Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006–2016)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Data Source
2.3. Sampling Method and Sample Size
2.4. Outcome Variable
2.5. Explanatory Variables
2.6. Data Analysis
3. Results
3.1. Sociodemographics Chacterictics
3.2. Under-Five Children Charcteristics
3.3. Prevalence of Anemia among Under-5 Children in Nepal
3.4. Spatial Variation of Anemia among Under-5 Children in Nepal
3.5. Determinants of Anemia among Under-5 Children
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Frequency | Percentage |
---|---|---|
Mother’s Age | ||
15–24 | 3412 | 39.3 |
25–34 | 4156 | 47.9 |
35–44 | 1016 | 11.7 |
Above 45 | 91 | 1.1 |
Religion | ||
Hindu | 7367 | 84.9 |
Buddhist | 589 | 6.8 |
Muslim | 478 | 5.5 |
Others | 239 | 2.8 |
Education level of mother | ||
No | 4513 | 52.0 |
Primary | 1612 | 18.6 |
Secondary | 2078 | 24.0 |
Higher | 472 | 5.4 |
Education level of father | ||
No | 2422 | 27.9 |
Primary | 2663 | 30.7 |
Secondary | 1691 | 19.5 |
Higher | 1385 | 16.0 |
Don’t know | 514 | 5.9 |
Type of residence | ||
Urban | 1824 | 21.0 |
Rural | 6850 | 79.0 |
Ethnicity | ||
Brahmin/Chettri | 2715 | 31.3 |
Janajati | 1674 | 19.2 |
Terai others | 1065 | 12.3 |
Dalit | 1047 | 12.1 |
Muslim | 349 | 4.0 |
Newar | 342 | 3.9 |
Others | 1483 | 17.2 |
Wealth Index | ||
Poorest | 2142 | 24.7 |
Poorer | 1869 | 21.5 |
Middle | 1854 | 21.4 |
Richer | 1598 | 18.4 |
Richest | 1212 | 14.0 |
No. of under-five children | ||
1 to 2 | 7417 | 85.5 |
3 and above | 1258 | 14.5 |
No. of HH size | ||
2 to 4 | 2372 | 27.3 |
5 to 7 | 3968 | 45.7 |
8 and above | 2332 | 26.9 |
Development Region | ||
Eastern | 1944 | 22.4 |
Central | 2848 | 32.8 |
Western | 2019 | 23.3 |
Mid-Western | 1014 | 11.7 |
Far Western | 850 | 9.8 |
Characteristics | Frequency | Percentage |
---|---|---|
Age in months | ||
6–11 | 900 | 10.4 |
12–23 | 1911 | 22.0 |
24–59 | 5864 | 67.6 |
Sex | ||
Male | 4443 | 51.1 |
Female | 4242 | 48.9 |
Child is twin | ||
Yes | 75 | 0.9 |
No | 8600 | 99.1 |
Birth Size | ||
Very small | 407 | 4.7 |
Small | 1136 | 13.1 |
Average | 5416 | 62.4 |
Larger and very large | 1708 | 19.7 |
Don’t know | 8 | 0.1 |
Preceding birth interval | ||
24 months and less | 1448 | 16.7 |
More than 24 months | 4404 | 50.8 |
First birth | 2823 | 32.5 |
Succeeding birth interval | ||
Last birth | 880 | 75.8 |
24 months and less | 1217 | 10.1 |
More than 24 months | 6578 | 45.0 |
Underweight | ||
No | 5559 | 64.1 |
Yes | 3075 | 35.4 |
Wasting | ||
No | 7637 | 88.0 |
Yes | 992 | 11.4 |
Stunting | ||
No | 4525 | 52.2 |
Yes | 4104 | 47.3 |
Fever Last 2 weeks | ||
No | 7012 | 80.8 |
Yes | 1661 | 19.2 |
Diarrhea last 2 week | ||
No | 7682 | 88.6 |
Yes | 987 | 11.4 |
Cough last 2 week | ||
No | 6935 | 79.9 |
Yes | 1738 | 20.0 |
2005 | 2011 | 2016 | |
---|---|---|---|
Moran’s Index | 0.170688 | 0.018449 | 0.157314 |
Expected Index | −0.003861 | −0.003472 | −0.002618 |
p | 0.0000 | 0.331 | 00000 |
Z score | 5.18 | 0.7405 | 5.4444 |
Characteristics | Odd Ratio | 95% CI | p Value |
---|---|---|---|
Mother’s age | |||
15–24 | 1.731 | 1.132–2.648 | <0.01 |
25–34 | 0.723 | 1.384–0.906 | |
35–44 | 0.299 | 1.261–0.814 | |
45 and above | 1 | 1 | |
Mother’s Education | |||
No education | 1.922 | 1.579–2.339 | <0.01 |
Primary | 1.510 | 1.222–1.866 | |
Secondary | 1.575 | 1.281–1.936 | |
Higher | 1 | 1 | |
Father’s education | |||
No education | 1.370 | 1.200–1.565 | <0.01 |
Primary | 1.238 | 1.087–1410 | |
Secondary | 1.086 | 0.942–1.253 | |
Higher | 1 | 1 | |
Wealth index | <0.001 | ||
Poorest | 1.333 | 1.160–1.533 | |
Poorer | 1.532 | 1.323–1.774 | |
Middle | 1.725 | 1.484–2.005 | |
Richer | 1.481 | 1.272–1.726 | |
Richest | 1 | 1 | |
Household size | <0.01 | ||
2 to 4 | 0.767 | 0.685–0.860 | |
5 to 7 | 0.850 | 0.768–0.940 | |
8 and above | 1 | 1 | |
No. of under-5 children | <0.01 | ||
1 to 2 | 0.774 | 0.689–0.869 | |
3 and more | 1 | 1 | |
Age of child (in a month) | |||
6 to 11 | 5.327 | 4.538–6.253 | <0.001 |
12 to 23 | 3.462 | 3.107–3.857 | |
24 to 59 | 1 | 1 | |
Child is twin | |||
Yes | 1 | 1 | 0.022 |
No | 0.588 | 0.383–0.934 | |
Birth size | |||
Large than average | 0.782 | 0.684–0.895 | <0.01 |
Average | 0.542 | 0.866–1.0079 | |
Small than average | 1 | 1 | |
Stunting | |||
Yes | 1.203 | 1.107–1.308 | <0.01 |
No | 1 | 1 | |
Underweight | |||
Yes | 1.358 | 1.245–1.482 | <0.01 |
No | 1 | 1 | |
Wasting | |||
Yes | 1.533 | 1.342–1.752 | <0.01 |
No | 1 | 1 | |
Had fever | |||
Yes | 1 | 1 | <0.01 |
No | 0.807 | 0.726–0.869 | |
Had diarrhea | |||
Yes | 1 | 1 | <0.01 |
No | 0.686 | 0.601–0.783 | |
Had Cough | |||
Yes | 1 | 1 | <0.01 |
No | 0.794 | 0.715–0.875 | |
Year of survey | 0.001 | ||
2006 | 1 | 1 | |
2011 | 0.922 | 0.832–1.023 | |
2016 | 1.157 | 1.044–1.283 | |
Preceding birth interval | |||
First birth | 1 | 1 | 0.02 |
24 months and less | 1.213 | 1.049–1.266 | |
More than 24 month | 1.152 | 1.070–1.3751 | |
Succeeding birth interval | |||
24 and less | 0482 | 0.426–0.546 | <0.01 |
More than 24 | 0.562 | 0.488–0.648 | |
Last birth | 1 | 1 |
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Sharma, S.; Acharya, B.K.; Wu, Q. Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006–2016). Int. J. Environ. Res. Public Health 2022, 19, 8664. https://doi.org/10.3390/ijerph19148664
Sharma S, Acharya BK, Wu Q. Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006–2016). International Journal of Environmental Research and Public Health. 2022; 19(14):8664. https://doi.org/10.3390/ijerph19148664
Chicago/Turabian StyleSharma, Shristi, Bipin Kumar Acharya, and Qian Wu. 2022. "Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006–2016)" International Journal of Environmental Research and Public Health 19, no. 14: 8664. https://doi.org/10.3390/ijerph19148664