Geographical pattern and associated factors of anemia among children aged 6–59 months in Ethiopia: Further analysis of Ethiopian demographic and health survey 2016

Abstract

BackgroundAnemia remains the major public health concern among under-five children in Ethiopia. ObjectiveTo assess geographical pattern and associated factors of anemia among children aged 6–59 months. MethodThis study was done using Ethiopian Demographic and Health Survey data of 2016 among 8,439 children aged 6–59 months which was nationwide community based cross-sectional survey. Hemoglobin level < 11 g/dl used to diagnose anemia. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of anemia. Multilevel logistic regression conducted to identify predictors of anemia with p < 0.05, and proportional change in variance was done to uncover the effect of individual and community level factors on childhood anemia. Model fitness was assured via AIC, LLR & DIC. ResultIndividual and community level factors accounted 57.46% of childhood anemia. The odds of childhood anemia was 60% more likely among children of anemic mothers than children of none anemic mothers (AOR = 1.6, 95%CI (1.4, 1.90)), and the odds of anemia was 51% less likely among children in the age group between 24 and 41 months than children whose age was less than one year (AOR = 0.49, 95 % CI(0.40,0.60)). The odds of anemia was increased by 30 % in stunted children (AOR = 1.3, 95% CI (1.01, 1.6). High hotspot areas of anemia were observed in Somali, Dire Dawa, Harari, Gambela, Oromia and Afar parts of Ethiopia. ConclusionChildhood anemia is not evenly distributed and significant hotspot anemic areas observed in eastern, south-western, south-eastern and north-eastern parts of Ethiopia and maternal anemia, child age, infection, stunting, fathers education level, current maternal working status, and household wealth index, whereas geographical region and community wealth index were factors that increased the odds of anemia at individual and community levels respectively.