Multilevel and Interaction Modeling of Factors Associated with moderate to severe Anaemia among children Undefive years in Uganda

Abstract

The purpose of this study was to use multilevel and interaction modeling in examining the factors associated with child moderate to severe anaemia in Uganda using 2016 Demographic and Health Survey. The data set had a hierarchical structure and to account for this hierarchy in the data, a random effects regression model was fitted to find the significant factors affecting childhood moderate to severe anaemia. The results of the study showed that sex of a child, age of a child, age of mother, birth order and type of toilet facility were significant predictors of child moderate to severe anaemia. Female children had lower risk of anaemia compared to males (OR=0.774, p=0.004). Children aged 24-59 months had reduced risk of anaemia compared to children aged 6-23 months (OR=0.290, p=0.000). Also children born to mothers of older age ie 20-29, 30-39 and 40-49 had reduced risk of having moderate to severe anaemia (OR=0.442, p=0.338; OR 0.336, p=0.000; OR=0.310, p=0.000) respectively. The study also pointed out that children from mothers with no toilet facility had higher risk of having moderate to severe anaemia (OR=1.521, p=0.030). Also 25.6% of the variability in anaemia prevalence is attributed to mother differences. The effect of education level and household wealth on child moderate to severe anaemia was also found to be significantly different by region in which the mothers of the children live. Children born of poor mothers from northern and western region had higher risk of moderate to severe anaemia than children of poor mothers from central (OR=2.771, p=0.021; OR=3.098, p=0.007) respectively. It is recommended that government and other stake holders needs to extend poverty eradication programs targeting children from the poor families that cannot afford basic needs and more emphasis put northern and western Uganda as priority. Also the government should create public awareness through sensitizing mothers about the dangers of anaemia in children to especially those mothers that did not attend schools