Determinants of Anaemia in Children Under Five Years in Ghana

Abstract

Background: Anaemia in children under five years remains an important public health concern. It affects the physical and cognitive development of the child and increases morbidity and mortality among children under five years old. Knowledge of the determinants of anaemia is integral for effective policy decisions and interventions. Objectives: This study sought to investigate the determinants of anaemia in children under five years in Ghana. Methods: The study employed a secondary data analysis of a nationally representative 2014 Ghana Demographic and Health Survey (DHS) data. A total of 2343 children under 5years were included in the analysis. Ordered logistic regression analysis was performed to assess the determinants of anaemia using four models. Results: The findings of the study revealed that the overall prevalence of anaemia in children under 5years in Ghana was 69.61% with 27.19% being mildly anaemic, 39.56% moderately anaemic and 2.86% severely anaemic. The highest prevalence was found in the Northern Region (84.84%) whiles Ashanti Region recorded the lowest prevalence of 52.89%. The determinants of anaemia were found to exist at the child, maternal and household levels. Factors independently associated with increased odds of anaemia in children under five years were child’s age below 2years (OR=2.14, 95%CI 1.79-2.56), being a male child (OR=1.26 95% CI 1.07-1.49), increasing birth order (OR=1.07, 95% CI 1.01-1.14), history of fever (OR=1.96, 95% CI 1.55-2.48), children of severely anaemic mothers (OR=9.14, 95% CI 1.37-61.11), moderately anaemic mothers (OR=1.77, 95%CI 1.33-2.35), and mildly anaemic mothers (OR=1.51, 95%CI 1.26-1.81), children living in households with 2 children under five years (OR=1.24, 95%CI 1.03- 1.49), children living in household with three and more children under 5years (OR=1.32, 95%CI 1.02-1.70) and children from poorer households (OR=1.36, 95%CI=1.03-1.70). Moreover, factors independently associated with reduced odds of anaemia in children under five years in Ghana were increasing maternal age (p<0.05), secondary education of mother (OR=0.71, 95%CI 0.55-0.90), higher education of mother (OR=0.48, 95%CI 0.26-0.89), children from richest households (OR=0.48 95%CI 0.33-0.70), residing in Ashanti Region (OR=0.65, 95% CI 0.43-0.98) and Brong Ahafo Region (OR=0.62, 95% CI 0.41-0.94). However, history of diarrhoea, vitamin A supplementation, fathers’ educational level, household size, source of drinking water, main floor material and locality were not independent determinants of anaemia in children under five years in Ghana in this study. Conclusion: The study reports high prevalence of anaemia in children under five years in Ghana. Determinants of anaemia in children under five years were child’s age, gender of child, birth order, history of fever, mothers’ age, mothers’ educational level, mothers’ anaemia status, number of children under 5years in household, household wealth status and region of residence. The findings imply the need for holistic policy interventions to address the problem of anaemia in children under five years in Ghana.