Factors Associated with Anemia Among Children 6–23 Months of Age in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey

Figures & data

Figure 1 Characteristics of mothers (caretakers) by age in Ethiopia: A multilevel analysis of data from the 2016 Ethiopia Demographic and Health Survey (n=2554).

Table 1 Individual-level Characteristics of Children in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey (n=2554)

Variables	Frequency (Weighted)	Percentage (%)
Child sex
Male	1192	47
Female	1362	53
Child age
6–11	923	36
12–17	985	38.5
18–23	646	25
Birth weight
Average	1043	40.8
Larger than average	793	31
Smaller than average	718	28
Number of children <5in household
<3	2164	84.7
3–4	371	14
≥5	19	0.74
Religion
Orthodox	862	33.7
Protestant	563	22
Muslim	1046	41
Other	83	3.3
Maternal employment status
No	1904	74.5
Yes	650	25.5
Maternal educational level
No education	1566	61.3
Primary	797	31.20
Secondary	128	5.2
Higher	63	2.5
Media exposure
None	2062	80.72
Exposed to either newspaper, radio or TV	478	18.71
Exposed to all media	14	0.56
Vaccination status
No	395	15.5
Incomplete	1331	52
Full	828	32
Maternal anemia
No	1777	70
Yes	749	30
Diarrhea
No	2039	80
Yes	515	20
Fever
No	2034	79.64
Yes	520	20.36
Symptoms of acute respiratory infection
No	1920	75.19
Yes	634	24.81
Child stunting
No	1710	67
Yes	844	33
Child wasting
No	2196	86
Yes	358	14
Child Underweight
No	2019	79
Yes	535	21

Table 2 Feeding Practice Characteristics of Children in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey (n=2554)

Variables	Frequency (Weighted)	Percentage
Child breastfeeding status
Still breastfeeding	2214	87
Never breastfed	49	1.92
Ever breastfed, but not currently	291	11
Exclusive breastfeeding
No	2228	91.67
Yes	202	8.33
Grains
Not consumed	1138	44.59
Consumed	1415	55.41
Tubers
Not consumed	1965	76.96
Consumed	588	23.04
Fruits
Not consumed	2222	87
Consumed	331	13
Beans
Not consumed	2035	79.70
Consumed	518	20.30
Dietary products
Not consumed	1884	74
Consumed	670	26
Meat
Not consumed	2401	94.03
Consumed	152	5.97
Egg
Not consumed	2113	82.74
Consumed	441	17.26
Vegetables
Not consumed	2211	86.57
Consumed	343	13.43
Minimum meal frequency per day
Less than twice	864	34.77
At least twice	1620	65.23

Table 3 Community-Level Characteristics of 6–23 Months Old Children in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey (n=2554)

Variables	Frequency (Weighted)	Percentage (%)
Region
Tigray	196	7.66
Afar	25	0.97
Amhara	481	18.84
Oromia	1120	43.85
SNNP	530	20.76
Benishangul Gumuz	26	1.01
Gambela	6	0.24
Somali	99	3.87
Harari	5	0.21
Addis Ababa	57	2.23
Dire Dawa	9	0.36
Place of residence
Rural	2266	89
Urban	288	11
Community-women education
Low	1200	47
High	1354	53
Community-women unemployment
Low	1169	46
High	1385	54
Community-poverty
Low	1398	54.7
High	1156	45.25

Abbreviation: SNNP, Southern Nations and Peoples of Ethiopia.

Table 4 Individual- and Community-Level Factors Associated with Anemia Among Children 6–23 Months of Age in Ethiopia: A Multilevel Analysis of Data from the 2016 Ethiopia Demographic and Health Survey (n=2554)

Variables	Anemia Level				AOR (95%CI)
	Frequency (%)
	No	Mild	Moderate	Severe
Sex
Male	321 (26.9)	300 (25)	522 (43.8)	48.8 (4.1)	1
Female	385.6 (28)	401.5 (29.5)	526.5 (38.6)	48.6 (3.57)	0.84 (0.72–0.98)*
Child age
6–11	208.8 (22.6)	265 (28.75)	413 (44.8)	35 (3.8)	1
12–17	276 (28)	267.8 (27)	390 (39.6)	51 (5.2)	0.98 (0.82–1.17)
18–23	222 (34)	168 (26)	245 (38)	10.9 (1.69)	0.76 (0.61–0.93)**
Child underweight
No	594 (29)	556.8 (27.6)	809.8 (40)	58 (2.88)	1
Yes	112 (20.99)	144 (26.97)	239 (44.7)	39 (7.4)	1.42 (1.17–1.73)***
Media exposure
None	539.8 (26)	568.86 (27.6)	859 (41.7)	94 (4.6)	1
Exposed to either newspaper, radio, or TV	157 (32.87)	129.77 (27.2)	188 (39.4)	3 (0.6)	0.78 (0.61–0.99)*
Exposed to all media	9.85 (68.5)	2.5 (17)	1.6 (11)	0.44 (3)	0.31 (0.12–0.79)*
Child fever
No	591 (29)	549 (27)	815.5 (40)	78.2 (3.8)	1
Yes	115.7 (22.3)	152 (29.2)	233.18 (44.8)	19 (3.7)	1.41** (1.03–1.93)
Exclusive breastfeeding
No	617 (27.7)	600 (27)	921 (41.4)	88 (4)	1
Yes	65.78 (32.5)	48.9 (24)	81 (40.3)	6.2 (3.1)	0.73* (0.54–0.98)
Maternal anemia
No	561 (31.6)	491 (27.6)	673 (37.9)	51 (2.88)	1
Yes	140.5 (18.75)	204.5 (27.29)	358.16 (47.79)	46 (6.17)	1.53 (1.28–1.82)***
Community-poverty
Low	449 (32.11)	406.6 (29)	519 (37)	23.76 (1.7)	1
high	257.6 (22)	294.5 (25.5)	529.7 (45.8)	73.7 (6.4)	1.3 (1.01–1.67)*
Region
Tigray	48.2 (24.65)	62 (31.7)	80.9 (41)	4 (2.22)	1
Afar	2.5 (10.2)	6.4 (26.9)	14.6 (59.3)	1.1 (4.5)	1.27 (0.79–2.03)
Amhara	163 (33.97)	146 (30.4)	146.6 (30.5)	24. 8(5)	0.65 (0.45–0.94)*
Oromia	251 (22.4)	311 (27.8)	516 (46)	42 (3.7)	0.97 (0.65–1.45)
Somalia	8.7 (8.8)	17.8 (17)	62.4 (63)	9.9 (10)	2.08 (1.31–3.29)**
Benishangul Gumuz	10.38 (40)	7.6 (29.5)	7.47 (28.9)	0.39 (1.5)	0.39 (0.25–0.61)***
SNNP	197 (37)	133 (25)	187 (35.3)	12.8 2.4)	0.62 (0.40–0.96)*
Gambela	1.8 (28.6)	1.47 (23.8)	2.87 (46)	0.09 (1.5)	0.95 (0.58–1.55)
Harari	0.93 (17.8)	1.13 (21.6)	2.8 (55.7)	0.36 (6.9)	1.97 (1.18–3.31)*
Addis Ababa	21.5 (37.68)	12 (21.4)	22.5 (39.5)	0.83 (1.5)	1.36 (0.81–2.28)
Dire Dawa	1.5 (16.3)	1.66 (18)	5.2 (55.8)	0.91 (9.9)	2.30 (1.33–3.97)

Notes: *p-value<0.05; **p-value<0.01; ***p-value <0.001, 1-reference category.

Abbreviations: AOR, adjusted odds ratio; SNNPR, Southern Nations, Nationalities and Peoples Region.

Table 5 Random Intercept Variances of Two-level Mixed Effect Models

Random Effects	Model 1	Model 5
Variance ()	0.72*	0.2*
VPC2 (%)	18	5.73

Notes: is community random intercept variances. *p-value <0.001. Hint: models 2 and 3 are not presented.

Abbreviation: VPC₍₂₎, variance partition coefficient for cluster.

Figure 2 Receiver Operating Characteristics curve for anemia among children 6–23 months of age in Ethiopia: A multilevel analysis of data from the 2016 Ethiopia Demographic and Health Survey (n=2554).