Socio demographic determinants of anaemia and nutritional status in the Democratic Republic of Congo, Uganda and Malawi
Anaemia is a worldwide public health concern. Anaemia is multifactorial and its related factors are classified according to their position in the pathophysiological process. Socioeconomic and demographic factors such as poor education, cultural norms such as food taboos can predispose children and women to anaemia through immediate causes such as physiological, biological, diet and infections. However, socioeconomic and demographic factors associated with anaemia are not widely reported and it is difficult to find published literature on this subject, which could be due to the lack of data. The objective of this research is to provide an understanding of socioeconomic and demographic factors related with anaemia among children and women and the links between anaemia during childhood and child nutritional status which can be used as a basis for policy formulation, planning and implementation. Almost three quarters of children and half of women in DRC (2007) Uganda (2006) and Malawi (2004) are anaemic. Multilevel ordinal regression models were fitted for anaemia among children and multilevel logistic regression models for anaemia among women. The models showed variations in anaemia prevalence within the countries at the community level. However, country level interactions indicate that there are no significant differences in the risk of anaemia in children and women between these countries. Endogenous switching regression models were fitted to the data to explore the link between anaemia and child's health outcomes. Anaemia is endogenous to children's nutritional status (weight for age z scores) which should be accounted for. The prevalence of anaemia is high in DRC (71% Uganda (74% and Malawi (73% and anaemia is a severe public health problem in the three countries. Although it will take considerable time for the three countries to control anaemia, it is not an impossible task. By improving nutrition and iron status, and treating helminth and malaria infections, the prevalence of anaemia can decrease as observed in Malawi in 2010. More effort is needed to identify the pathways through which anaemia within each country may be addressed.