Anemia prevalence and its predictors among children under-five years in Ghana. A multilevel analysis of the 2019 Ghana malaria indicator survey

Despite the implementation of anemia control interventions in Ghana, prevalence of anemia is still high in children under-five years although it has reduced by 24% between 2008 and 2019. Further reducing the prevalence of anemia requires identifying and targeting critical risk factors associated to anemia. This study seeks to identify predictors of anemia among children under-five years in Ghana. Data from 2019 Ghana MIS was analyzed using both fixed and random effect logistic regression models. Among the 2434 children under-five years, 54% (95% CI 52.0, 57.0) of them were anemic. In the multivariable multilevel model, the risk of anemia was found to be higher in younger children, children who had malaria, children whose mothers were not covered for health insurance, adolescent mothers’, non-Christian mothers and poorer households. Significant unobserved community level effects in anemia prevalence were observed. We observed high prevalence of anemia in children under-five and critical risk factors at the child, household, and community levels in this population of children. Multifaceted and targeted approaches are needed to help reduce the anemia prevalence in this setting so as to achieve multiple SDGs which are related to risk and prevalence of anemia by 2030.