Prevalence and risk factors of childhood anemia in Nepal: A multilevel analysis

INTRODUCTION

Anemia is a common problem in children particularly in developing countries and taking steps to tackle it is one of the major public health challenges for Nepal. The objective of this study is to investigate the prevalence of individual, household and community level determinants of childhood anemia in Nepal.

METHODS

Data was taken from a nationally representative sample of 1,942 Nepalese children aged from 6-59 months. The Chi-square test was used to determine the bivariate relationship between the selected variables and childhood anemia and a multilevel logistic regression model with a random intercept at household and community level was used to identify important determinants of this kind of anemia.

RESULTS

The results showed that 52.6% (95% CI: 49.8%-55.4%) of the children were anemic while 26.6% (95% CI: 24.0%-29.3%) of them were moderate to severe. The prevalence of overall anemia was higher among children aged less than 11 months as well as in underweight children, children of underweight, anemic and uneducated mothers and those in the terrain ecological regions. Multivariable analysis showed that children aged less than 11 months, who were underweight and had anemic mothers were more likely to have moderate or severe anemia. Children in the hilly ecological region were less likely to have it compared to mountain and terrain ecological regions. Children in middle-class families and children of mothers who completed secondary education were more likely to have anemia.

CONCLUSION

Nepal is facing a serious public health problem due to the high prevalence of childhood anemia. This adverse situation occurs due to socio-demographic and geographical factors such as age, malnutrition status, mother's anemia status, socio-economic status and regional variations. Prevention of childhood anemia should be given top priority in Nepal and should be considered as a major public health intervention.

Malnutrition in South Asia-A Critical Reappraisal

Malnutrition continues to be a major public health challenge especially in South Asian developing countries. The aim of the present review is to spotlight the magnitude of the prevalence of malnutrition and its dynamics in South Asian region and to suggest potential approaches for the prevention and control of this issue of public health significance. An extensive review of literature, covering malnutrition and its determinants, health and economic consequences and pragmatic preventive strategies was performed on computer based bibliographic databases (PubMed, Google Scholar, Scopus, Medline and Sciencedirect.com ) to retrieve abstracts and full texts for India, Pakistan, Bangladesh, Sri Lanka and Nepal. All relevant titles and abstracts were examined and evaluated for malnutrition and its prevalence in South Asia. The results revealed malnutrition to be a major public health problem and a potential cause of high disease burden and mortality in South Asia. Compelling evidence suggests malnutrition to be the leading cause of stunting, wasting and underweight with drastic economic consequences among vulnerable populations. Reduced cognitive performance and low productivity have also been associated with micronutrients malnutrition. Suboptimal breastfeeding, inadequate food supply, micronutrient deficiencies, low household income, poor health care system, increased healthcare costs, illiteracy, unhygienic and substandard living, inappropriate child's care and the caregiver, food insecurity and on top of that vicious cycle of poverty, have been recognized as principal indicators for growing malnutrition prevalence in South Asia. Global organizations, local governments, program managers, NGOs, academia, industry in particular and the society at large need to take up the challenge to completely confiscate malnutrition from the region for economic prosperity and a healthier future.