An abstract is provided to the study below. After reading the abstract, identify the level of evidence using the Evidence Hierarchy.
Abstract:
Background: Anemia is one of the world's public health problem, especially in developing nations. The majority of women of childbearing age
(15-49) are affected by anemia. Women's role in the decision-making process is significant for their health and related issues such as anemia. So
far, there is no evidence of women's decision- making autonomy on anemia. Consequently, this study aimed to robustly examine both individual-
and group-level women's decision-making autonomy and other determinants of anemia among married women in Ethiopia.
Methods: We examined data from an Ethiopian demographic and health survey conducted in 2016. Our analysis included 9220 married women of
childbearing age (15-49 years). For bivariate analysis, we applied the chi-squared (X2) test. The relationship between individual and group-level
women's decision-making autonomy and anemia was assessed using multilevel binary logistic regression models while adjusting other socio-
demographic and economic characteristics.
Results: In this study the magnitude of anemia was 30.5% (95% CI; 29.5-31.4). According to our multilevel analysis, group-level women's
autonomy was found to be negatively related with anemia than individual-level women's autonomy (AOR =0.53, 95% CI =0.41-0.69). In addition,
the indicator of women's wealth index at group level was a protective factor (AOR=0.68, 95% CI =0.51-0.90) to develop anemia. Among
individual-level indicators women's age (AOR=0.73, 95% CI =0.60-0.89), use of contraceptive (AOR=0.66, 95% CI =0.55-0.81), BMI (AOR
=0.71, 95% CI =0.59-0.86) and employment status (AOR=0.88, 95% CI =0.79-0.98) were negatively related with anemia. While women who
follow Muslim religion (AOR=1.62, 95% CI =1.32- 1.97,), women who had five and above number of children (AOR=93, 95% CI =1.53-2.46),
and who were pregnant (AOR=1.21, 95% CI =1.04-1.40) were positively associated with anemia. Our final model showed that around 27% of the
variability of having anemia was because of group-level differences (ICC=0.27, P <0.001). In addition, both individual and group-level factors
account for 56.4% of the variance in the in the severity of anemia across communities (PCV=56.4%).
Conclusions: Our study showed that empowering women within households is not only an important mechanism to reduce anemia among
married women but also serves as a way to improve the lives of other women within the society.
A
