Prevalence and determinants of anemia among young (15–24 years) women in Ethiopia: A multilevel analysis of the 2016 Ethiopian demographic and health survey data

Abstract

Background Anemia is a major global public health problem that had tremendous impacts on human health, social and economic development. African countries contribute to the highest-burden of anemia among women, particularly in adolescent females and young women. Anemia among young women remains a public health problem in most parts of Africa, including Ethiopia. Therefore, this study aimed to investigate the prevalence and determinants of anemia among young women in Ethiopia. Methods A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 5796 young women (15–24 years) was included in this study. We employed a multilevel analysis to assess factors associated with anemia since the EDHS has hierarchical nature. Deviance, Intraclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were used for model comparison as well as for assessing model fitness. Variables with a p-value of less than 0.20 at bivariable multilevel analysis were considered for the multivariable multilevel analysis. In the multivariable multilevel analysis variables with p-value ≤ 0.05 were declared to be a significant factor associated with anemia, and the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported to assess the strength and direction of the association. Results The overall prevalence of anemia among young women was 21.7% (95%CI = 20.7%, 22.8%). In the multivariable multilevel binary logistic regression analysis; being Muslim religion follower [adjusted odds ratio (AOR) = 1.31, 95%CI = 1.07, 1.70] and being protestant religion follower [AOR = 1.31; 95%CI = 1.01, 1.71], being rural dweller [AOR = 1.34; 95%CI = 1.02, 1.78], and being married [AOR = 1.46; 95%CI = 1.22, 1.74] were significantly associated with higher odds of anemia among young women. While, modern contraceptive use (AOR = 0.66; 95%CI = 0.53, 0.83) were significantly associated with lower odds of anemia among young women. Conclusion In this study, the prevalence of anemia among young women was high. Being a follower of Muslim and protestant religions, being married women, modern contraceptive use and being from the rural area were found to be significant determinants of anemia among young women. Therefore, giving special attention to these high-risk groups and distributing modern contraceptives for those in need of it could decrease this devastating public health problem in young women.

Multilevel analysis of determinants of anemia among young women (15-24) in sub-Sahara Africa

“…This might be associated with hormonal contraceptives are important to reduce excessive bleeding during the menstrual period that ultimately reduces blood loss over time [ 37 , 38 ]. Young married women had a higher risk of developing anemia compared with unmarried women supported by previous studies conducted in Ethiopia [ 24 , 25 ]. This might be due to as married women can get repeated pregnancy and this frequent pregnancy might lead to increased risk of hemorrhage before, during and after delivery that exposes them to a higher risk of anemia [ 39 ].…”

“…Women who used modern contraceptives had lower odds of developing anemia supported by studies conducted in Ethiopia and Pennsylvania [ 24 , 25 , 31 ]. This might be associated with hormonal contraceptives are important to reduce excessive bleeding during the menstrual period that ultimately reduces blood loss over time [ 37 , 38 ].…”

Anaemia and its determinants among reproductive age women (15–49 years) in the Gambia: a multi-level analysis of 2019–20 Gambian Demographic and Health Survey Data

“…This prevalence is less observed than studies conducted in Gambia [ 28 , 29 ]. It is almost in agreement with a study conducted in Tanzania and Ghana [ 39 ]; nevertheless, this figure is higher than studies investigated in Ethiopia 22.7% 22.1% [ 40 , 41 ], Rwanda [ 42 ]. The possible justification for why this study's empirical findings are higher than the one mentioned above might be due to countries profiles of anaemia and other communicable diseases, participants' attitudes, knowledge, and educational backgrounds towards anaemia.…”

“…The multi-level logistic regression analysis depicted those women who have current contraceptives have less likely to be anaemic patients than current contraceptive nonusers. This finding is supported by literature investigated in Ethiopia [ 41 ], Rwanda [ 42 ], 24 Sub-Saharan Africa study [ 43 ]. The DHS data of 12 developing countries was conducted to determine the existence and degree of contraceptive benefits other than prevention of unintended pregnancy found a reduction rate of 32% to 44% odds of anaemia exposure among contraceptive users [ 44 ].…”

“…Study participants residing in the region of Brikama have a less likely chance of developing anaemia than their counterparts of the Banjul region. Although differences across regions did not well investigated in the Gambia, studies from similar developing countries found a regional variation of anemia [ 41 , 42 ]. This could be demonstrated by differences in anemia risk in the spread of communicable diseases associated to regional geographic conditions, food supply, availability of a variety of foods, accessibility, and use of healthcare facilities.…”