Spatial distribution and socioeconomic correlates of anaemia among women of reproductive age in Ghana: a hotspot analysis of the 2022 Demographic and Health Survey
- 1Department of Public Health, Faculty of Medical Sciences, Presbyterian University, Ghana.
Abstract
BackgroundAnaemia in women of reproductive age is a persistent contributor to maternal morbidity and adverse birth outcomes in sub-Saharan Africa. Ghanaian surveys have repeatedly placed national anaemia prevalence in the World Health Organizations severe public health problem range, yet the geographical distribution of this burden, and the socioeconomic factors that may account for it after geographical adjustment, remain insufficiently elucidated.
MethodsThis cross-sectional study analysed the womens and geospatial files of the 2022 Ghana Demographic and Health Survey. Anaemia was defined as altitude- and smoking-adjusted haemoglobin below World Health Organization thresholds among 7,557 women aged 15-49 years with a valid measurement. Survey-weighted multivariable logistic regression, accounting for clustering, stratification, and sampling weights, was used to elucidate socioeconomic and demographic correlates. Cluster-level prevalence was tested for spatial clustering with global Morans I and local Getis-Ord Gi* statistics (k-nearest neighbour weights, k = 8).
ResultsWeighted anaemia prevalence was estimated at 41.1% (mild: 22.6%, moderate: 17.3%, and severe: 1.1%). Pregnant women appeared to have higher adjusted odds of anaemia than non-pregnant women (adjusted odds ratio [AOR] 1.71, 95% CI 1.38-2.12), as did women in the Northern (AOR 1.54, 95% CI 1.16-2.06) and Savannah (AOR 1.35, 95% CI 1.04-1.76) regions relative to Greater Accra, while the Ahafo region showed lower odds (AOR 0.64, 95% CI 0.43-0.94). Associations with rural residence, education, and wealth that were significant in crude analysis appeared substantially attenuated after adjustment. Morans I suggested significant positive spatial autocorrelation (I = 0.156, p = 0.001); Getis-Ord Gi* identified 109 hotspot and 117 cold spot clusters among 618 clusters, with hotspots concentrated in the north and cold spots in the mid-southern forest belt.
ConclusionTwo in five women of reproductive age in Ghana were estimated to have been anaemic in 2022. Risk appeared to be shaped more by region and pregnancy status than by household wealth or education once geography was accounted for. Anaemia-control programming may benefit from prioritising the identified northern hotspot areas alongside routine antenatal supplementation.
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BibTeX
@misc{siddiq2026spatial,
title = {{Spatial distribution and socioeconomic correlates of anaemia among women of reproductive age in Ghana: a hotspot analysis of the 2022 Demographic and Health Survey}},
author = {A. I. Siddiq and T. Arthur-Gyimah and G. D.-G. Aitee and J. N. A. J. Oku and E. Vondee and G. O. Asumang},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.05.26364763},
url = {https://www.medrxiv.org/content/10.64898/2026.10.05.26364763v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Spatial distribution and socioeconomic correlates of anaemia among women of reproductive age in Ghana: a hotspot analysis of the 2022 Demographic and Health Survey
AU - A. I. Siddiq
AU - T. Arthur-Gyimah
AU - G. D.-G. Aitee
AU - J. N. A. J. Oku
AU - E. Vondee
AU - G. O. Asumang
PY - 2026
DA - 2026/10/05
PB - medRxiv
DO - 10.64898/2026.10.05.26364763
UR - https://www.medrxiv.org/content/10.64898/2026.10.05.26364763v1
AB - BackgroundAnaemia in women of reproductive age is a persistent contributor to maternal morbidity and adverse birth outcomes in sub-Saharan Africa. Ghanaian surveys have repeatedly placed national anaemia prevalence in the World Health Organizations severe public health problem range, yet the geographical distribution of this burden, and the socioeconomic factors that may account for it after geographical adjustment, remain insufficiently elucidated. MethodsThis cross-sectional study analysed the womens and geospatial files of the 2022 Ghana Demographic and Health Survey. Anaemia was defined as altitude- and smoking-adjusted haemoglobin below World Health Organization thresholds among 7,557 women aged 15-49 years with a valid measurement. Survey-weighted multivariable logistic regression, accounting for clustering, stratification, and sampling weights, was used to elucidate socioeconomic and demographic correlates. Cluster-level prevalence was tested for spatial clustering with global Morans I and local Getis-Ord Gi* statistics (k-nearest neighbour weights, k = 8). ResultsWeighted anaemia prevalence was estimated at 41.1% (mild: 22.6%, moderate: 17.3%, and severe: 1.1%). Pregnant women appeared to have higher adjusted odds of anaemia than non-pregnant women (adjusted odds ratio [AOR] 1.71, 95% CI 1.38-2.12), as did women in the Northern (AOR 1.54, 95% CI 1.16-2.06) and Savannah (AOR 1.35, 95% CI 1.04-1.76) regions relative to Greater Accra, while the Ahafo region showed lower odds (AOR 0.64, 95% CI 0.43-0.94). Associations with rural residence, education, and wealth that were significant in crude analysis appeared substantially attenuated after adjustment. Morans I suggested significant positive spatial autocorrelation (I = 0.156, p = 0.001); Getis-Ord Gi* identified 109 hotspot and 117 cold spot clusters among 618 clusters, with hotspots concentrated in the north and cold spots in the mid-southern forest belt. ConclusionTwo in five women of reproductive age in Ghana were estimated to have been anaemic in 2022. Risk appeared to be shaped more by region and pregnancy status than by household wealth or education once geography was accounted for. Anaemia-control programming may benefit from prioritising the identified northern hotspot areas alongside routine antenatal supplementation.
ER -