Characteristics of study participants
Data on 7689children between the ages of 6–59 months were included in the final analysis. The mean age of the children was 31.7 with a SD of +/-15.6 (median: 31 months, range: 6 to 59 months). There was uniform distribution of children by age with the lowest proportion of children (11.7%) found in the lowest age group of 5-11months.Ruraland urban representation of 83% and 17%, respectively. Around one fourth of the children 1826 (23.7%) were fourth and fifth birth order. The major number of households (45.3%) has two children and more than one-third (35.3%) of households had only one child with in the stated age range (Table 1).
Half of (49.8%) of mothers /caregivers of the children were within the age group of 20–29 years and around two third (65.1%) were Illiterate. More than two-third of the mothers (71.7%) were not currently working. More than one third (36.4%) of households were grouped under poorest rank of wealth index, and one from three mothers (33.2%) did not visit antenatal care during their recent pregnancy (Table 2).
Considering the nutritional status of the children, more than one third (39%) of the children were stunted, around one-quarter (26%) were underweight, and one-in ten (11.4%) were wasted. Nearly half (48.7%) of the children were not received Vitamin A supplementation in last 6 months (Table 3).
Factors Associated with Anemia among Children Aged 6– 59 Months
In the bivariate logistic regression analysis age of child, sex, maternal age, residence, maternal educational status, number of house hold members, sex of house hold head, wealth index, currently living with husband, respondent currently working, birth order of the child, birth status, birth interval, number of ANC visit, deworming during pregnancy, recent diarrhea, vitamin A in last 6months, level of stunting, level of underweight, and level of wasting were significantly associated with anemia.
Multivariable logistic regression analysis was performed to identify statistically significant predictors of anemia (Table 4). In multivariable analysis children in the age group of 6–11, 12–23,24–35, 36–47 months were 6.2 times (AOR = 6.19; 95% CI: 4.62,8.30), 4.2 times (AOR = 4.20; 95% CI: 3.27,5.40),2.1 times (AOR = 2.15; 95% CI: 1.67,2.79) and 1.5 times (AOR = 1.49; 95% CI: 1.14,1.97)more likely to be anemic than children in the highest age range (48–59 months) respectively.
Children of mothers aged 20–29 and 30–39 years were 1.6 times (AOR = 1.64; 95% CI: 1.21, 2.23) and 1.3 times (AOR = 1.29; 95% CI: 1.01, 1.66) respectively more likely to be anemic than children of mothers in the highest age range (40–49 years).Considering wealth index of the households, children born from the poorest households were 1.5(AOR = 1.23; 95% CI: 1.23, 1.95) times more likely to be anemic than children from richest households. Children from mothers not currently living with husband were 1.3 times (AOR = 1.31; 95% CI: 1.02, 1.67) more likely to be anemic than children of mothers currently living with their husband.
Considering birth order of the child, children born in the order of eighth and above, sixth and seventh and fourth and fifth were 1.8 times (AOR = 1.79; 95% CI: 1.29, 2.49), 1.5 times (AOR = 1.50; 95% CI: 1.14, 1.98), and 1.4 times (AOR = 1.09; 95% CI: 1.09, 1.72) respectively more likely to be anemic than first birth order children. The lower the birth interval, the higher the likely of developing anemia. Children with birth interval of less than 18 months,18–23 months, and 24–35 months were 1.7 times (AOR = 1.71; 95% CI: 1.26,2.34),1.6 times (AOR = 1.59; 95% CI: 1.22,2.07), and 1.4 times (AOR = 1.42; 95% CI: 1.17,1.73) respectively more likely to have anemia than children with birth interval of greater than or equal to 48 months.
Children of mothers with only 1 ANC visit were 1.5 times (AOR = 1.50; 95% CI: 1.02, 2.22) more likely to develop anemia than children of mothers with the recommended number of ANC visit ( > = 4times).Stunted and underweight children were1.5 times (AOR = 1.47; 95% CI: 1.14, 1.88), and 1.4 times (AOR = 1.46; 95% CI: 1.04, 2.03) more likely to be anemic than normal children (Table 4).