Determinants of Hemoglobin Status in Filipino Children and Women Population Based on a Nationwide Survey

Abstract

This study aimed to determine anemia prevalence and assess the determinants of hemoglobin status of Filipino children and women using data from the National Nutrition Survey (NNS) 2013. The NNS 2013 covered 17 regions and 80 provinces by the Department of Science and Technology – Food and Nutrition Research Institute (DOST-FNRI) using a multistage sampling design. Data analysis was done in three population groups: preschool-aged children (PSAC) 6–71 mo (n = 3,089), school-aged children (SAC) 6–14 yr old (n = 7,561), and non-pregnant women (NPW) of reproductive age 15–49 yr old (n = 7,074). The prevalence of anemia was 13.9%, 9.9%, and 13.4% in PSAC, SAC, and NPW, respectively. Among PSAC, the older age group 3–5 yr old (β = 0.68, p < 0.001) was associated with a higher hemoglobin level than the younger age group 6 mo – 2 yr. Among SAC, being a female (β = –0.19, p < 0.001) and residing in rural areas (β = –0.11, p = 0.03) determined lower levels of hemoglobin. Adequate serum retinol level was associated with higher hemoglobin levels in PSAC (β = 0.01, p = 0.02), SAC (β = 0.01, p < 0.001), and NPW (β = 0.01, p < 0.001). Adequate serum zinc concentration was associated with higher hemoglobin level in SAC (β = 0.01, p < 0.001) and NPW (β = 0.00, p = 0.01). Stunting was negatively associated with hemoglobin levels in PSAC (β = –0.32, p = 0.01) and SAC (β = –0.16, p = 0.01). Observed associations of age, sex, place of residence, marital status, micronutrient status, and stunting with hemoglobin levels could support nutrition-specific interventions such as micronutrient supplementation, food fortification, and nutrition education aimed at anemia control and treatment. Future studies could also improve our understanding of the determinants of anemia in the Philippines.