Determinants of anemia status among pregnant women in ethiopia: using 2016 ethiopian demographic and health survey data; application of ordinal logistic regression models

Abstract

Background Anemia is a serious public health problem that occurs when the blood contains fewer red blood cells than normal. In Ethiopia, the prevalence of anemia in pregnancy increased between 2005 and 2016. The aim of this study was to determine what factors influence the anemia status of pregnant women in Ethiopia. Methods Anemia status in a sample of 1053 pregnant women was studied using data from Ethiopia's Demographic and Health Survey 2016. Percentages and graphs were used to show the prevalence of anemia. The marginal probability effect was used to determine the contribution of each explanatory variable category to a single response category of anemia level. Ordinal logistic regression models were constructed, and the best-fitting model was selected to reveal significant anemia status variables. Results The prevalence of anemia in pregnant women was found to be 37.51% (3.04% severe, 17.28% moderate, and 17.1% mild anemic). The fitted partial proportional odds model revealed that anemia status of pregnant women was significantly associated with region afar (OR = 0.45; CI: 0.21–0.96), antenatal care visits above 4 (OR = 1.58; CI: 1.03–2.43), parity between 1–2 (OR = 0.47;CI: 0.26–0.85), iron taking (OR = 3.68;CI: 2.41–5.64), and higher education (OR = 4.75;CI: 2.29–9.85). Conclusions Anemia among pregnant women has been identified as a moderate public health issue in Ethiopia. The study revealed that the prevalence of anemia varied among regions which the highest (65.9%) and the lowest (9%) being from Somali and Addis Ababa, respectively. As a result, it is argued that treatments target iron consumption, maternal education, antenatal visits, and mothers' access to health care.

Prevalence and factors associated with anaemia among pregnant women attending antenatal care in a district hospital and its feeder community healthcare centre of the Limpopo Province, South Africa

“…This result is comparable to a study in Nigeria,[ 3 ] but slightly higher than the rates in many studies. [ 5 , 6 , 7 , 8 ] However, our finding is lower than the rate reported by others. [ 9 , 10 ] There is a concern with 5% of pregnant women with severe anaemia, which need urgent attention.…”

“…[ 8 ] In contrast, other studies found that anaemia is prevalent among those in the age group less than 25 years. [ 5 , 6 , 7 , 8 , 9 , 10 ] Similarly, our finding indicates that pregnant women aged <25 years are at higher risk of developing anaemia in pregnancy, but the result was not statistically significant. Poor knowledge of anaemia in pregnancy is a challenge.…”

“…[ 6 , 8 , 10 ] Another study revealed that pregnant women's anaemia status was significantly associated with higher education. [ 5 ] In univariate analysis, our study finding shows that anaemia is prevalent among women without formal, primary and secondary education. The possible reason could be that less-educated women are likely unemployed, cannot afford to eat nourishing food and enrol early for antenatal care.…”

“…[ 9 ] 25.8% in Uganda[ 10 ] and 26.2% in Kenya. [ 27 ] However, lower than the rates of 37.51% found in Ethiopia[ 5 ], 72.6% in Nigeria[ 4 ], 42.7%[ 28 ] and 50.8%[ 8 ] in Ghana, and 43.1% in Eswatin. [ 6 ] Our finding is also lower than the rate of 37% reported in earlier studies in the KwaZulu Natal Province of SA.…”

“…The risk of moderate-to-severe anaemia rises as pregnancy progresses[ 3 , 5 , 6 , 7 , 8 , 9 , 10 ] and contributes to obstetric haemorrhage, caesarean sections and need for postpartum blood transfusion, preeclampsia, intensive care admission and prolonged hospital stay. [ 11 , 12 , 13 ] Other adverse outcomes from pregnancy anaemia include low birth weight, preterm delivery, small for gestational age, neonatal intensive care admission, stillbirth and early neonatal death.…”