Prevalence And Predictors of Anaemia Among Children 6 - 59 Months in Sub-Saharan Africa: A Multilevel Analysis of National Demographic Health Data

Background : Anaemia is one of the leading causes of morbidity and mortality among under-five children in Sub-Saharan Africa (SSA). Anaemia has a significant impact on children's health. It can interfere with cognitive and physical development, and in severe situations, and it can prove fatal. The purpose of this study is to provide a detailed review of the current prevalence of anaemia in SSA and to identify important risk factors among children under five years, and suggest practical solutions for prevention and control. Methods: This study used a cross-sectional approach using data from the most recent Demographic and Health Surveys (DHS) of 22 countries in SSA, from 2010 to 2023. A total of 93524 participants were included in the study. A multilevel logistic regression model was used to identify the predictors of anaemia among children under five years. Pooled prevalence and adjusted odds ratio, with a 95% confidence interval were reported. Statistical significance was set at p ≤ 0.05. Data management and analysis were performed using STATA version 18 macOS version. Results: The overall prevalence of anaemia across all the included countries is 61% (95% CI: 61%-62%), with the lowest prevalence reported in Rwanda 37% (95% CI: 35%-39%) and highest prevalences were reported in Mali 82% (95% CI: 81%-84%). Children aged 24-59 months were significantly less likely (AOR: 0.54, 95% CI: 0.505 - 0.586) to experience anaemia compared to those aged 6-23 months. Children who received a Vitamin A supplement (AOR: 0.86, 95% CI: 0.814 - 0.916) and dewormer (AOR: 0.86, 95%CI: 0.812 – 0.914) were less likely to be anaemic. Anaemia is less prevalent among children whose mothers took iron supplements (59.5%) compared to those who did not (68.1%). Anaemia prevalence is highest among children of mothers with no education (68.8%) and lesser among mothers with higher education (49.4%). The chi-square test (𝜒2 = 294.9, p < 0.0001) indicates a significant association between maternal education and anaemia. The chi-square test (𝜒2 = 54.3, p < 0.0001) shows a significant association between iron supplementation during pregnancy and anaemia. Conclusion: Our study showed a high prevalence of anaemia in SSA, suggesting the urgency of timely and comprehensive efforts with regards to this problem. Women empowerment and promoting integrated maternal and child health service delivery models are essential in dealing with childhood anaemia and improving children’s well-being and development in SSA and achieving SDG 2 in the sub-region.