Table 4 Adjusted association between anaemia and environmental factors and other study covariates among children 6–59 months in Ethiopia, EDHS 2005–2016 (n = 21,918)

Environmental factors

Sanitation facility

 Improved

Ref

Ref

Ref

Ref

Ref

 Unimproved

1.05 (0.94–1.16)

1.03 (0.91–1.16)

0.98 (0.87–1.11)

0.98 (0.87–1.11)

0.93 (0.82–1.05)

 Open defecation

1.41 (1.27–1.56)**

1.43 (1.27–1.60)**

1.29 (1.15–1.46)

1.21 (1.06–1.36)*

1.19 (1.05–1.36)*

Source of drinking water

 Improved

Ref

Ref

Ref

Ref

Ref

 Unimproved

1.17 (1.09–1.24)**

1.16 (1.08–1.25)**

1.13 (1.05–1.22)*

1.09 (1.01–1.18)*

1.03 (0.95–1.12)

Time to get a water source

 On-premise

Ref

Ref

Ref

Ref

Ref

  ≤ 30 min

0.91 (0.81–1.02)

0.94 (0.82–1.08)

0.86 (0.75–0.98)*

0.85 (0.74–0.98)*

0.98 (0.85–1.13)

 31–60 min

0.99 (0.87–1.13)

1.04 (0.89–1.21)

0.95 (0.81–1.11)

0.94 (0.81–1.09)

1.04 (0.88–1.23)

  > 60 min

1.14 (0.99–1.30)

1.23 (1.05–1.44)*

1.09 (0.93–1.29)

1.08 (0.93–1.26)

1.17 (0.98–1.38)

Housing status

 Built from finished materials

Ref

Ref

Ref

 Built from natural or unfinished materials

1.11 (0.95–1.29)

1.18 (0.98–1.42)

1.10 (0.91–1.33)

Type of cooking fuel

 Clean fuels

Ref

 Solid fuels

1.06 (0.85–1.32)

Child factors

Sex

 Male

Ref

Ref

Ref

Ref

 Female

0.95 (0.89–1.02)

0.95 (0.89–1.02)

0.96 (0.89–1.02)

0.96 (0.89–1.02)

Age (months)

 6–11

3.62 (3.23–4.06)**

3.63 (3.25–4.07)

3.61 (3.22–4.03)**

2.94 (2.62–3.30)**

 12–23

3.38 (3.08–3.70)**

3.38 (3.09–3.69)

3.39 (3.10–3.71)**

2.70 (2.46–2.97)**

 24–35

2.07 (1.90–2.26)**

2.06 (1.89–2.25)

2.06 (1.89–2.24)**

1.62 (1.48–1.77)**

 36–59

Ref

Ref

Ref

Ref

Size of a child at birth

 Larger

Ref

Ref

 Average

0.99 (0.91–1.07)

0.97 (0.89–1.05)

 Small

1.06 (0.97–1.15)

1.03 (0.94–1.13)

Full vaccination

 Yes

Ref

Ref

Ref

Ref

 No

1.12 (1.03–1.22)*

1.09 (1.01–1.18)*

1.08 (1.00–1.18)*

1.14 (1.05–1.24)*

Received deworming medication in the last 6 months

 Yes

Ref

Ref

Ref

Ref

 No

1.12 (1.01–1.25)*

1.10 (0.99–1.22)

1.11 (0.99–1.23)

1.11 (1.01–1.24)*

Iron supplementation

 Yes

0.88 (0.77–1.02)

0.90 (0.78–1.04)

0.91 (0.78–1.04)

0.95 (0.82–1.09)

 No

Ref

Ref

Ref

Ref

Vitamin A last 6 months

 Yes

Ref

Ref

Ref

Ref

 No

1.09 (1.02–1.18)*

1.06 (0.99–1.14)

1.06 (0.98–1.14)

1.02 (0.94–1.09)

Currently breastfeeding

 Yes

Ref

 No

1.01 (0.93–1.08)

Birth interval

 7- 33 months

Ref

  ≥ 33 months

0.99 (0.92–1.06)

Diarrhoea

 Yes

1.05 (0.95–1.15)

 No

Ref

Parental factors

Mother's age

 15–18

0.73 (0.47–1.14)

0.73 (0.47–1.14)

0.71 (0.45–1.11)

 18–24

1.04 (0.94–1.15)

1.04 (0.94–1.14)

1.01 (0.91–1.11)

 25–34

1.05 (0.97–1.14)

1.05 (0.97–1.15)

1.03 (0.94–1.12)

 35–49

Ref

Ref

Ref

Mother's education

 No education

1.04 (0.96–1.14)

 Primary and above

Ref

Mother's currently working

 Yes

Ref

Ref

Ref

 No

1.11 (1.03–1.20)*

1.11 (1.03–1.19)*

1.10 (1.02–1.19)*

Maternal BMI (kg/m²)

  < 18.5

Ref

Ref

Ref

 18.5 to 24.9

0.84 (0.77–0.90)**

0.85 (0.78–0.91)

0.84 (0.78–0.91)**

 25 + 

0.84 (0.73–1.03)

0.86 (0.73–1.01)

0.82 (0.69–0.96)*

Listening to radio

 Yes

Ref

Ref

Ref

 Not at all

1.12 (1.04–1.21)*

1.08 (1.01–1.18)*

1.04 (0.95–1.12)

Watching television

 Yes

Ref

Ref

Ref

 Not at all

1.27 (1.15–1.41)**

1.26 (1.14–1.39)**

1.27 (1.14–1.40)**

Household factors

Wealth index

 Poor

1.27 (1.15–1.40)**

1.18 (1.06–1.31)*

 Middle

1.05 (0.94–1.17)

1.01 (0.90–1.13)

 Rich

Ref

Ref

Community-level characteristics

Residence

 Urban

Ref

 Rural

1.23 (1.06–1.42)*

Region

 Agrarian

Ref

 Pastoralist

1.58 (1.44–1.74)**

 City administration/ Metropolis/

1.43 (1.27–1.62)**

EDHS

 2005

0.45 (0.40–0.51)**

 2011

0.50 (0.46–0.55)**

 2016

Ref

Random effect

 ICC (%)

6.38

5.48

5.02

4.86

4.93

4.24

 Log-likelihood

-14060.391

-13799.074

-10389.692

-10325.692

-10360.817

-10177.156