Socioeconomic determinants of haemoglobin levels of African women are less important in areas with more health facilities: a multilevel analysis

Haverkate, Manon; Smits, Jeroen; Meijerink, Hinta; Ven, André van der

doi:10.1136/jech-2012-202336

Cited by 12 publications

(15 citation statements)

References 31 publications

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“…This is consistent with the study of Haverkate et al, (2014). They have considered land ownership as one of the measures of wealth.…”

Section: Discussionsupporting

confidence: 89%

Socioeconomic Determinants of Maternal Anemia: A Disaggregated Level Analysis From Assam, India

Dutta¹,

Sengupta²

2017

International Conference on Public Health

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This study examines socio-economic determinants associated with maternal mortality at disaggregated level in Assam, the state with highest maternal mortality ratio in India. An extensive door-to-door household survey was carried out during 2014-15 using multistage sampling to select villages in districts with high number of reported maternal deaths. The samples consist of currently pregnant women, mother with children 0-24 months and members of families who have experienced of maternal death. The study reveals that prevailing incidences of maternal mortality and maternal complications are the result of maternal anemia. Maternal complications are more likely to be associated with lower concentration of hemoglobin level, which is a proxy for maternal anemia. In addition, concentration of hemoglobin level is positively related to socioeconomic factors-literacy, land ownershipand habitat/occupation of the sample population. As a policy prescription, such findings should encourage the policymakers to identify context specific determinants of maternal anemia for appropriate interventions, instead of 'one-size-fits-all' type of approach.

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“…This is consistent with the study of Haverkate et al, (2014). They have considered land ownership as one of the measures of wealth.…”

Section: Discussionsupporting

confidence: 89%

Socioeconomic Determinants of Maternal Anemia: A Disaggregated Level Analysis From Assam, India

Dutta¹,

Sengupta²

2017

International Conference on Public Health

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“…Many studies have shown inverse relationships between BMI and anemia [31, 32, 34, 42]. A multi-country, multi-level analysis of hemoglobin levels of African women showed stronger associations of anemia with socioeconomic and contextual factors than with BMI [11]. Micronutrient deficiencies have been shown to have different roles in etiology of varying severities of anemia [17].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of published studies on anemia in SSA focus on children and pregnant women [4–9]. Men and elderly populations have received relatively little attention [10, 11]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences

Adamu

Crampin

Kayuni

et al. 2017

Popul Health Metrics

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BackgroundThe global burden of anemia is large especially in sub-Saharan Africa, where HIV is common and lifestyles are changing rapidly with urbanization. The effects of these changes are unknown. Studies of anemia usually focus on pregnant women or children, among whom the burden is greatest. We describe prevalence and risk factors for anemia among rural and urban men and women of all ages in Malawi.MethodsWe analyzed data from a population-wide cross-sectional survey of adults conducted in two sites, Karonga (rural) and Lilongwe (urban), commencing in May 2013. We used multinomial logistic regression models, stratified by sex to identify risk factors for mild and moderate-to-severe anemia.ResultsAnemia prevalence was assessed among 8,926 men (age range 18–100 years) and 14,978 women (age range: 18–103 years). Weighted prevalence levels for all, mild, and moderate-to-severe anemia were 8.2, 6.7 and 1.2% in rural men; 19.4, 12.0 and 7.4% in rural women; 5.9, 5.1 and 0.8% in urban men; and 23.4, 13.6 and 10.1% in urban women. Among women, the odds of anemia were higher among urban residents and those with higher socioeconomic status. Increasing age was associated with higher anemia prevalence in men. Among both men and women, HIV infection was a consistent risk factor for severity of anemia, though its relative effect was stronger on moderate-to-severe anemia.ConclusionsThe drivers of anemia in this population are complex, include both socioeconomic and biological factors and are affecting men and women differently. The associations with urban lifestyle and HIV indicate opportunities for targeted intervention.

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“…Many studies do report travel time, distance, or health facility population coverage as significant factors in adequate ANC attendance[ 49 , 55 – 57 ]. Haverkate et al’s analysis of women’s hemoglobin status found that hemoglobin differences due to wealth quintiles were attenuated by increased number of health facilities[ 60 ]. In our analyses, HSC capacity, access, and supply factors were not associated with any IFA receipt, regardless of whether ANC variables were included in the model or not.…”

Section: Discussionmentioning

confidence: 99%

Individual and Facility-Level Determinants of Iron and Folic Acid Receipt and Adequate Consumption among Pregnant Women in Rural Bihar, India

et al. 2015

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BackgroundIn Bihar, India, high maternal anemia prevalence and low iron and folic acid supplement (IFA) receipt and consumption have continued over time despite universal IFA distribution and counseling during pregnancy.PurposeTo examine individual and facility-level determinants of IFA receipt and consumption among pregnant women in rural Bihar, India.MethodsUsing District Level Household Survey (2007–08) data, multilevel modeling was conducted to examine the determinants of two outcomes: IFA receipt (any IFA receipt vs. none) and IFA consumption (≥90 days vs. <90 days). Individual-level and facility-level factors were included. Factor analysis was utilized to construct antenatal care (ANC) quality and health sub-center (HSC) capacity variables.ResultsOverall, 37% of women received any IFA during their last pregnancy. Of those, 24% consumed IFA for 90 or more days. Women were more likely to receive any IFA when they received additional ANC services and counseling, and attended ANC earlier and more frequently. Significant interactions were found between ANC quality factors (odds ratio (OR): 0.37, 95% confidence interval (CI): 0.25, 0.56) and between ANC services and ANC timing and frequency (OR: 0.68, 95% CI: 0.56, 0.82). No HSC factors were significantly associated with IFA receipt. Women were more likely to consume IFA for ≥90 days if they attended at least 4 ANC check-ups and received more ANC services. IFA supply at the HSC (OR: 1.37, 95% CI: 1.04, 1.82) was also significantly associated with IFA consumption.ConclusionsOur findings indicate that individual and ANC factors (timing, frequency, and quality) play a key role in facilitating IFA receipt and consumption. Although HSC capacity factors were not found to influence our outcomes, significant variation at the facility level indicates unmeasured factors that could be important to address in future interventions.

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Socioeconomic determinants of haemoglobin levels of African women are less important in areas with more health facilities: a multilevel analysis

Abstract: Interventions aimed at improving the Hb level of African women should take socioeconomic and contextual aspects into account. Increasing availability of health facilities might be a tool for reducing socioeconomic differences.

Cited by 12 publications

References 31 publications

Socioeconomic Determinants of Maternal Anemia: A Disaggregated Level Analysis From Assam, India

Socioeconomic Determinants of Maternal Anemia: A Disaggregated Level Analysis From Assam, India

Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences

Individual and Facility-Level Determinants of Iron and Folic Acid Receipt and Adequate Consumption among Pregnant Women in Rural Bihar, India

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