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Nuwabaine L, Kawuki J, Kamoga L, Sserwanja Q, Gatasi G, Donkor E, Mutisya LM, Asiimwe JB. Factors associated with anaemia among pregnant women in Rwanda: an analysis of the Rwanda demographic and health survey of 2020. BMC Pregnancy Childbirth 2024; 24:328. [PMID: 38678175 PMCID: PMC11055334 DOI: 10.1186/s12884-024-06528-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda. METHODS Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value < 11 g/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26). RESULTS Of the 435 pregnant women, 24.6% (95%CI: 21.1-29.3) were anaemic (1 in 4 pregnant women). Not working (AOR = 2.45; 95%CI: 1.14-5.26), being unmarried (AOR = 1.23; 95%CI: 1.24-3.57), low wealth index (AOR = 9.19; 95%CI: 1.64-51.56), having difficulty accessing a nearby health facility (AOR = 5.40; 95%CI: 2.21-13.23), and normal body mass index (AOR = 3.33; 95%CI: 1.46-7.59) were associated with higher odds of being anaemic. However, not taking iron supplements (AOR = 0.16; 95% CI: 0.04-0.67), having no exposure to television (AOR = 0.35; 95%CI: 0.14-0.91), being from the southern region (AOR = 0.14; 95% CI: 0.03-0.66), and low husband/partner's education (AOR = 0.08; 95% CI: 0.01-0.59) were associated with lower odds of being anaemic. CONCLUSIONS The study findings indicate a high prevalence of anaemia in pregnancy, which was associated with several socio-demographics. There is a need for setting up mobile clinics and health facilities in hard-to-reach areas for easy accessibility to early anaemia screening services. Conducting mass screening for anaemia targeting pregnant women who are not working, the unmarried, and those with a low wealth index would also be beneficial. The intake of locally available iron rich foods and/ or bio-fortified foods is also recommended.
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Affiliation(s)
- Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Livingstone Kamoga
- Department of Nursing, Makerere University College of Health Sciences, Makerere, Uganda
| | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
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Let S, Tiwari S, Singh A, Chakrabarty M. Prevalence and determinants of anaemia among women of reproductive age in Aspirational Districts of India: an analysis of NFHS 4 and NFHS 5 data. BMC Public Health 2024; 24:437. [PMID: 38347505 PMCID: PMC10860231 DOI: 10.1186/s12889-024-17789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Over one-third of women worldwide suffer from anaemia. The prevalence of anaemia is particularly pronounced among women of reproductive age (WRA) in developing countries, such as India. No prior study has ever exclusively studied the prevalence of anaemia across the Aspirational Districts of India. Therefore, the purpose of this study was to examine the prevalence of anaemia across Aspirational Districts of India and to identify the determinants of anaemia among WRA in these districts. METHODS From the National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21), data on 114,444 and 108,782 women aged 15-49 from Aspirational Districts were analyzed in our study, respectively. Bivariate statistics and multivariable binary logistic regression were used to identify the determinants of anaemia. RESULTS The national prevalence of anaemia among WRA has increased from 53% in NFHS-4 to 57% in NFHS-5 whereas anaemia among WRA in Aspirational Districts has increased from 58.7% in NFHS-4 to 61.1% in NFHS-5. Between 2015 and 2021, over 60% of Aspirational Districts experienced an increase in the prevalence of anaemia and one-fourth, specifically 29 out of 112, observed a rise by at least 10 percentage points (pp). Notably, there are significant variations in anaemia prevalence among districts, with Simdega and Udalgiri having the highest anaemia prevalence in NFHS-4 and NFHS-5 at 78.2% and 81.5%, respectively. During this period, Barpeta followed by Udalgiri of Assam have witnessed the maximum increase with 29.4% and 26.7% respectively. Moreover, pooled regression results show women with three to four children [AOR: 1.13, 95% CI: 1.08-1.17], women who breastfeed [AOR: 1.17, 95% CI: 1.13-1.20], Scheduled Tribe women [AOR: 1.39, 95% CI: 1.35-1.44], poorest women [AOR: 1.27, 95% CI: 1.22-1.33] and women those who consume fish occasionally [AOR: 1.14, 95% CI: 1.12-1.17] were more likely to be anaemic. CONCLUSION The significant increase in anaemia among WRA in Aspirational Districts of India is a matter of concern. Given the rise in anaemia among WRA, determinants-based and district-specific measures must be designed and implemented to reduce the prevalence of anaemia among Aspirational Districts of India.
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Affiliation(s)
- Subhojit Let
- Department of Geography, Banaras Hindu University, Varanasi, India
| | - Seema Tiwari
- Geography Section, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aditya Singh
- Department of Geography, Banaras Hindu University, Varanasi, India.
- Girl Innovation, Research, and Learning (GIRL) Center, Population Council, New York, NY, United States of America.
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Singh A, Ram S, Chandra R, Tanti A, Singh S, Kundu A. A district-level geospatial analysis of anaemia prevalence among rural men in India, 2019-21. Int J Equity Health 2024; 23:9. [PMID: 38243230 PMCID: PMC10799465 DOI: 10.1186/s12939-023-02089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/28/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Despite its considerable impact on health and productivity, anemia among men has received limited attention. In a country as diverse as India, characterized by extensive geographic variations, there is a pressing need to investigate the nuanced spatial patterns of anemia prevalence among men. The identification of specific hotspots holds critical implications for policymaking, especially in rural areas, where a substantial portion of India's population resides. METHODS The study conducted an analysis on a sample of 61,481 rural men from 707 districts of India, utilizing data from the National Family Health Survey-5 (2019-21). Various analytical techniques, including Moran's I, univariate LISA (Local Indicators of Spatial Association), bivariate LISA, and spatial regression models such as SLM (Spatial Lag Model), and SEM (Spatial Error Model) were employed to examine the geographic patterns and spatial correlates of anaemia prevalence in the study population. RESULTS In rural India, three out of every ten men were found to be anemic. The univariate Moran's I value for anaemia was 0.66, indicating a substantial degree of spatial autocorrelation in anaemia prevalence across the districts in India. Cluster and outlier analysis identified five prominent 'hotspots' of anaemia prevalence across 97 districts, primarily concentrated in the eastern region (encompassing West Bengal, Jharkhand, and Odisha), the Dandakaranya region, the Madhya Pradesh-Maharashtra border, lower Assam, and select districts in Jammu and Kashmir. The results of SLM revealed significant positive association between anaemia prevalence at the district-level and several key factors including a higher proportion of Scheduled Tribes, men in the 49-54 years age group, men with limited or no formal education, individuals of the Muslim faith, economically disadvantaged men, and those who reported alcohol consumption. CONCLUSIONS Substantial spatial heterogeneity in anaemia prevalence among men in rural India suggests the need for region-specific targeted interventions to reduce the burden of anaemia among men in rural India and enhance the overall health of this population.
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Affiliation(s)
- Aditya Singh
- Department of Geography, Banaras Hindu University, Varanasi, India.
- Girl Innovation, Research, and Learning (GIRL) Centre, Population Council, New York, USA.
| | - Sumit Ram
- Department of Geography, Banaras Hindu University, Varanasi, India.
| | - Rakesh Chandra
- School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Arabindo Tanti
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, India
| | | | - Ananya Kundu
- Department of Geography, University of Calcutta, Kolkata, India
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Alem AZ, Efendi F, McKenna L, Felipe-Dimog EB, Chilot D, Tonapa SI, Susanti IA, Zainuri A. Prevalence and factors associated with anemia in women of reproductive age across low- and middle-income countries based on national data. Sci Rep 2023; 13:20335. [PMID: 37990069 PMCID: PMC10663544 DOI: 10.1038/s41598-023-46739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/04/2023] [Indexed: 11/23/2023] Open
Abstract
Anemia is a global threat among women of reproductive age (WRA), or 15-49 years old women, both in developed and developing countries. Prevalence of anemia in WRA is higher by fourfold in developing countries, based on extensive studies and surveys conducted by WHO and UNICEF. However, there is limited studies that conducted pooled analysis of anemia prevalence in low resource countries. This study aimed to assess the prevalence and factors associated with anemia among women of reproductive age in low- and middle-income countries (LMICs). This study used secondary data from the Demographic and Health Survey (DHS) in 46 low- and middle-income countries during 2010-2021. Descriptive statistics of proportions between pregnant and non-pregnant mothers were assessed. Multilevel binary logistic regression was used to test the factors associated with anemia among women of reproductive age. A total of 881,148 women of childbearing age in LMICs were included. This study found a high prevalence of 45.20% (95% CI 41.21, 49.16) of anemia was observed in among pregnant women and 39.52% (95% CI 33.88, 45.15) anemia was observed in non-pregnant women. Educational status, wealth status, family size, media exposure, and residence were common factors significantly associated with anemia in both pregnant and non-pregnant women. The high global burden of anemia in LMICs continues to underline the need for unusual approaches and target interventions on an individual basis. Global commitment and movement to reduce the prevalence of anemia need to be revisited and redesigned for current circumstances.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Jl. Mulyorejo Kampus C Unair, Surabaya, 60115, Indonesia.
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | - Eva Belingon Felipe-Dimog
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Nursing Department, Mountain Province State Polytechnic College, Bontoc, Mountain Province, Philippines
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Agus Zainuri
- Faculty of Public Health, Universitas Cenderawasih, Jayapura, Indonesia
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Merid MW, Chilot D, Alem AZ, Aragaw FM, Asratie MH, Belay DG, Kibret AA. An unacceptably high burden of anaemia and it's predictors among young women (15-24 years) in low and middle income countries; set back to SDG progress. BMC Public Health 2023; 23:1292. [PMID: 37407912 DOI: 10.1186/s12889-023-16187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Anaemia is a major global public health problem, considerably affects young women in resource limited countries. The available researches on anaemia focused on children, pregnant women, or all women of reproductive age. However, women's biology and life experiences vary dramatically across 15 to 49 years, putting young women bear the higher burden of anaemia, mainly in low and middle income countries (LMICs). Therefore, this study assessed the burden of anaemia among young women (15-24 years) in 24 LMICs which conducted Demographic and Health Surveys (DHS) between 2016 and 2021. METHOD Data analysis was carried out with STATA version 14. The forest plot was used to explore the pooled prevalence of anaemia. Multilevel binary logistic regression was fitted to accommodate the hierarchical nature of the DHS data. Accordingly, a model with lowest deviance (model III) was the best-fitted model. All variables with a p-value ≤ 0.2 in the bi-variable analysis were fitted in the multi-level multivariable model. Adjusted odds ratio with 95% CI and p < 0.05 were presented to declare statistical significance. RESULT The pooled prevalence of anaemia among young (15-24 years) women in 24 LMICs was 41.58% (95%CI: 34.51, 48.65). Country wise, Mali (62.95%) and Rwanda (14.13%) constitute the highest and lowest prevalence of anaemia. In this study, young women who lived in the poorest wealth status, had no education, were underweight, perceived distance to the health facility a big problem, larger family size, and women who had ever terminated pregnancy were associated with increased odds of anaemia. Whereas, young women who were overweight and not breast feeding had decreased odds of anaemia. CONCLUSION The unacceptably high burden of anaemia among young women setbacks the SDG target; to end all forms of malnutrition by 2030. Therefore, it is highly recommended to take relevant interventions to reduce the burden of anaemia targeted the young women who are uneducated, have low socio-economic status, limited access to health facilities, and lived in larger family size.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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