CHAPTER ONE
GENERAL INTRODUCTION
1.0 Introduction
This chapter consists of background, historical review, conceptual review, contextual review,
empirical review, theoretical review, problem statement,
general objective, specific objective, research questions, significant of study, justification of
study, scope of study, and definition of terms.
1.1 Background to the Study
Anemia has long been recognized as a health issue, but its specific impact during pregnancy
gained attention in the late 19th and early 20th centuries. Early medical thought often viewed
anemia as a natural consequence of pregnancy, linked to maternal depletion. Advances in
hematology in the early 20th century identified iron and folate deficiencies as key causes,
leading to the introduction of dietary supplementation programs and more accurate diagnoses
(Milman, 2011). By the mid-20th century, anemia in pregnancy became a global public
health priority, with the World Health Organization (WHO) advocating for iron and folic acid

supplementation as part of antenatal care. In low- and middle-income countries like
Cameroon, anemia prevalence remained high due to malnutrition, parasitic infections, and
poor healthcare access (WHO, 2021). Over time, research revealed the multifactorial nature
of anemia, with contributions from malaria, hookworm infections, and micronutrient
deficiencies such as vitamin B12 (World Bank, 2020). The government and international

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partners have since introduced programs to combat anemia, including supplementation,
malaria prevention, and health education.
Conceptually, anemia in pregnancy is a critical health condition defined as a hemoglobin
level less than 11 g/dL during gestation, as per the World Health Organization (WHO, 2021).
It is primarily caused by iron deficiency, folate deficiency, and chronic conditions like
malaria and sickle cell anemia. During pregnancy, the increased demand for oxygen andthe most common cause. Malaria, hookworm infections, and poor dietary practices contribute
to the high rates of anemia in the country, particularly in rural and underserved areas. In the
South West Region, specifically in Buea, where access to healthcare services can be limited
due to geographical and socio-economic barriers, the burden of anemia is felt more acutely.
Women in this region often have limited access to antenatal care, nutritional counseling, and
iron supplementation programs. Socio-cultural beliefs about health, nutrition, and pregnancy
also influence how women perceive and manage anemia. These factors often lead to low
awareness of the risks associated with anemia, including its potential consequences on
maternal and fetal health, such as preterm birth, low birth weight, and maternal mortality
(Tebeu. et al., 2019).