Background Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing Rwanda where It was increased comparing 2015 to 2010 Demographic and Health Survey (DHS) reports. A thorough understanding of the its risk factors is necessary to design new better approaches. However, to the best of our knowledge, no study assessing factors associated with anemia among WRA has been conducted. Therefore, this study aims to identify anemia risk factors among WRA in Rwanda. Methods This was a quantitative, cross-sectional study using secondary data from the Rwanda Demographic and Health Survey (RDHS) 2014-2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having equal or below to 10.9 g/dl for a pregnant woman, and hemoglobin level equal or below to 11.9 g/ for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis respectively. We reported Odds Ratio (OR), 95% Confidence Intervals (CI) and p-values. We used Stata version 14.2 for all analyses. Results The prevalence of anemia among WRA was 19.2% (95% CI: 18.0 - 20.5). After controlling for other variables, the factors associated with were being obese (OR: 0.61, 95% CI: 0.40 - 0.91), being in rich category (OR: 0.74, 95% CI: 0.63 - 0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74 - 0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50 - 0.73). The factors associated with higher odds of anemia were being underweight (OR: 1.39, 95% CI: 1.09 - 1.78), using an Intra Uterus Device (OR: 1.98, 95% CI: 1.05 - 3.75), and living in the Southern province (OR: 1.45, 95% CI: 1.11 - 1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06 - 1.88). Conclusion Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations, improve women economic status, and strengthen iron supplementation especially for IUD users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.
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