Spatial Distribution and Analysis of Risk Factors Associated with Anemia Among Women of Reproductive Age: Case of 2014 Rwanda Demographic and Health Survey Data

Background:Anemia is an important public health problem affecting all age groups of the population. The objective of this study was to identify the risk factors associated with anemia among women of childbearing age in Rwanda and map their spatial variation.Methods:The 2014/15 Rwanda Demographic and Health survey data was used and the structured logistic regression model was fitted to the data, where fixed effects were modeled parametrically, non-linear effects were modeled non-parametrically using second order random walk priors and spatial effects were modeled using Markov Random field priors.Results:The prevalence of anemia among non-pregnant women of reproductive age was 18.9%. Women from the households which use water from the unprotected well had a higher risk of having anemia than a woman from the household where they use water piped into dwelling or yard. The risk of anemia was higher among underweight women and women living in households without toilet facilities. The anemia was less pronounced among the women using contraception, literate women, women from the households which use a bed net and living in rich households.Conclusion:The findings from this study highlighted the districts with the highest number of anemic women and this can help the policymakers and other public health institutions to design a specific programme targeting these districts in order to improve the health status and living conditions of these women. The findings also suggest an improvement of toilet facilities, bed net use and source of drinking water in affected households.

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Risk factors of anemia among Women of Reproductive Age in Rwanda: implications for designing better interventions

10.21203/rs.2.14859/v1 ◽

2019 ◽

Author(s):

Dieudonne Hakizimana ◽

Marie Paul Nisingizwe ◽

Jenae Logan ◽

Rex Wong

Keyword(s):

Public Health ◽

Risk Factors ◽

Pregnant Woman ◽

Health Survey ◽

Multivariable Analysis ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Hormonal Contraceptives ◽

Women Of Reproductive Age ◽

Factors Associated

Abstract Background Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing Rwanda where It was increased comparing 2015 to 2010 Demographic and Health Survey (DHS) reports. A thorough understanding of the its risk factors is necessary to design new better approaches. However, to the best of our knowledge, no study assessing factors associated with anemia among WRA has been conducted. Therefore, this study aims to identify anemia risk factors among WRA in Rwanda. Methods This was a quantitative, cross-sectional study using secondary data from the Rwanda Demographic and Health Survey (RDHS) 2014-2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having equal or below to 10.9 g/dl for a pregnant woman, and hemoglobin level equal or below to 11.9 g/ for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis respectively. We reported Odds Ratio (OR), 95% Confidence Intervals (CI) and p-values. We used Stata version 14.2 for all analyses. Results The prevalence of anemia among WRA was 19.2% (95% CI: 18.0 - 20.5). After controlling for other variables, the factors associated with were being obese (OR: 0.61, 95% CI: 0.40 - 0.91), being in rich category (OR: 0.74, 95% CI: 0.63 - 0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74 - 0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50 - 0.73). The factors associated with higher odds of anemia were being underweight (OR: 1.39, 95% CI: 1.09 - 1.78), using an Intra Uterus Device (OR: 1.98, 95% CI: 1.05 - 3.75), and living in the Southern province (OR: 1.45, 95% CI: 1.11 - 1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06 - 1.88). Conclusion Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations, improve women economic status, and strengthen iron supplementation especially for IUD users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.

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