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Spatial variations and determinants of anemia among under-five children in Ethiopia, EDHS 2005-2016
Zelalem Alamrew Anteneh1, Jean-Pierre Van Geertruyden2
1Department of Epidemiology, Bahir Dar University, Bahir Dar, Ethiopia.
Insights
Anemia affects over half of children in Ethiopia, with higher risks in younger children and poorer households. Targeted interventions in high-prevalence regions are crucial to combat this public health issue.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Anemia poses a significant public health challenge in sub-Saharan Africa.
- Ethiopia has witnessed a rise in anemia prevalence over the past two decades.
- Geospatial distribution and determinants of childhood anemia in Ethiopia remain underexplored at a national level.
Purpose of the Study:
- To investigate the geospatial distribution of anemia among children in Ethiopia.
- To identify key determinants associated with childhood anemia nationally.
- To inform targeted public health interventions.
Main Methods:
- Utilized Ethiopian Demographic and Health Survey (EDHS) data from 2005-2016.
- Included 19,699 children in the analysis.
- Employed descriptive statistics, geospatial analysis, and Generalized Linear Mixed Models (GLMMs).
Main Results:
- Overall anemia prevalence was 51.5%, with significant spatial variation across clusters.
- Younger children (6-11 months) and those from poorer households had higher odds of anemia.
- Maternal age (15-24 years) and higher numbers of under-five children in a household were associated with increased anemia risk.
Conclusions:
- Childhood anemia exhibits significant geospatial variation in Ethiopia, concentrated in Eastern, Northeastern, and Western regions.
- Identified key risk factors including age, socioeconomic status, and household composition.
- Recommended targeted interventions in identified high-risk areas and for specific determinant factors to mitigate anemia's impact.
Background:
Anemia has severe public health significance in sub-Saharan Africa. In Ethiopia, anemia has been increasing in the last two decades, reaching the highest national level in 2016, however, the geospatial distribution and determinants of anemia in children weren't well explored at a national level.
Methods:
We used the Ethiopian Demographic and Health Survey(EDHS) data from 2005-2016. The data consists of samples of households (HHs) obtained through a two-stage stratified sampling procedure. Our analysis included 19,699 children. Descriptive statistics, geospatial analysis, and Generalized Linear Mixed Model (GLMMs) were used.
Results:
The overall prevalence of anemia was 51.5%; the spatial distribution of anemia significantly different across clusters in each survey. Children from 6 to 11 months had higher odds of anemia compared to 24-59 months (Adjusted Odds ratio (AOR) = 3.4, 95%Confidence level (CI): 2.99-3.76). Children with the first and second birth order were less likely to be anemic compared to fifth and above (AOR = 0.60, 95%CI: 0.38-0.95, and AOR = 0.83, 95%C: 0.73-0.93) respectively. Mothers' age 15 to 24 years was associated with higher odds of anemia compared to 35 to 49 years (AOR = 1.37, 95%CI: 1.20-1.55). Children from HHs with the poorest and poorer wealth category showed a higher odds of anemia compared to the richest (AOR = 1.67, 95%CI: 1.45-1.93, and AOR = 1.25, 95%CI: 1.08-1.45) respectively. Moreover, children from HHs with one to two under-five children were less likely to be anemic compared to those three and more (AOR = 0.83, 95%CI: 0.76-0.91).
Conclusions:
The geospatial distribution of anemia among children varies in Ethiopia; it was highest in the East, Northeast, and Western regions of the country. Several factors were associated with anemia; therefore, interventions targeting the hotspots areas and specific determinant factors should be implemented by the concerned bodies to reduce the consequences of anemia on the generation.
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