A multilevel approach to correlates of anaemia in women in the Democratic Republic of Congo: findings from a nationally representative survey.

BACKGROUND/

objectivesAnaemia accounts for a significant proportion of pre- and post-partum morbidity and mortality in low-income countries with sequelae, including an increased risk of infection. Factors contributing to anaemia need to be addressed through the introduction of evidence-based measures to control and prevent the disease. We aimed to determine the prevalence of anaemia in women of child-bearing age in the Democratic Republic of Congo (DRC) and investigate the associated individual, household and community level factors. SUBJECTS/

methodsCross sectional representative population data from the 2013-2014 DRC Demographic and Health Survey (DHS) was used. The primary outcome was anaemia in women, stratified according to pregnancy in those of child-bearing age. A haemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was used as the indicator of anaemia. Using a three-level random intercept model this study explored risk factors at individual, household and community levels and quantified the observed and unobserved variations between households and communities.

resultsThirty-eight percent of women in the DRC are anaemic. Anaemia is significantly higher in younger, pregnant and underweight women, as well as those with comorbidities, including HIV and malaria who are living in the capital city Kinshasa. Anaemia varies within and between households and communities in the DRC.

conclusionsIntegrated approaches to reduce anaemia in settings with high malaria and HIV prevalence such as the DRC should target households.