhood anemia. Only the number of bednets in their home was negatively associated with childhood anemia and statistically significant (OR=0.60, 95% CI: 0.37-0.97, p=0.038).    Conclusion: The finding suggests that the distribution of mosquito nets or insecticide-treated bednets can be an extremely effective and easily preventable method in low resource settings such as Haiti, which has not been emphasized in childhood anemia intervention. The finding of the most interest also includes a strong basis of support from community members in terms of commitment and willingness to make changes. A multi-sectoral and communitybased approach is critical to solve this intractable problem.