“The hidden hunger”: Understanding the burden of anaemia and its determinants among pregnant and non-pregnant women in Ethiopia
Anaemia is a global public health problem associated with increased mortality and morbidity. The highest prevalence of anaemia exists in the developing world where its causes are multi-factorial. The objective of the study was to assess the burden of anaemia and its determinants among pregnant and non-pregnant women in Ethiopia. The 2005 Demographic and Health Survey data of Ethiopia were used. Permission to download and analyze the data was granted from ORC Macro, in Calverton, USA. SPSS v10.0 was used to analyze the data. Both univariate and multivariate analysis were carried out. Trend analysis was done using the stat-calc programme on Epi-info 2002. For all statistical tests, significance level was set at p-value of 0.05. A total of 5960 women of child bearing age were included in the analysis. The mean haemoglobin was 12.72g/dl (95%CI: 12.66, 12.78g/dl). The general prevalence of anaemia among women was 27.7% (95%CI: 26.6, 28.9%). The prevalence of anaemia was 33.0% (95%CI: 28.7, 37.2%) and 27.3% (95%CI: 26.1, 28.4%) among pregnant and non-pregnant women respectively. The chi2 for linear trend test revealed a significant negative association between prevalence of anaemia and women’s educational status, grouped altitude of residential places and household wealth index categories (p<0.05, for all three variables). The prevalence of anaemia was positively associated with past five years fertility level (chi2 for linear trend=35.2, df =2, p<0.0001). Not possessing any toilet facilities (OR 1.85 95%CI: 1.66, 2.1), being resident of rural area (OR 2.02 95%CI: 1.75, 2.32) and not using contraceptive methods (OR 1.63 95%CI: 1.34, 1.98) were also associated with prevalence of anaemia among women. Logistic regression showed toilet possession to be the only independent predictor of prevalence of anaemia among pregnant women (Adj OR 2.17 95%CI: 1.28, 3.85). However, regression analysis among non-pregnant women revealed not having any toilet facilities (Adj OR 1.20 95%CI: 1.02, 1.42), lowering altitude categories of residential areas and not using contraception methods (Adj OR 1.39 95%CI: 1.13, 1.72) to be independent predictors of prevalence of anaemia. In conclusion, anaemia is a moderate public health problem among women in Ethiopia but there exist significant differences in magnitude by socio-economic status of women and their families and where they live. Interventions designed to address maternal anaemia should pay attention to both nutritional and non-nutritional intervention strategies that may include environmental sanitation, de-worming, and provision and promotion of family planning methods.