Individual, Maternal, Household, and Community Level Variability in Determining Inequalities in Childhood Anaemia within Ethiopia: Four-Level Multilevel Analysis Approach

Kenenisa Abdisa Kuse; Demie Seyoum Jima; Teshita Uke Chikako; John Elvis Hagan Jr; Abdul-Aziz Seidu; Richard Gyan Aboagye; Bright Opoku Ahinkorah

doi:10.3390/children9091415

Individual, Maternal, Household, and Community Level Variability in Determining Inequalities in Childhood Anaemia within Ethiopia: Four-Level Multilevel Analysis Approach

Children (Basel). 2022 Sep 19;9(9):1415. doi: 10.3390/children9091415.

Authors

Kenenisa Abdisa Kuse¹, Demie Seyoum Jima¹, Teshita Uke Chikako², John Elvis Hagan Jr^{3

4}, Abdul-Aziz Seidu^{5

6}, Richard Gyan Aboagye⁷, Bright Opoku Ahinkorah⁸

Affiliations

¹ Department of Statistics, Bule Hora University, Bule Hora P.O.Box 144, Ethiopia.
² Wondo Genet College of Forestry and Natural Resource, Hawassa University, Hawassa P.O. Box 05, Ethiopia.
³ Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana.
⁴ Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany.
⁵ College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia.
⁶ Centre for Gender, Takoradi Technical University, Takoradi P.O. Box 256, Ghana.
⁷ Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana.
⁸ School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia.

Abstract

Background: Childhood anaemia is a major public health issue necessitating rapid attention due to its debilitating consequences on the child, family, and society. Previous studies have assessed the prevalence and contributing factors to childhood anaemia in many developing countries. Yet, little is known about the factors that contribute to childhood anaemia in Ethiopia. The study examined the factors associated with inequalities of childhood anaemia in Ethiopia. Methods: Data for the study were extracted from the 2016 Demographic and Health Survey of Ethiopia. A total of 7960 children were considered in the final study. Bivariate and multilevel ordinal logistic regression analyses were used to estimate determinants of inequalities of childhood anaemia status. Results: Overall, the prevalence of mild, moderate, and severe anaemia among the children were 24.5%, 28.4%, and 2.2%, respectively. The child's age (in months), sex of the child, preceding birth interval (in months), mother's educational level, antenatal care visit, wealth index of mothers, source of drinking water, type of toilet facility, place of residence, and region were significantly associated with childhood anaemia. The multilevel random coefficient model found that there is a variation of childhood anaemia among women (intra-cluster correlation [ICC] = 15.06%), households (ICC = 15.6%), and communities (ICC = 14.22%) in Ethiopia. Conclusions: This study showed that anaemia is common among Ethiopian children. Factors found to be associated with childhood anaemia were the sociodemographic characteristics of the child and their mothers. We recommend that existing programs and interventions to prevent and reduce childhood anaemia be strengthened. Moreover, a targeted intervention includes deworming, intensified year-round behavior change communication campaigns and testing using digital methods, and point-of-care treatment.

Keywords: Ethiopia; anaemia; childhood; multilevel logistic regression.

Grants and funding

The authors sincerely thank Bielefeld University, Germany, for providing financial support through the Open Access Publication Fund for the article processing charge.