Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: a multilevel and spatial analysis

• Published in: BMJ open Vol. 9; no. 4; p. e027276
• Main Authors: Kibret, Kelemu Tilahun, Chojenta, Catherine, D’Arcy, Ellie, Loxton, Deborah
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 04.04.2019; BMJ Publishing Group
• Subjects: Adolescent; Adult; Age; Anemia; Anemia - epidemiology; Breast Feeding; Cross-Sectional Studies; Epidemiology; Ethiopia - epidemiology; Female; Geography; Health Surveys; Hemoglobin; HIV; Human immunodeficiency virus; Humans; Infections; Iron; Logistic Models; Maternal Age; Middle Aged; Multilevel Analysis; Nutrition research; Pregnancy; Prevalence; Public health; Quantitative analysis; Risk Factors; Rural areas; Sanitation; Spatial Analysis; Systematic review; Trends; Womens health; Young Adult; Ethiopia; East Africa; multilevel analysis; spatial analysis; reproductive age women; anemia; women
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-027276

ObjectiveThe aim of this study was to assess the spatial distribution and determinant factors of anaemia among reproductive age women in Ethiopia.MethodsAn in-depth analysis of the 2016 Ethiopian Demographic and Health Survey data was undertaken. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas for anaemia among women of reproductive age. A multilevel logistic regression model was used to identify independent predictors of anaemia among women of reproductive age.ResultsOlder age (adjusted OR [AOR]=0.75; 95% CI 0.64 to 0.96), no education (AOR=1.37; 95% CI 1.102 to 1.72), lowest wealth quantile (AOR=1.29; 95% CI 1.014 to 1.60), currently pregnant (AOR=1.28; 95% CI 1.10 to 1.51, currently breast feeding (AOR=1.09; 95% CI 1.025 to 1.28), high gravidity (AOR=1.39; 95% CI 1.13 to 1.69) and HIV positive (AOR=2.11; 95% CI 1.59 to 2.79) are individual factors associated with the occurrence of anaemia. Likewise, living in a rural area (AOR=1.29; 95% CI 1.02 to 1.63) and availability of unimproved latrine facilities (AOR=1.18; 95% CI 1.01 to 1.39) are community-level factors associated with higher odds of anaemia. The spatial analysis indicated that statistically high hotspots of anaemia were observed in the eastern (Somali, Dire Dawa and Harari regions) and north-eastern (Afar) parts of the country.ConclusionThe prevalence rate of anaemia among women of reproductive age varied across the country. Significant hotspots/high prevalence of anaemia was observed in the eastern and north-eastern parts of Ethiopia. Anaemia prevention strategies need to be targeted on rural residents, women with limited to no education, women who are breast feeding, areas with poor latrine facilities and women who are HIV positive.