Population attributable fraction estimates for factors associated with different types of anaemia among women in Ethiopia: multilevel multinomial analysis

Objective: This study aimed to identify factors for different levels of anaemia among Ethiopian women and to estimate the population attributable fraction (PAF). Design: This study was a detailed analysis of data of the 2016 Ethiopian Demographic and Health Survey data. Adjusted OR (AOR) with 95 % CI was computed using multilevel multinomial regression models, and the PAF were estimated using these AOR. Setting: This study was conducted in Ethiopia. Participants: Women of reproductive age. Results: The PAF showed that the proportion of mild anaemia cases attributable to having no formal education was 14 center dot 6 % (95 % CI 3 center dot 4, 24 center dot 5), high gravidity (>= 4) was 11 center dot 2 % (95 % CI 1 center dot 2, 19 center dot 9) and currently breast-feeding was 5 center dot 2 % (95 % CI 0 center dot 0, 10 center dot 7). Similarly, the proportion of moderate-severe anaemia cases attributable to being in a rural residence was 38 center dot 1 % (95 % CI 15 center dot 9, 54 center dot 8); poorest wealth quantile, 12 center dot 6 % (95 % CI 2 center dot 9, 24 center dot 6); giving birth in the last 5 years, 10 center dot 5 % (95 % CI 2 center dot 9, 18 center dot 2) and unimproved latrine facilities, 17 % (95 % CI 0, 32 center dot 5). Conclusions: The PAF suggest that rural residency, low education, low wealth status, high parity, pregnancy and breast-feeding contribute substantially to the occurrence of anaemia among women in Ethiopia. Mild anaemia could be reduced by setting intervention strategies targeting women with low education, multigravida women and breast-feeding women, while preventing moderate-severe anaemia may require increasing income and improving living environments through the accessibility of hygienic latrines.