Multilevel Analysis of the Effects of Individual- and Community-Level Factors on Childhood Anemia, Severe Anemia, and Hemoglobin Concentration in Malawi

Background: The purpose of this article was to examine individual- and community-level factors associated with childhood anemia, severe anemia, and hemoglobin (Hb) concentration in Malawi. Methods: Using data from the 2010 Malawi demographic and health survey (MDHS), the multi-level regression models were constructed to analyze 2597 children aged 6-59 months living in 849 communities. Results: The results showed that both childhood anemia and severe anemia were negatively associated with child's age, no fever in the previous 2 weeks and height-for-age, and positively associated with residing in poor household. Childhood anemia was negatively associated with community female education. Child's age, no fever in the previous 2 weeks and maternal Hb levels were positively associated with child Hb concentration, while residing in poorest households was negatively associated with children's Hb concentration. Conclusion: Comprehensive public health strategies aimed at reducing childhood anemia need to focus more on the significant characteristics addressed in this study.