Objective
Adolescent girls are at risk of anaemia due to the increased nutrient demands because of growth, menstrual blood loss and possible pregnancies. Sociocultural and household conditions influence their risk. We aimed to identify the sociocultural and economic factors of anaemia in adolescent girls in Nepal.
Design
The Nepal Demographic and Health Surveys (NDHS) conducted in 2006, 2011, and 2016 were pooled for secondary analysis. We used data on haemoglobin measurements for anaemia and conducted bivariate and multivariable logistic regression analyses to identify factors associated with anaemia.
Setting
Nationally representative NDHS households with adolescent girls 15-19 years of age.
Participants
Non-pregnant adolescent girls 15 to 19 years, with a haemoglobin measurement (N=3731).
Results
The overall prevalence of anaemia among adolescent girls was 39.6%. Adolescents from socially disadvantaged caste/ethnicity groups were 1.42 times (95% CI: 1.13, 1.78) more likely to have anaemia compared to those from Brahmin/Chhetri households. We found a counter-intuitive association between socio-economic status and anaemia where adolescents from the middle (aOR 1.37, 95% CI: 1.01, 1.85) and highest (aOR 1.74, 95% CI: 1.18, 2.56) quintiles were at increased odds of anaemia. Relative geographical inequality was observed where adolescents from the Terai region had 3.5 times (95% CI: 2.32, 5.33) higher odds of anaemia.
Conclusions
The disparities in the distribution of anaemia among adolescents by caste/ethnicity groups, wealth quintiles and geographical regions are evident. Reducing the anaemia burden will require addressing the social determinants of anaemia by allocating resources and expanding anaemia prevention programmes to target adolescents at higher risk.