Multinomial logistic regression analysis of the determinants of anaemia severity among children aged 6–59 months in Ghana: new evidence from the 2019 Malaria Indicator Survey

Abstract

Background Anaemia among children under age fve is a major public health issue. Although anaemia prevalence is declining in Ghana, the severity among anaemic children is worsening. This study aims to investigate the determi nants of anaemia severity among children aged 6 to 59 months in Ghana. Method The study utilized a weighted sample of 1,258 children with anaemia with data obtained from the 2019 Ghana Malaria Indicator Survey. The predictor variables included maternal, household child and health system char acteristics. SPSS version. At the multivariate level, three diferent multinomial logistic models were run with selected predictor variables. All tests were conducted at the 95% confdence level. Results The overall anaemia prevalence among children under age fve was 43.5%. Of these, 2.6% were severely anaemic, 48.5% were moderately anaemic, and 48.9% had mild anaemia. The multinomial analysis showed that maternal, household, child and health system factors signifcantly predicted anaemia levels among anaemic children. The results indicate that a lower likelihood of anaemia severity is likely to be found among children whose mothers belong to Pentecostal/Charismatic faith (AOR=0.18-model I; AOR=0.15-model III) and children who tested negative for malaria (AOR=0.28-model II and III). Again, a higher probability of anaemia severity was found among anaemic children whose mothers were not aware of NHIS coverage of malaria (AOR=2.41-model II, AOR=2.60-model III). With regard to moderate anaemia level, children who belong to the poorest, poorer and middle household wealth index had a higher likelihood of being moderately anaemic compared to those in rich households. Similarly, anaemic children who were less than 12 months old (AOR=2.21-model II, AOR=2.29-model III) and those between the ages of 1–2 years (AOR=1.84-model II, AOR=1.83-model III) were more likely to have moderate anaemia levels. Conclusion The study fndings show the importance of understanding the interrelation among diferent factors that infuence anaemia severity among children under age fve as critical in developing strategies and programmes aimed at addressing childhood anaemia.