Trends and Determinants of Anemia among Under-Five Children in Ethiopia, Evidence from 2005 – 2016 Ethiopian Demographic and Health Survey; Mixed-Effect Binary Logistic Regression and Multivariate Decomposition Analysis

Abstract

Background: Anemia is a major public health problem and it is defined as the condition of having a low number of red blood cells or a low amount of haemoglobin from the normal level. This situation touches most under-five-year old children. Objective: This study aimed to examine the trends of anemia prevalence among children aged between 6 to 59 months and its determinants in Ethiopia based on three consecutive Ethiopian Demographic and Health Surveys (EDHSs). Methods: A total of 3,716 in 2005, 8,365 in 2011 and 7,563 in 2016 children aged between 6 to 59 month were involved in this study. To identify significantly contributing factors for the increase in anemia prevalence in Ethiopia over the last 11 years’ logit-based multivariate decomposition analysis was used and mixed-effect logistic regression model was fitted to identify determinant factors. Result: 47.13% of the change in anemia prevalence over time was attributable to difference in behavior. Being single (AOR = 0.665; 95%CI: 0.482 – 0.737), big stunted (AOR = 1.533; 95%CI: 1.359 – 1.729), being underweight (AOR = 1.200; 95%CI: 1.040 – 1.384), being wasted (AOR = 1.261; 95%CI: 1.038 – 1.530), having more than three under-five children (AOR = 1.463; 95%CI: 1.041 – 2.058), source of drinking water was not improved (AOR =1.165; 95%CI: 1.052 – 1.291) mother was anemic (AOR = 1.664; 95%CI: 1.487 – 1.862), fever history (AOR = 1.427; 95%CI: 1.211 – 1.683) were more likely to experience the prevalence of anemia. Conclusion: This study found that the prevalence of anemia has increases over time in Ethiopia since 2005. Stunning, underweight, wasting, mothers age, source of drinking water, number of under-five children, wealth status, maternal anemia, birth order, being twin or single, age of children, birth size, fever and cough history were significant predictors of anemia prevalence. Designing interventions that address maternal anemia and strengthening the economic status of the family are recommended to reduce childhood anemia. Furthermore, it is better to strengthen the strategies of early detection and management of stunted, wasted, and underweight children to decrease childhood anemia.

Keywords: Childhood anemia, Mixed effect logistic regression, Multivariate decomposition analysis, Ethiopia

DOI: 10.7176/JCSD/67-03

Publication date: January 31^st 2022