From: Factors associated with anemia among children in South and Southeast Asia: a multilevel analysis
 | Anemia status %[95% CI] | ||||||
---|---|---|---|---|---|---|---|
Study variables | Bangladesh (DHS 2011) | Cambodia (DHS 2014) | India (NFHS 2016) | Maldives (DHS 2016/17) | Myanmar (DHS 2015) | Nepal (DHS 2016) | SSEA Pooled |
Sample sizes (n) | n = 1,937 | n = 3,310 | n = 155,393 | n = 1,696 | n = 2,934 | n = 1,747 | n = 167,017 |
Overall prevalence | 51 (48.4–53.6) | 55.4 (53.1–57.7) | 57.5 (57.1–57.9) | 50.8 (47.6–53.9) | 59 (56.6–61.3) | 51.4 (48.4–54.3) | 57.3 (56.9–57.7) |
Mild anemia | 29.7 (27.5–32.1) | 29.23 (27.3–31.2) | 27.8 (27.5–28.1) | 29.3 (26.3–32.4) | 31.8 (29.7–33.9) | 25.9 (23.7–28.1) | 27.9 (27.6–28.2) |
Moderate anemia | 20.6 (18.6–22.8) | 25.8 (23.8–27.9) | 28.2 (27.2–28.6) | 20.9 (17.9–24.3) | 26.7 (24.5–29) | 25.1 (22.4–27.8) | 27.9 (27.6–28.3) |
Severe anemia | 0.6 (0.3–1.1) | 0.4 (0.2–0.6) | 1.4 (1.3–1.5) | 0.5 (0.2–1.3] | 0.4 (0.2–0.7) | 0.5 (0.2–0.9) | 1.4 (1.3–1.5) |
Individual-level factors | Â | Â | Â | Â | Â | Â | Â |
Child-level factors | Â | Â | Â | Â | Â | Â | Â |
Sex of child | Â | Â | Â | Â | Â | Â | Â |
Male | 51.7 (48.1–55.3) | 57.5* (54.4–60.6) | 57.4 (56.8–57.9) | 54.4** (50.4–58.2) | 58.3 (55.1–61.4) | 51.8 (48.1–55.5) | 57.2 (56.7–57.7) |
Female | 50.2 (46.6–53.9) | 53.2 (50.1–56.3) | 57.7 (57.1–58.3) | 46.7 (42.6–50.9) | 59.6 (56.5–62.7) | 51 (46.6–55.3) | 57.4 (56.8–57.9) |
Child age (months) | Â | Â | Â | Â | Â | Â | Â |
6–11 | 74.2*** (66.9–80.4) | 78.1*** (72-83.2) | 67.9*** (66.8–69) | 66.2** (55.6–75.3) | 79.5*** (72.9–84.8) | 69.1** (60.7–76.3) | 68.4*** (67.3–69.4) |
12–23 | 68.3 (62.8–73.3) | 73.3 (69.3–76.9) | 69.6 (68.8–70.3) | 53.6 (46.5–60.4) | 77.2 (72.7–81.1) | 66.1 (60.3–71.3) | 69.6 (68.8–70.3) |
24–35 | 46.6 (40.7–52.6) | 49.5 (45.3–53.7) | 61.1 (60.34-62.0) | 51.5 (45-57.9) | 59.1 (53.9–64.1) | 52.5 (46.9–58.1) | 60.5 (59.7–61.3) |
36–47 | 43.1 (38.2–48) | 45.2 (40.6–49.9) | 51.1 (50.3–51.9) | 51.4 (45.9–57) | 50.1 (45.7–54.4) | 41.2 (35.7–46.8) | 50.8 (50-51.5) |
48–59 | 36.8 (31.8–42.2) | 40.1 (35.3–44.9) | 44.0 (43.2–44.8) | 40.3 (45.9–57) | 42.8 (37.9–47.8) | 36.9 (31.2–42.3) | 43.7 (42.9–44.5) |
Recent fever | Â | Â | Â | Â | Â | Â | Â |
No | 47.5 (44.1–50.9) | 53** (50.2–55.8) | 57.1*** (56.6–57.3) | 48.9 (45.9–52) | 58* (55.4–60.5) | 50.4 (47.2–53.7) | 56.8*** (56.4–57.2) |
Yes | 56.66 (52.6–60.6) | 61.1 (57.3–64.8) | 60.5 (59.5–61.4) | 56.6 (48.6–64.2) | 63.6 (58.3–68.5) | 54.4 (48.7–60) | 60.3 (59.4–61.1) |
Recent diarrhea | Â | Â | Â | Â | Â | Â | Â |
No | 51.1** (48.3–53.8) | 54** (51.5–56.4) | 56.9*** (56.4–57.3) | 50.6 (47.5–53.8) | 58.9* (56.3–61.4) | 51.5 (48.6–54.4) | 56.7*** (56.2–57.1) |
Yes | 49.8 (38.3–61.3) | 65.3 (58.8–71.3) | 63.9 (62.7–65.1) | 52.9 (37.3–68) | 59.5 (52.4–66.2) | 48.9 (37.5–60.5) | 63.5 (62.4–64.7) |
Children stunted | Â | Â | Â | Â | Â | Â | Â |
Not stunted | 48.8* (45.6–52.0) | 52.6** (49.9–55.4) | 53.9*** (53.4–54.5) | 50.7 (47.3–54.1) | 58.8 (56.1–61.5) | 49.1* (45.3–52.8) | 53.8*** (53.3–54.3) |
Stunted | 53.3 (48.9–57.6) | 60.6 (56.9–64.1) | 63.1 (62.5–63.7) | 50 (41.5–58.5) | 59.1 (54.9–63.2) | 55.4 (50.7–60.1) | 62.7 (62.2–63.3) |
Children underweight | Â | Â | Â | Â | Â | Â | Â |
Not underweight | 51.4 (48.1–54.6) | 53.52** (51-55.9) | 54.7*** (54.2–55.2) | 50.6 (47.3–54) | 58.1 (55.3–60.7) | 48.2** (44.7–51.7) | 54.6*** (54.1–55.1) |
Underweight | 49.5 (45.1–53.9) | 60.7 (56.3–65.1) | 62.6 (61.9–63.2) | 53.1 (43.8–62.1) | 62.5 (57.6–67.1) | 59.5 (54.6–64.3) | 62.3 (61.7–62.9) |
Children wasted | Â | Â | Â | Â | Â | Â | Â |
Not wasted | 50.9 (48-53.7) | 54.3** (52-56.7) | 56.7*** (56.2–57.2) | 50.5 (47.2–53.8) | 58.5 (56.1–61) | 49.6*** (46.6–52.7) | 56.5*** (56.1–56.9) |
Wasted | 49.6 (43.5–55.8) | 64.6 (57.6–71.1) | 60.7 (59.8–61.5) | 51.6 (40.6–62.4) | 63.7 (55.1–71.5) | 68.1 (60-75.1) | 60.6 (59.7–61.5) |
Mothers and household-level factors | Â | Â | Â | Â | Â | Â | Â |
Mothers age (years) | Â | Â | Â | Â | Â | Â | Â |
15–24 | 54.2* (50.2–58.1) | 62.1** (57.9–66) | 61.37*** (60.6-62.05) | 54.1 (46-62.1) | 67.1** (62.1–71.6) | 55* (50.8–59.1) | 61.1*** (60.5–61.8) |
25–34 | 47.8 (44.1–51.5) | 53 (49.8–56.1) | 55.9 (55.3–56.4) | 50.9 (46.9–54.8) | 57.4 (54.1–60.6) | 49.9 (46.1–53.6) | 55.6 (55.1–56.1) |
35–49 | 49.1 (41.3–56.8) | 53.4 (48.5–58.3) | 54.6 (53.5–55.8) | 48.8 (42.1–55.6) | 57.3 (53.2–61.4) | 44.8 (35.9–54.1) | 54.4 (53.4–55.5) |
Mothers education level | Â | Â | Â | Â | Â | Â | Â |
No education | 52.1 (45.9–58.1) | 55.3* (49.1–61.3) | 64.4*** (63.7–65) | 38.6 (18.9–62.8) | 53.6* (48-59.2) | 56.3* (51.5–60.9) | 64*** (63.3–64.6) |
Primary | 52.3 (47.9–56.5) | 58 (55.1–60.8) | 59.6 (58.6–60.5) | 44.9 (39.1–50.9) | 60.9 (57.2–64.4) | 53.2 (47.1–59.2) | 59.1 (58.2–59.9) |
Secondary or above | 49.8 (46.2–53.4) | 51.1 (47.2–55) | 53.7 (53.1–54.3) | 52.4 (48.9–55.9) | 58.6 (54.8–62.2) | 47.1 (42.9–51.4) | 53.6 (53.1–54.1) |
Wealth quintile | Â | Â | Â | Â | Â | Â | Â |
Poorest | 55.8** (50.2–61.1) | 63.1*** (58.4–67.5) | 63.5*** (62.8–64.1) | 45.2** (40.9–49.5) | 59.8* (55.4–64) | 48.9** (43.3–54.6) | 63.1*** (62.4–63.7) |
Poor | 57.8 (52.2–63.2) | 60.6 (55.7–65.3) | 58.9 (58.1–59.6) | 48.1 (42.9–53.2) | 59.5 (54.8–64) | 47.8 (41.8–53.9) | 58.7 (58-59.4) |
Middle | 52.8 (47.3–58.4) | 54 (48.8–59.1) | 58.1 (57.2–58.9) | 45.8 (39.9–49.8) | 59.8 (54.2–65.3) | 60.1 (54.4–65.5) | 57.8 (57.1–58.6) |
Richer | 44.1 (38.6–49.6) | 53.9 (48.8–58.9) | 53.1 (52.1–54.2) | 55.1 (44.2–65.4) | 53.9 (48.3–59.4) | 56.3 (49.8–62.6) | 53.1 (52.1–54.1) |
Richest | 43 (37.3–48.9) | 43 (38.4–47.7) | 51.3 (50.1–52.6) | 78 (61-88.9) | 61.7 (55.4–67.7) | 39.2 (32.1–46.7) | 51.2 (50-52.4) |
Maternal anemia | Â | Â | Â | Â | Â | Â | Â |
Not anemic | 43.8*** (40.5–47.1) | 49.2*** (46.4–52.1) | 49.5*** (48.9–50.1) | 43.2** (38.9–47.6) | 53*** (49.8–56.1) | 43.1*** (39.1–46.6) | 49.3*** (48.8–49.9) |
Anemic | 60.5 (56.9–64.1) | 63.1 (59.7–66.3) | 63.7 (63.2–64.3) | 55.4 (51.2–59.6) | 67 (63.6–70.2) | 61.8 (57.7–65.7) | 63.6 (63.1–64.2) |
Community-level factors | Â | Â | Â | Â | Â | Â | Â |
Place of residence | Â | Â | Â | Â | Â | Â | Â |
Urban | 45.8* (41.2–50.5) | 42.8*** (38.3–47.5) | 54.8*** (53.8–55.8) | 65.9** (56.1–74.5) | 60.6 (55,8-65.3) | 48.1* (44.2–51.9) | 54.6*** (53.7–55.6) |
Rural | 52.5 (49.4–55.6) | 57.5 (54.9–60) | 58.6 (58.2–59.1) | 45.5 (42.9–48.2) | 58.5 (55.7–61.2) | 55.2 (50.8–59.6) | 58.4 (58-58.8) |
Community maternal anemia a | Â | Â | Â | Â | Â | Â | Â |
Low | 44.2*** (40.7–47.8) | 49.7*** (46.4–52.9) | 50.4*** (49.8–51.1) | 44.6** (40.2–49.1) | 54.5** (50.9–58.1) | 42.6*** (38.8–46.5) | 50.3*** (49.7–50.9) |
High | 57.3 (53.7–60.9) | 60.6 (57.3–63.7) | 63.7 (63.1–64.3) | 56.9 (52.1–61.5) | 63 (59.8–66.1) | 60.2 (56.2–64.1) | 63.5 (63-64.1) |
Community parity b | Â | Â | Â | Â | Â | Â | Â |
Low | 48.6** (45.5–51.6) | 54.1 (51.2–57.1) | 55.4*** (54.8–55.9) | 52.6 (48.5–56.6) | 58.4* (55.5–61.2) | 48.6** (44.8–52.4) | 55.3*** (54.8–55.8) |
High | 55.8 (50.9–60.6) | 57.7 (53.9–61.4) | 61.8 (61.2–62.5) | 46.5 (41.5–52.1) | 60.2 (55.5–64.7) | 55.5 (51–60) | 61.5 (60.9–62.1) |
Community wealth c | Â | Â | Â | Â | Â | Â | Â |
Low | 47.1** (43.5–50.7) | 49.4*** (46.2–52.5) | 54.8*** (54.2–55.5) | 54.9** (50.1–59.9) | 58.2* (54.8–61.4) | 53.9** (50.2–57.6) | 54.8*** (54.1–55.4) |
High | 54.8 (51.1–58.6) | 62.1 (58.8–65.1) | 60.3 (59.8–60.8) | 44.8 (41-48.72) | 59.7 (56.1–63.3) | 47.3 (42.6–52.1) | 60.1 (59.6–60.6) |
Community female education d | Â | Â | Â | Â | Â | Â | Â |
Low | 53.3 (49.3–57.3) | 57.5* (54.6–60.4) | 62.7*** (62.2–63.3) | 46.6* (41.3–52) | 59.5* (56.2–62.4) | 56.5** (52.4–60.6) | 62.3*** (61.8–62.8) |
High | 49.1 (45.6–52.6) | 51.9 (47.9–55.9) | 52.9 (52.3–53.3) | 53.5 (49.5–57.4) | 58.3 (54.6–61.8) | 45.9 (41.9–50) | 52.9 (52.3–53.5) |
Community safe water access e | Â | Â | Â | Â | Â | Â | Â |
Low | 53.6 (45.9–61.3) | - | 57.5 (57.1–58.1) | 58.3** (52.1–64.2) | 61.5 (57.4–65.4) | 53.3** (49.8–56.9) | 57.6 (56.8–58.3) |
High | 50.7 (47.9–53.5) | - | 57.4 (56.5–57.8) | 45.1 (42.1–48.2) | 57.3 (54.2–60.3) | 46.3 (41.2–51.6) | 57.4 (56.9–57.9) |
Community toilet facility f | Â | Â | Â | Â | Â | Â | Â |
Low | 51.1 (47.5–54.6) | 59.8** (56.6–63.2) | 60.6*** (60.1–61.1) | 52.2 (39.1–65.1) | 59.5 (56.2–62.7) | 56.8** (51.5–61.9) | 60.6*** (60.1–61.1) |
High | 50.9 (47-54.9) | 50.5 (47.3–53.7) | 54.4 (53.7–55.1) | 50.7 (47.4–54) | 58.3 (54.6–61.9) | 48.3 (44.6–52) | 54.3 (53.7–54.9) |