Multilevel analysis of anemia and associated factors among women of reproductive age (15–49 years) in Liberia: Evidence from the 2019/20 Liberia demographic and health survey data

Background: Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia. Methods: We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age. Results: The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97–46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20–24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25–29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30–34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35–39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40–44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45–49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia. Conclusion: In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.