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Maternal and pediatric nutrition

A multilevel approach to correlates of anaemia in women in the Democratic Republic of Congo: findings from a nationally representative survey

European Journal of Clinical Nutrition volume 74, pages 720–731 (2020)Cite this article

Subjects

Abstract

Background/Objectives:

Anaemia accounts for a significant proportion of pre- and post-partum morbidity and mortality in low-income countries with sequelae, including an increased risk of infection. Factors contributing to anaemia need to be addressed through the introduction of evidence-based measures to control and prevent the disease. We aimed to determine the prevalence of anaemia in women of child-bearing age in the Democratic Republic of Congo (DRC) and investigate the associated individual, household and community level factors.

Subjects/Methods:

Cross sectional representative population data from the 2013–2014 DRC Demographic and Health Survey (DHS) was used. The primary outcome was anaemia in women, stratified according to pregnancy in those of child-bearing age. A haemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was used as the indicator of anaemia. Using a three-level random intercept model this study explored risk factors at individual, household and community levels and quantified the observed and unobserved variations between households and communities.

Results:

Thirty-eight percent of women in the DRC are anaemic. Anaemia is significantly higher in younger, pregnant and underweight women, as well as those with comorbidities, including HIV and malaria who are living in the capital city Kinshasa. Anaemia varies within and between households and communities in the DRC.

Conclusions:

Integrated approaches to reduce anaemia in settings with high malaria and HIV prevalence such as the DRC should target households.

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Acknowledgements

We are grateful to the USAID, DHS Programme for granting us access to the Democratic Republic of Congo 2013–2014 Demographic Health Surveys.

Author contributions

NK formulated the research question and designed the study. NK performed statistical analysis. NK, SP, NM, AC and GK wrote the paper. NK, SP, NM, GK and AC had primary responsibility for final content. All authors have read and approved the final manuscript.

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Authors and Affiliations

  1. School of Health and Care Professions, PB Centre for Global Health, University of Portsmouth, Portsmouth, United Kingdom

    Ngianga II Kandala & Saseendran Pallikadavath

  2. Centre for Global Health and Policy, Faculty of Social Science, University of Southampton, Southampton, United Kingdom

    Andrew Amos Channon

  3. School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom

    Gavin Knight

  4. African Institute for Development Policy, Lilongwe, Malawi

    Nyovani Janet Madise

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  1. Ngianga II Kandala
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Correspondence to Ngianga II Kandala.

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Kandala, N.I., Pallikadavath, S., Amos Channon, A. et al. A multilevel approach to correlates of anaemia in women in the Democratic Republic of Congo: findings from a nationally representative survey. Eur J Clin Nutr 74, 720–731 (2020). https://doi.org/10.1038/s41430-019-0524-8

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