Anemia prevalence and its predictors among children under-five years in Ghana. A multilevel analysis of the 2019 Ghana malaria indicator survey

Abstract

Despite the implementation of anemia control interventions in Ghana, prevalence of anemia is still high in children under-five years although it has reduced by 24% between 2008 and 2019. Further reducing the prevalence of anemia requires identifying and targeting critical risk factors associated to anemia. This study seeks to identify predictors of anemia among children under-five years in Ghana. Data from 2019 Ghana MIS was analyzed using both fixed and random effect logistic regression models. Among the 2434 children under-five years, 54% (95% CI 52.0, 57.0) of them were anemic. In the multivariable multilevel model, the risk of anemia was found to be higher in younger children, children who had malaria, children whose mothers were not covered for health insurance, adolescent mothers’, non-Christian mothers and poorer households. Significant unobserved community level effects in anemia prevalence were observed. We observed high prevalence of anemia in children under-five and critical risk factors at the child, household, and community levels in this population of children. Multifaceted and targeted approaches are needed to help reduce the anemia prevalence in this setting so as to achieve multiple SDGs which are related to risk and prevalence of anemia by 2030.

Maternal Anemia Emerges as a Potential Risk Factor for Anemia in Children Aged 6-59 Months in Tanzania: Evidence from the 2022 TDHS-MIS Cross-Sectional Household Survey

“…Male children in this study had a higher probability of developing anemia compared to female children (AOR = 1.27; 95% CI: 1.06; 1.51). This trend is consistent with several other ndings in previous studies [10,23,26]. This might be explained by the fact that male children tend to have a higher growth rate, which results in an increased demand for iron in the body [32].…”

“…Additionally, children aged between 6 and 23 months (AOR = 1.72; 95% CI: 1.43; 2.07) had a higher chance of developing anemia compared to children over 23 months of age. This nding is in line with several previous studies [21,23,24,26]. After six months of age, children begin to introduce complementary foods into their diet.…”

“…Compared to other African countries, such as Nigeria (68.1%) [14], Togo (70.9%) [8], and Mozambique (80.3%) [22], Tanzania showed converging rates, although lower than those of Ghana [16,23], Ethiopia [15,24], Zimbabwe [25], and Namibia [26]. Among these affected children, 40.8% had mild anemia, 56.4% moderate anemia, and 2.8% severe anemia.…”

“…While the WHO considers a prevalence of anemia above 40% as a serious public health problem [1,2], most African countries, including the context of this study, face rates well above this threshold. It is crucial to improve existing policies and implement speci c interventions, such as geographic, behavioral, community, and individual strategies, to drastically reduce these rates [23].…”

Random Intercept Multilevel Modeling of Determinants of Unintended Pregnancies in Sub-Saharan Africa

“…All the analyses were performed using Stata 17.0. All analysis accounted for weighting, clustering, stratification and design effect using the survey mode in Stata ("svy") due to the complex survey design of the MIS (Malaria Indicator Survey) data [23]. Statistical significance was declared at 0.05 alpha levels.…”