PDF(Pubmed)
Abstract：
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.
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.
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%).
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.
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.
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%).
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.
摘要：
贫血是世界范围内的公共卫生问题之一,尤其是在发展中国家。大多数育龄妇女（15-49岁）受到贫血的影响。妇女在决策过程中的作用对她们的健康和贫血等相关问题具有重要意义。到目前为止,没有证据表明女性对贫血的自主决策。因此,本研究旨在对埃塞俄比亚已婚女性中个体和群体层面女性的决策自主性和贫血的其他决定因素进行有力检验。
我们检查了2016年埃塞俄比亚人口和健康调查的数据。我们的分析包括9220名育龄妇女（15-49岁）。对于双变量分析，我们应用卡方(X2)检验。在调整其他社会人口统计学和经济特征的同时，使用多水平二元逻辑回归模型评估了个体和群体水平女性的决策自主性与贫血之间的关系。
在这项研究中，贫血的程度为30.5%（95%CI;29.5-31.4）。根据我们的多层次分析，发现团体水平的女性自主性与贫血负相关，而个体水平的女性自主性负相关（AOR=0.53，95％CI=0.41-0.69）。此外,女性财富指数在群体水平是贫血的保护因素(AOR=0.68,95%CI=0.51-0.90).在个体水平指标中，女性的年龄(AOR=0.73，95%CI=0.60-0.89)，使用避孕药具（AOR=0.66，95%CI=0.55-0.81），BMI(AOR=0.71,95%CI=0.59-0.86)和就业状况(AOR=0.88,95%CI=0.79-0.98)与贫血呈负相干。而信奉穆斯林宗教的女性（AOR=1.62，95%CI=1.32-1.97），有5个以上子女的妇女（AOR=93，95%CI=1.53-2.46），妊娠者(AOR=1.21,95%CI=1.04～1.40)与贫血呈正相关。我们的最终模型显示，约27%的贫血变异性是由于组水平差异（ICC=0.27，P<0.001）。此外,个体因素和群体因素均占各社区贫血严重程度差异的56.4%(PCV=56.4%).
我们的研究表明，在家庭中赋予妇女权力不仅是减少已婚妇女贫血的重要机制，而且还可以改善社会中其他妇女的生活。
我们检查了2016年埃塞俄比亚人口和健康调查的数据。我们的分析包括9220名育龄妇女（15-49岁）。对于双变量分析，我们应用卡方(X2)检验。在调整其他社会人口统计学和经济特征的同时，使用多水平二元逻辑回归模型评估了个体和群体水平女性的决策自主性与贫血之间的关系。
在这项研究中，贫血的程度为30.5%（95%CI;29.5-31.4）。根据我们的多层次分析，发现团体水平的女性自主性与贫血负相关，而个体水平的女性自主性负相关（AOR=0.53，95％CI=0.41-0.69）。此外,女性财富指数在群体水平是贫血的保护因素(AOR=0.68,95%CI=0.51-0.90).在个体水平指标中，女性的年龄(AOR=0.73，95%CI=0.60-0.89)，使用避孕药具（AOR=0.66，95%CI=0.55-0.81），BMI(AOR=0.71,95%CI=0.59-0.86)和就业状况(AOR=0.88,95%CI=0.79-0.98)与贫血呈负相干。而信奉穆斯林宗教的女性（AOR=1.62，95%CI=1.32-1.97），有5个以上子女的妇女（AOR=93，95%CI=1.53-2.46），妊娠者(AOR=1.21,95%CI=1.04～1.40)与贫血呈正相关。我们的最终模型显示，约27%的贫血变异性是由于组水平差异（ICC=0.27，P<0.001）。此外,个体因素和群体因素均占各社区贫血严重程度差异的56.4%(PCV=56.4%).
我们的研究表明，在家庭中赋予妇女权力不仅是减少已婚妇女贫血的重要机制，而且还可以改善社会中其他妇女的生活。
