Differential effects of socio-demographic factors on maternal haemoglobin concentration in three sub-Saharan African Countries

Dickson A Amugsi,Zacharie T Dimbuene,Catherine Kyobutungi

doi:10.1038/s41598-020-78617-3

Abstract

Low Haemoglobin concentration (Hb) among women of reproductive age is a severe public health problem in sub-Saharan Africa. This study investigated the effects of putative socio-demographic factors on maternal Hb at different points of the conditional distribution of Hb concentration. We utilised quantile regression to analyse the Demographic and Health Surveys data from Ghana, Democratic Republic of the Congo (DRC) and Mozambique. In Ghana, maternal schooling had a positive effect on Hb of mothers in the 5th and 10th quantiles. A one-year increase in education was associated with an increase in Hb across all quantiles in Mozambique. Conversely, a year increase in schooling was associated with a decrease in Hb of mothers in the three upper quantiles in DRC. A unit change in body mass index had a positive effect on Hb of mothers in the 5th, 10th, 50th and 90th, and 5th to 50th quantiles in Ghana and Mozambique, respectively. We observed differential effects of breastfeeding on maternal Hb across all quantiles in the three countries. The effects of socio-demographic factors on maternal Hb vary at the various points of its distribution. Interventions to address maternal anaemia should take these variations into account to identify the most vulnerable groups.

Highlights

Maternal anaemia or low haemoglobin (Hb) concentration, a condition in which the Haemoglobin concentration (Hb) is lower than normal is a worldwide public health problem[1]
In Democratic Republic of the Congo (DRC), 68% of mothers indicated they were breastfeeding at the time of the study, while the number of breastfeeding mothers in Ghana and Mozambique stood at 58%, respectively
We investigated the effects of putative socio-demographic factors on maternal Hb concentration in Ghana, DRC and Mozambique, using quantile regression to understand the differential effects of these factors at different points of the conditional distribution of the Hb concentration

Summary

Introduction

Maternal anaemia or low haemoglobin (Hb) concentration, a condition in which the Hb is lower than normal is a worldwide public health problem[1]. This study intends to achieve this goal by using an analytical strategy that focuses on the effects of socio-demographic factors at different stages of the conditional distribution of maternal Hb concentration. The existing literature has identified several factors that have both negative and positive effects on maternal Hb concentration Some of these factors include maternal age, education, parity, marital status, household size, socioeconomic status, place of residence, body mass index (BMI) and b reastfeeding[18,19,20,21,22,23,24,25]. The quantile regression analytical strategy utilised in this paper can determine the effects of the socio-demographic factors at different points of the distribution of maternal Hb concentration. The objective of this study was to examine the effects of socio-demographic factors on maternal Hb concentration using quantile regression This type of analysis is currently missing in the anaemia research arena.

Objectives

Methods

Results

Discussion

Conclusion