Background: In the early stages of life, anemia leads to severe negative consequences on the cognitive, growth and development of children. The Ethiopian demographic and health survey showed an increasing trend of anemia nationally. Objective: The aim of this study is to assess the magnitude and factors associated with anemia among under-five children. Methods: A health facility based cross sectional study was conducted among 409 systematically selected children 6-59 months attending services at public and private health institutions in Kombolcha Town, Northeast Ethiopia. Data were collected using structured questioner from mother or caretakers.  The data entry and analysis were done by SPSS version 20. Binary logistic regression was fitted to determine associations. The odds ratio with the 95% confidence intervals were reported. Results: From the total participant 213(53.9%) were males with the mean age of 26 months (SD+15.2). The overall prevalence of anemia was 52.2% (95% CI, 46.8%-57%). Being in the age of 6-11 months (AOR= 6.23, 95% CI: 2.44, 15.95), 12-23 months (AOR= 3.74, 95%CI: 1.63, 8.60), maternal age ≥30 years (AOR=0.37 (0.18, 0.77), exclusive breast feeding until six months (AOR=0.27, 95% CI: 0.16, 0.45), having low dietary diversity score (AOR=2.61, 95% CI: 1.55, 4.38), having history of diarrhea (AOR= 1.87, 95% CI: 1.12, 3.12) and having the lowest family monthly income (AOR=16.97, 95% CI: 4.95, 58.20) were identified as factors associated with anemia. Conclusion: The magnitude of anemia in children was a public health problem in the study area. child age, maternal age, exclusive breastfeeding, dietary diversity score, diarrhea and family income were found to be associated with anemia.

Background Childhood anemia is an important public health problem in Ethiopia. The northeast part of the country is among the areas affected by recurrent drought. Despite its significance, studies are scarce on childhood anemia particularly, in the study area. This study aimed to assess the proportion and factors associated with anemia among under-five children in Kombolcha town. Methods A facility-based cross-sectional study was conducted among 409 systematically selected 6 to 59 months aged children visited health institutions in Kombolcha town. Data were collected using structured questionnaires from mothers/caretakers. The data entry and analysis were done using EpiData version 3.1 and SPSS version 26 respectively. Binary logistic regression was fitted to identify factors associated with anemia. Statistical significance was declared at p-value ≤ 0.05. The effect size was reported using the adjusted odds ratio with its 95% confidence interval. Results Of the participants, 213(53.9%) were males with a mean age of 26 months (SD ± 15.2). The proportion of anemia was 52.2% (95% CI, 46.8-57%). Being in the age of 6–11 months (AOR = 6.23, 95% CI: 2.44, 15.95), 12–23 months (AOR = 3.74, 95%CI: 1.63, 8.60), having low dietary diversity score (AOR = 2.61, 95% CI: 1.55, 4.38), having a history of diarrhea (AOR = 1.87, 95% CI: 1.12, 3.12) and having the lowest family monthly income (AOR = 16.97, 95% CI: 4.95, 58.20) were positively associated with anemia. Whereas, maternal age ≥ 30 years (AOR = 0.37 (0.18, 0.77) and exclusive breastfeeding until six months (AOR = 0.27, 95% CI: 0.16, 0.45) were negatively associated with anemia. Conclusions Childhood anemia was a public health problem in the study area. Child age, maternal age, exclusive breastfeeding, dietary diversity score, diarrhea, and family income were significantly associated with anemia.