What factors are associated with the increase of anemia in Ethiopian children aged 6 to 59 months between 2011 and 2016?

Abstract

Background In Ethiopia more than half of the children under 5 years are anemic and between 2011 and 2016 anemia in children under-5 increased by 28.7%. This study aimed to analyze this increase in anemia by socio-demographic characteristics. Method This study was a secondary analysis of the data from the Ethiopian Demographic Health Surveys (EDHS) for 2011 and 2016. The increase of anemia was calculated using percentage change. The chi-square test was used to determine the association between anemia and six predictor variables of age, sex, mother’s educational level, residence, wealth quintile and region. The strength of association was measured using Cramer’s V. Results Anemia increased in all age groups, both sexes, urban and rural residencies, across all wealth quintiles, all maternal education levels and all regions of Ethiopia except Benishangul Gumuz. The highest increase of anemia was seen among children born to mothers with above secondary education (65.8%), living in urban areas (40.1%), in the lowest wealth quintile (41.5%), and children from Tigray region (42.9%). Severe anemia increased in all age categories except in infants aged 9–11 months. Children of mothers with above secondary educational level had the highest increase of mild and moderate anemia. Severe anemia decreased in the second and middle wealth quintiles whereas it increased in the rest quintiles. Benishangul Gumuz is the only region where mild, moderate, and severe anemia decreased. Pearson’s chi-square (χ2) test showed that all the predictor variables except sex were significantly associated with anemia. Although highly significant (p < 0.001) using the chi-square test, Cramer’s V showed that residence (V = 0.052–0.066) and maternal education (V = 0.041–0.044) were only weakly associated with anemia. Conclusion Anemia in children under-5 continues to be a severe public health problem in Ethiopia. Benishangul Gumuz region is the only region that was able to reduce the prevalence of all forms of anemia under-5 between 2011 and 2016, consequently other regions of Ethiopia could learn from this experience. The high increase of anemia in children born to mothers with above secondary education and highest wealth quintiles points to poor dietary practices, therefore, community based nutrition education for mothers needs to be strengthened.

Co-morbid anaemia and stunting among children 2–5 years old in southern Ethiopia: a community-based cross-sectional study

“…2 According to the Ethiopian Demographic and Health Survey (EDHS) of 2016, 38% of children less than 5 years of age were stunted and 57% were anaemic. 3 When looking only at the age group of 2-5 years, the recent study in Ethiopia reported 33% of prevalence for anaemia 4 and 45% of prevalence for stunting. 5 Both anaemia and stunting during early life can lead to serious health effects later in life such as increased susceptibility to infections and chronic diseases, impaired cognitive and physical development, and low economic productivity of individuals and the society.…”

“…2 According to the Ethiopian Demographic and Health Survey (EDHS) of 2016, 38% of children less than 5 years of age were stunted and 57% were anaemic. 3 When looking only at the age group of 2–5 years, the recent study in Ethiopia reported 33% of prevalence for anaemia 4 and 45% of prevalence for stunting. 5 …”

Household environment associated with anaemia among children aged 6–59 months in Ethiopia: a multilevel analysis of Ethiopia demographic and health survey (2005–2016)

“…For instance, the prevalence of anaemia increased sharply from 44 to 57% among children aged 6–59 months in Ethiopia between 2011 to 2016 [ 9 ]. The cause of this recent increments in childhood anaemia is not well-defined [ 14 ] and this sharp increase of anaemia may be due to selection bias. Furthermore, the Ethiopian National Nutrition Program's (NPP) second phase (2015–2020) failed to reduce anaemia in children aged 6–59 months from 39 to 24% by 2020, necessitating a recalculation of the national strategy [ 15 ].…”

“…Earlier studies in Ethiopia on anaemia were mainly localised [ 23 – 27 ], and the population-based studies on anaemia have focused on the prevalence and socio-demographic determinants [ 5 , 14 , 28 – 30 ]. Additional studies have mapped anaemia distribution [ 28 , 31 , 32 ] and regional inequalities [ 33 ].…”

Childhood undernutrition mediates the relationship between open defecation with anemia among Ethiopian children: a nationally representative cross-sectional study

“…stunting, wasting, and underweight) as a potential mechanism. Previous studies investigated different forms of child undernutrition [ 45 – 52 ] and anemia [ 53 – 57 ] in Ethiopia, however, information regarding the association of OD with anemia is limited. Given the limited evidence on the relationship between OD and child anemia, the objective of this study was twofold: [ 1 ] to investigate the association between OD and anemia in children 6–59 months of age in Ethiopia, and [ 2 ] to examine whether childhood undernutrition (i.e.…”