Drivers of anaemia reduction among women of reproductive age in the eastern and upper west regions of Ghana: A secondary data analysis of the Ghana demographic and health surveys

Abstract

Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, mortality, and poor pregnancy outcomes. Globally, there is growing interest to reduce anaemia among WRA. In Ghana, anaemia among WRA declined at the national level between 2008 (59%) and 2014 (42%). There were also important declines at the sub-national level. The Eastern region (in the south) and Upper West region (in the north) provide an interesting opportunity to understand the decline. Identifying the drivers of anaemia reduction among WRA in Ghana provides important implementation science evidence for designing effective interventions. This current study examined the drivers of reduced anaemia prevalence in women of reproductive age using data from the Ghana Demographic and Health Surveys for 2008 and 2014. Anaemia was diagnosed as haemoglobin<12.0g/dl. Data were summarized using proportions and 95% confidence intervals. A weighted binary logistic-based multivariate decomposition technique was used to identify the potential drivers of anaemia across surveys for 2003, 2008 and 2014. Sensitivity analysis was carried out to test the robustness of the results of the decomposition analysis using haemoglobin concentration. The results of the decomposition analysis were presented as endowment and coefficient effects. Statistical analysis was carried out using Stata version 15. There was an improvement in access to water and sanitation, health services, family planning, and health insurance across surveys. Drivers of anaemia reduction over time at the national level included wealth index and maternal age, education, use of hormonal contraception and body mass index (BMI). In the Eastern region, the drivers of change were household wealth index, maternal age, hormonal contraceptive use and BMI. The drivers of change in the Upper West region, were household access to water, maternal education and BMI. The findings suggest that multi-level interventions are needed across sectors to further reduce anaemia among WRA. Key words: Anaemia, Women, Nutrition, Reproductive-age, Ghana, Haemoglobin, Regression, Decomposition analysis

Spectrum of thyroid dysfunction at a tertiary care hospital: A retrospective study

“…Ghana is located on the coast of Gulf of Guinea in West Africa, bordered to the north by Burkina Faso, to the south by the Atlantic Ocean, to the east and west by Togo and Côte d'Ivoire respectively. Ghana's current population is 32,893,251 [11]. Accra, the capital city where KBTH is located, has a population of 2,660,000 (2023), a 2.11% increase from 2022 [11].…”

“…Ghana's current population is 32,893,251 [11]. Accra, the capital city where KBTH is located, has a population of 2,660,000 (2023), a 2.11% increase from 2022 [11]. KBTH remains the leading national referral center, and the only tertiary health facility in the southern-eastern part of Ghana.…”

Association between exposure to smoke from cooking fuels and anaemia among women of reproductive age in Ghana

“…In Ghana, anaemia in WRA has decreased from 59% in 2008 to 42% in 2014. Tetteh et al 34 observed improvements in the wealth index of families as a result of a variety of characteristics including the mother’s age, education, usage of hormonal contraception, and body mass index (BMI) which partially explained the decline in anaemia among WRA over the years. The household wealth index, a measure of the family’s socioeconomic status (SES), the capacity of the household to obtain basic needs and healthcare services, and the ability of the household to provide for the needs of household members, was critical to the lowering prevalence of WRA in Ghana.…”

“…However, there has been a paucity of research on the detrimental health effects of biomass smoke exposure in the Ghanaian context 35 , 36 , where a significant proportion of the population use firewood exclusively or in combination with LPG or kerosene for fuel/energy. The studies of Tetteh et al 34 and Armo-Annor et al 37 are the only known studies that explored solid fuel use-related anaemia among women. Even so, the study of Tetteh et al 34 considered the drivers of anaemia reduction among WRA, with less emphasis on the effect of cooking fuel use on anaemia risk, while focusing on The Eastern and Upper West regions of Ghana.…”

“…The studies of Tetteh et al 34 and Armo-Annor et al 37 are the only known studies that explored solid fuel use-related anaemia among women. Even so, the study of Tetteh et al 34 considered the drivers of anaemia reduction among WRA, with less emphasis on the effect of cooking fuel use on anaemia risk, while focusing on The Eastern and Upper West regions of Ghana. Armo-Annor et al 37 also focused on women engaged in biomass-based fish smoking as their primary livelihood, implying that they have higher exposure rates compared with women who use solid fuel for cooking.…”