Multilevel bivariate analysis of childhood anemia and anthropometric failure among under-five children in sub-Saharan Africa

Abstract

Childhood anemia and malnutrition remain critical public health challenges in Sub-Saharan Africa (SSA), with anemia affecting approximately 47.4% of preschool children globally. A cross sectional secondary data analysis from recent Demographic and Health Survey data was used. This study examined factors associated with childhood anemia and composite index anthropometric failure (CIAF) across 34 SSA countries. CIAF captures overall under nutrition by integrating stunting, underweight and wasting. Multilevel bivariate binary logistic regression was used to identify various shared and specific predictors. The prevalence of CIAF and anemia was 38.4% and 61%, respectively. The OR value 1.458 revealed that there was significantly association between CIAF and anemia. Key factors associated with both conditions included the child’s age, maternal education, household wealth index, child sex, parity, residence, type of birth, maternal age, diarrhea, and optimal antenatal care (ANC). Additionally, maternal anemia, maternal occupation, vitamin A supplementation, birth interval, household media exposure, and gestational age showed significant associations with CIAF or anemia. The findings suggest the need for integrated strategies, including improved ANC services, enhanced maternal education, and socioeconomic support to reduce the burden of under nutrition and anemia in children. Addressing these interconnected factors may improve child health outcomes in SSA.