The urban–rural differential in the association between household wealth index and anemia among women in reproductive age in Ethiopia, 2016

Abstract

Background Anemia is more prevalent among women, and it is a moderate public health problem in Ethiopia. The wealth status and place of residence of a woman have implications on the intervention of anemia. Studies that examined the relationship between women’s wealth index status and residency in Ethiopia are scarce. We aimed to identify the urban–rural differential in the association between household wealth index and anemia among women of childbearing age in Ethiopia. Method A cross-sectional design was employed with a nationally representative sample of 14,100 women aged 15–49-year-old from the Ethiopian demographic and health survey conducted in 2016. We used the two-stage sampling method to select the sample size. The primary outcome was anemia in women of childbearing age. A hemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was the indicator of anemia. Using a three-level random intercept model to explore associated factors at the individual and household levels quantified the observed and unobserved variations between household wealth index and residence on anemia. Results Women belonging to a lower household wealth index category were more anemic (29.6%) than those middle and above wealth index categories. Women who lived in rural areas (25.5%) were prone to anemia than those who lived in urban areas (17.5%). The odds of anemia were significantly higher in women of the low household wealth category who living in rural compared to women of the middle and above household wealth category who living in urban (AOR = 1.37, 95% CI 1.14–1.65, P < 0.001). Conclusion In this study, anemia is more common among women who live in rural with the low house wealth category. Therefore, novel public health interventions should target women who live in rural areas with the lowest household wealth status.

Determinants of anaemia prevalence in women of reproductive age in Nigeria: A cross-sectional study using secondary data from Nigeria Demographic and Health Survey 2018

“…Our finding that rural residence predicted increased risk of anaemia and its severity is consistent with increased odds of being anaemic among pregnant women, 28,31,32 non-pregnant women, 24 and all WRA 4,11,13,15,21,44 in prior studies but differs from other studies where a rural residence is protective 14 or urban residence is a risk factor. 16 Low access to mass media in rural areas resulting in inequitable access to health information might contribute to the risk of being anaemic even though media exposure was only significant for moderate anaemia among all WRA and NPW in our model.…”

“…These findings agreed with existing evidence that the rich quintile reduced the likelihood of being anaemic among non-pregnant women 24 and in all WRA, 2,11,12,14,18,44 while being poor increased the likelihood of anaemia among all WRA. 4,13,16,17,21,22,31 High socio-economic status improves women's access to improved sanitation, adequate dietary diversity, enhanced access to health care facilities as well as better media exposure, which contribute to the prevention of anaemia among WRA. 51 The use of modern contraceptives reduced the risk of being anaemic and anaemia severity as was reported in several prior studies among non-pregnant women, 23,24 and all WRA.…”

“…The first category, individual maternal risk factors, included current pregnancy status, 11–16 increasing age, 11,13 younger age, 12,14 marital status, 14,17,18 large household size, 17 female-headed households, 14,19 underweight, 11,17,18 high parity, 12–14,19,20 ever had a terminated pregnancy, 14 non-use of modern contraceptives, 12,14,17,18 currently breastfeeding, 13,15 being HIV positive, 13,15,16 and tobacco use. 17 Household and socio-economic risk factors are the second set of factors and included region or province of residence, 4,17,18,20 rural residence, 4,11,13,15,21 urban residence, 14 low education, 4,12–14,16,19 low literacy, 17 being poor, 4,11–14,16…”

Prevalence of anemia and its associated factors among women of reproductive age group attending Gaur Provincial Hospital: A cross-sectional study

“…One study done in Ethiopia in 2016 demonstrates that the odds of suffering from anemia were significantly greater in women with low household wealth cohorts and those who lived in rural areas in comparison to females from the middle and higher household wealth cohorts who were from the urban area of residence (AOR = 1.37, 95% CI 1.14-1.65, P < 0.001). 16 Similar studies have demonstrated that the status of anemia is greater among rural females (66%). Likewise, the odds of suffering from anemia are greater along with decreasing financial status and conditions whatever their address was, but it has been demonstrated that the odds are greater if a poor woman belongs to urban areas as compared to similar ones in rural places after covariates have been adjusted.…”

Geostatistical analysis for spatial distribution of anemia (Hb level) among women of reproductive age and determinant factors

“…This might be due to less money to buy nutritious food, which in turn leads to inadequate nutrient intake and nutritional status. A recent survey also presented that families with lower income (29.6%) had the highest anemic issues than other wealth categories (Abate et al, 2021).…”