Despite modest progress in reducing stunting, reductions in anemia prevalence have been very rapid in many number of developing countries. This paper aims to first document the extent of this reduction across countries and regions, and then to statistically identify significant risk factors for anemia, and how these have changed over time.
DHS data were collated for two survey rounds each for 24 developing countries, for a total of 84,991 children 6-36 months of age. Multivariate regression models were used to analyze associations between anemia and a wide range of underlying risk factors.
Reductions in anemia prevalence were rapid for the sample as a whole (-1.2 points per year), but extremely rapid in Uganda (-4.6 points), Madagascar (-3.5 points) and Peru (-3.2 points), and in a number of other countries (1-3 points per year reduction). In the African sample the most important correlates with anemia were malarial factors (proxied by fever incidence), socioeconomic status, latrine use, piped water, neonatal and antenatal care, and birth intervals. Outside of Africa the most important predictor of anemia outcomes were parental education, latrine use, and vitamin A supplements (but not iron).
Consistent with global analyses of the epidemiology of anemia, our analysis points to anti-malaria efforts as the principal driver of anemia reduction in Africa, although there are many other risk factors for anemia, particularly poor access to health and WASH services and low socioeconomic status.