Prevalence and factors associated with underweight among 15–49-year-old women in Sierra Leone: A secondary Data Analysis of Sierra Leone Demographic Health Survey of 2019

Background: Women are at risk of being underweight due to biological, socio-economic, and cultural factors. Underweight women have higher risks of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with being underweight among women of reproductive age (15–49 years) in Sierra Leone. Methods We used the Sierra Leone Demographic and Health Survey (2019-SLDHS) data of 5,714 women aged 15 to 49 years, excluding the pregnant, post-natal, lactating, and post-menopausal women. A multistage stratified sampling approach was used to select study participants, and data was collected using validated questionnaires. A multivariable logistic regression analysis determined factors associated with underweight among 15–49-year-old women in Sierra Leone. Ethical approval for the study was obtained. Results The prevalence of underweight was 6.7% (502/7,514). Women who belonged to the 15–24-year age group (Adjusted Odds Ratio) (AOR) = 2.499,95%CI:2.394–2.596; p < 0.001 were 2.5 times more likely to be underweight compared to the 25–34-year age group. Not married women AOR = 0.594, 95%CI:0.467–0.755; p < 0.001 were less likely to be underweight compared to married women. Women residing in the northern region AOR = 0.734,95%CI:0.559–0.963; p = 0.026 were least likely to be underweight compared to the East. Women who did not listen to radios AOR = 0.673,95%CI:0.673–0.826; p < 0.001 were less likely to be underweight compared to those who did. Conclusion The prevalence of underweight among women in the reproductive age in Sierra Leone is low and the factor associated with underweight was age group (15–24 years). There is a need to address the socio-economic determinants of underweight among women, mainly due to poverty and other inequalities.