Factors associated with anaemia among women of reproductive age in Ethiopia: Multilevel ordinal logistic regression analysis

Abstract

Anaemia has prevailed as a mild to severe public health problem in Ethiopian women of reproductive age. Many studies carried out on anaemia have been limited to subnational assessments and subgroups of women. The effects of potential factors thought to affect anaemia and severity levels of anaemia have not been well considered. Therefore, this study identifies individual, household and community level factors associated with anaemia among women of reproductive age in Ethiopia applying multilevel ordinal logistic regression models. Proportional odds assumption was tested by likelihood ratio test. About 35.6% of the variation on anaemia was due to between household and community level differences. Pregnancy (adjusted odds ratio [AOR] = 2.30, 95% confidence interval [CI]: 1.82, 2.91), HIV (AOR = 2.40, 95% CI: 1.76, 3.25), giving birth once (AOR = 1.2, 95% CI: 1.05, 1.40), giving birth more than once (AOR = 1.4, 95% CI: 1.19, 1.71), living with five or more family members (AOR = 1.24, 95% CI: 1.05, 1.47), living in poorest households (AOR = 1.34, 95% CI: 1.2, 1.61) and rural area (AOR = 1.57, 95% CI: 1.28, 1.92) were associated with greater odds of more severe anaemia compared with their respective counter parts. Secondary and above education (AOR = 0.83, 95% CI: 0.70, 0.97) and use of pills, implants or injectable (AOR = 0.67, 95% CI: 0.59, 0.77) were associated with lower odds of more severe anaemia. Anaemia prevention and control programmes need to be strengthened for women living with HIV/AIDS and during pregnancy. Household poverty reduction and social protection services need to be strengthened and integrated in anaemia prevention and management activities in women.

Spatiotemporal distribution and determinants of open defecation among households in Ethiopia: A Mixed effect and spatial analysis

“…For community poverty, according to the world bank (WB), 2019/ 2020 report around 24% of the population is in poverty [ 27 ]. For community mass media exposure we have used 13.8% and also for community women’s education level we used 7.7% [ 28 ]. The normal distribution of aggregated community factors was assessed by histogram and Shapiro Wilks test and then we recorded them based on the appropriate measure of central tendency.…”

Individual and community-level determinants of childhood vaccination in Ethiopia

“…More importantly, it is often the cases of the respondents are observed nested within clusters or communities (i.e children nested with community/clusters) and so the use of the ordinal regression model which assumes the observations are independent which is problematic. In this case, the multilevel regression model better analyzes the response measurements [ 29 , 30 ]. A Multilevel Proportional Odds Model (MPOM) was used to identify the individual and community-level factors associated with child vaccination.…”

Household Solid Fuel Use and Associated Factors in Ethiopia: A Multilevel Analysis of Data From 2016 Ethiopian Demographic and Health Survey

“…Most of the variables were taken directly as they were in the EDHS data set. However, individual variables such as wealth index, age of the household, 4 educational status, household size, 20 and place of cooking food were reclassified. A wealth index was created using principal component analysis.…”