Introduction
Methods
Data source
Study variables and measurements
Outcome variable
Independent variables
Geospatial analysis
Statistical analysis
Results
Prevalence of anaemia
Variable | Urban | Rural | ||
---|---|---|---|---|
Frequency (n = 3,047) | Proportion of Anaemia | Frequency (n = 8,527) | Proportion of Anaemia | |
Age (years) | X2 = 8.7,p = 0.191 | X2 = 3.0, p = 0.688 | ||
15–19 | 158 | 55.9 | 525 | 54.1 |
20–24 | 793 | 50.7 | 2,251 | 49.3 |
25–29 | 963 | 48.3 | 2,391 | 48.4 |
30–34 | 696 | 51.0 | 1,772 | 51.7 |
35–39 | 351 | 46.8 | 1,126 | 51.3 |
40–44 | 74 | 62.4 | 400 | 49.2 |
45–49 | 12 | 36.6 | 62 | 52.1 |
Level of education | X2 = 27.863, p < 0.001 | X2 = 92.237, p < 0.001 | ||
No education | 659 | 56.2 | 4,115 | 55.6 |
Primary | 846 | 52.3 | 3,263 | 44.7 |
Secondary | 1,318 | 47.9 | 1,100 | 46.0 |
Higher | 224 | 35.4 | 49 | 35.1 |
Wealth index | X2 = 22.859, p < 0.001 | X2 = 13.404, p < 0.001 | ||
Poorest | 182 | 58.7 | 2,620 | 51.6 |
Poorer | 244 | 54.1 | 2,493 | 50.4 |
Middle | 443 | 56.1 | 1,883 | 48.6 |
Richer | 962 | 50.9 | 1,211 | 50.6 |
Richest | 1,216 | 44.9 | 320 | 41.2 |
Parity | X2 = 15.391, p < 0.001 | X2 = 6.939, p = 0.139 | ||
One | 958 | 49.0 | 1,856 | 50.3 |
Two | 761 | 46.5 | 1,633 | 47.5 |
Three | 501 | 48.1 | 1,437 | 48.2 |
Four | 328 | 55.2 | 1,122 | 49.9 |
Five or more | 499 | 55.8 | 2,509 | 52.6 |
Marital status | X2 = 2.635, p = 0.756 | X2 = 8.649, p = 0.124 | ||
Never in union | 118 | 52.1 | 132 | 45.9 |
Married | 2,147 | 49.9 | 6,751 | 50.7 |
Cohabitation | 679 | 50.3 | 1,388 | 47.7 |
Widowed | 9 | 51.1 | 40 | 45.8 |
Divorced | 24 | 50.9 | 73 | 44.8 |
Separated | 70 | 46.7 | 143 | 48.9 |
Labour force | X2 = 0.293, p = 0.588 | X2 = 0.179, p = 0.672 | ||
Not working | 1,055 | 47.7 | 2,676 | 49.5 |
Working | 1,992 | 51.2 | 5,851 | 50.3 |
Health insurance coverage | X2 = 5.263, p = 0.022 | X2 = 7.840, p = 0.005 | ||
No | 2,674 | 50.8 | 8,020 | 50.6 |
Yes | 373 | 44.0 | 507 | 42.3 |
Antenatal care visits | X2 = 1.350, p = 0.245 | X2 = 0.208, p = 0.648 | ||
Less than 8 | 2,807 | 50.5 | 8,406 | 50.0 |
8 or more | 240 | 44.6 | 121 | 56.8 |
Duration of pregnancy | X2 = 100.594, p < 0.001 | X2 = 173.492, p < 0.001 | ||
1st trimester | 876 | 35.1 | 2,243 | 37.6 |
2nd trimester | 1,152 | 58.5 | 3,466 | 53.7 |
3rd trimester | 1,019 | 53.3 | 2,818 | 55.5 |
Intestinal parasite drugs taken | X2 = 0.065, p = 0.798 | X2 = 0.484, p = 0.487 | ||
No | 1,508 | 49.7 | 5,094 | 49.2 |
Yes | 1,539 | 50.3 | 3,433 | 51.4 |
Iron tablets/syrup taken | X2 = 1.048, p = 0.306 | X2 = 0.279, p = 0.598 | ||
No | 472 | 47.1 | 2,339 | 49.8 |
Yes | 2,575 | 50.5 | 6,188 | 50.2 |
Community socio economic status | X2 = 13.432, p < 0.001 | X2 = 23.435, p < 0.001 | ||
Low | 417 | 57.1 | 6,240 | 51.8 |
Moderate | 599 | 57.0 | 1,840 | 44.7 |
High | 2,031 | 46.5 | 437 | 47.2 |
Community literacy level | X2 = 10.895, p = 0.004 | X2 = 25.512, p < 0.001 | ||
Low | 373 | 54.6 | 4,676 | 52.3 |
Moderate | 959 | 50.4 | 3,065 | 47.9 |
High | 1,715 | 48.8 | 786 | 45.6 |
Exposure to mass media | X2 = 2.668, p = 0.102 | X2 = 0.726, p = 0.394 | ||
No | 726 | 53.6 | 3,809 | 49.7 |
Yes | 2,321 | 48.9 | 4,718 | 50.3 |
Source of drinking water | X2 = 0.404, p = 0.817 | X2 = 2.611, p = 0.271 | ||
Improved | 2,513 | 50.0 | 4,560 | 49.7 |
Unimproved | 461 | 50.5 | 3,790 | 50.1 |
Other/not in the house | 73 | 45.6 | 177 | 57.0 |
Total | 3,047 | 50.0 | 8,527 | 50.0 |
Country | Urban | 95% confidence interval | Rural | 95% confidence interval |
---|---|---|---|---|
Burkina Faso | 57.2 | 46.9–67.0 | 56.9 | 52.8–61.0 |
Benin | 69.2 | 62.5–75.2 | 67.7 | 62.7–72.4 |
Burundi | 35.5 | 23.3–50.0 | 47.2 | 42.8–51.6 |
Congo DR | 51.3 | 45.0-57.5 | 40.9 | 37.0-44.8 |
Congo | 62.1 | 53.8–69.8 | 60.6 | 52.2–68.4 |
Cote d’Ivoire | 57.0 | 46.4–67.0 | 62.7 | 55.8–69.1 |
Cameroon | 34.7 | 27.8–42.2 | 41.4 | 35.4–47.7 |
Ethiopia | 30.4 | 19.2–44.5 | 31.2 | 27.9–34.7 |
Gabon | 54.2 | 47.8–60.6 | 61.3 | 47.2–73.7 |
Ghana | 37.7 | 28.4–48.4 | 57.0 | 47.7–65.8 |
Gambia | 48.1 | 40.9–55.3 | 67.5 | 58.0-75.8 |
Guinea | 52.9 | 42.4–63.1 | 44.0 | 37.5–50.7 |
Liberia | 36.6 | 26.1–48.5 | 49.1 | 38.1–60.1 |
Mali | 60.4 | 49.1–70.7 | 72.3 | 67.2–77.0 |
Malawi | 56.6 | 39.0-72.9 | 43.7 | 38.3–49.2 |
Mozambique | 53.1 | 46.5–59.6 | 51.0 | 47.4–54.5 |
Nigeria | 56.6 | 51.2–61.9 | 61.2 | 56.7–65.4 |
Niger | 58.4 | 45.6–70.2 | 61.0 | 56.7–65.1 |
Namibia | 23.1 | 13.4–36.7 | 27.8 | 16.0-43.7 |
Rwanda | 21.8 | 12.5–35.3 | 22.4 | 16.9–29.0 |
Sierra Leone | 46.0 | 33.1–59.4 | 61.5 | 53.9–68.6 |
Togo | 60.3 | 50.0-69.8 | 62.9 | 55.8–69.4 |
Tanzania | 48.7 | 41.2–56.3 | 61.0 | 55.8–69.4 |
Uganda | 31.7 | 22.5–42.5 | 35.7 | 30.8–41.0 |
Zambia | 43.9 | 37.3–50.7 | 38.5 | 34.2–43.0 |
Zimbabwe | 37.2 | 27.8–47.7 | 27.1 | 21.5–33.6 |
Total | 50.0 | 48.3–51.7 | 50.0 | 48.9–51.0 |
Spatial disparities in anaemia prevalence
Multivariable analysis of anaemia among pregnant women in SSA
Variable | Urban | Rural |
---|---|---|
Adjusted Odds Ratio (95% Confidence interval) | Adjusted Odds Ratio (95% Confidence interval) | |
Age (years) | ||
15–19 | Ref | Ref |
20–24 | 0.77 (0.54, 1.11) | 0.88 (0.72, 1.08) |
25–29 | 0.65**(0.44, 0.95) | 0.78**(0.62, 0.97) |
30–34 | 0.69(0.46, 1.04) | 0.78*(0.61, 0.99) |
35–39 | 0.52**(0.33, 0.81) | 0.77 (0.59, 1.01) |
40–44 | 0.69(0.37, 1.29) | 0.69**(0.50, 0.95) |
45–49 | 0.78(0.22, 2.77) | 0.79(0.45, 1.39) |
Level of education | ||
No education | Ref | Ref |
Primary | 0.81*(0.66, 0.99) | 0.67***(0.60, 0.74) |
Secondary | 0.74***(0.60, 0.91) | 0.76***(0.65, 0.87) |
Higher | 0.58**(0.41, 0.84) | 0.62(0.35, 1.11) |
Wealth index | ||
Poorest | Ref | Ref |
Poorer | 0.96(0.66, 1.40) | 0.92(0.83, 1.03) |
Middle | 0.97(0.69, 1.38) | 0.92(0.81, 1.04) |
Richer | 0.86(0.61, 1.22) | 1.00(0.85, 1.16) |
Richest | 0.79(0.55, 1.13) | 0.84(0.64, 1.12) |
Parity | ||
One | Ref | Ref |
Two | 0.92 (0.75, 1.14) | 0.96 (0.83, 1.11) |
Three | 1.05 (0.81, 1.35) | 0.96 (0.82, 1.14) |
Four | 1.24 (0.92, 1.66) | 1.05 (0.87, 1.27) |
Five or more | 1.33 (0.98, 1.80) | 1.09 (0.90, 1.32) |
Marital status | ||
Never in union | Ref | Ref |
Married | 0.86 (0.58, 1.29) | 1.29 (0.94, 1.77) |
Cohabitation | 0.92 (0.61, 1.40) | 1.32 (0.95, 1.83) |
Widowed | 1.38 (0.41, 4.70) | 0.97 (0.46, 2.06) |
Divorced | 0.51 (0.20, 1.34) | 0.99 (0.56, 1.74) |
Separated | 0.81 (0.44, 1.47) | 1.25 (0.81, 1.94) |
Labour force | ||
Not working | Ref | Ref |
Working | 1.08(0.92, 1.27) | 1.05 (0.96, 1.16) |
Health insurance coverage | ||
No | Ref | Ref |
Yes | 0.89 (0.70, 1.12) | 0.87 (0.72, 1.04) |
Antenatal care visits | ||
Less than 8 | Ref | Ref |
8 or more | 1.07 (0.79, 1.47) | 1.07 (0.76, 1.53) |
Duration of pregnancy | ||
1st trimester | Ref | Ref |
2nd trimester | 2.39***(1.99, 2.88) | 1.81***(1.63, 2.02) |
3rd trimester | 2.28***(1.89, 2.76) | 1.98***(1.77, 2.22) |
Intestinal parasite drug taken | ||
No | Ref | Ref |
Yes | 1.00 (0.85, 1.16) | 1.12**(1.02, 1.23) |
Iron tablets/syrup taken | ||
No | Ref | Ref |
Yes | 1.12 (0.91, 1.38) | 0.99 (0.89, 1.10) |
Community socioeconomic status | ||
Low | Ref | Ref |
Moderate | 0.94 (0.72, 1.23) | 0.83**(0.73, 0.93) |
High | 0.89 (0.68, 1.18) | 0.97 (0.77, 1.22) |
Community literacy level | ||
Low | Ref | Ref |
Moderate | 1.21(0.94, 1.56) | 0.90*(0.82, 0.99) |
High | 1.11 (0.85, 1.45) | 0.97 (0.77, 1.22) |
Exposure to mass media | ||
No | Ref | Ref |
Yes | 1.03 (0.86, 1.24) | 1.04 (0.95, 1.14) |
Source of drinking water | ||
Improved | Ref | Ref |
Unimproved | 0.96 (0.78, 1.20) | 0.95(0.87, 1.04) |
Other/not in the house | 0.90 (0.57, 1.44) | 1.30(0.97, 1.74) |
Logistic regression analysis of anaemia among pregnant women by countries in SSA
Country | Urban | Rural |
---|---|---|
Odds Ratio (95% Confidence Level) | Odds Ratio (95% Confidence Level) | |
Burkina Faso | 1.26(0.79, 2.00) | 1.59***(1.26, 2.01) |
Benin | 2.22***(1.51, 3.28) | 2.64***(2.01, 3.46) |
Burundi | 0.58*(0.34, 0.99) | 1.92***(1.46, 2.53) |
Congo DR | Ref | Ref |
Congo | 1.61 (0.94, 2.77) | 1.92***(1.46, 2.53) |
Cote d’Ivoire | 1.10 (0.68, 1.80) | 1.93***(1.40, 2.65) |
Cameroon | 0.53**(0.35, 0.81) | 0.94 (0.68, 1.26) |
Ethiopia | 0.55**(0.34, 0.90) | 0.89(0.72, 1.11) |
Gabon | 1.37 (0.94, 2.00) | 2.05***(1.41, 2.96) |
Ghana | 0.71 (0.43, 1.17) | 1.97***(1.34, 2.88) |
Gambia | 0.85 (0.56, 1.29) | 2.79***(1.98, 3.93) |
Guinea | 1.10 (0.68, 1.79) | 1.10(0.80, 1.50) |
Liberia | 0.88 (0.45, 1.70) | 1.41(0.98, 2.03) |
Mali | 1.53 (0.93, 2.53) | 3.71***(2.73, 5.05) |
Malawi | 0.83 (0.42, 1.63) | 0.97(0.74, 1.28) |
Mozambique | 1.01 (0.70, 1.46) | 1.38**(1.11, 1.71) |
Nigeria | 1.39 (0.98, 1.97) | 2.44***(1.92, 3.10) |
Niger | 1.28 (0.79, 2.08) | 1.94***(1.52, 2.47) |
Namibia | 0.25***(0.12, 0.52) | 0.44**(0.22, 0.88) |
Rwanda | 0.25***(0.12, 0.53) | 0.35***(0.24, 0.53) |
Sierra Leone | 0.93 (0.51, 1.70) | 2.11***(1.49, 2.97) |
Togo | 1.02 (0.68, 1.53) | 1.90***(1.38, 2.60) |
Tanzania | 1.02 (0.68, 1.53) | 2.06***(1.64, 2.59) |
Uganda | 0.41**(0.23, 0.73) | 0.76*(0.59, 0.99) |
Zambia | 0.45***(0.29, 0.68) | 0.75**(0.59, 0.95) |
Zimbabwe | 0.40**(0.24, 0.67 | 0.48***(0.33, 0.70) |