Severity and Determinants of Anemia Among Adolescent Girls in Africa: A Multicountry and Multilevel Analysis of 25 Countries.
4 affiliations
- 1Department of Statistics Addis Ababa University Addis Ababa Ethiopia aau.edu.et.
- 2Department of Data Science Debre Berhan University Debre Berhan Ethiopia dbu.edu.et.
- 3Department of Human Nutrition Bahir Dar University P.O. Box 79 Bahir Dar Ethiopia bdu.edu.et.
- 4Bahir Dar Food and Nutrition Research Center Bahir Dar University P.O. Box 79 Bahir Dar Ethiopia bdu.edu.et.
Abstract
Background
Anemia remains a major public health concern in Africa, with substantial health and developmental consequences. Adolescents, particularly girls, are at increased risk due to rapid growth, menstruation, and inadequate dietary intake. Identifying the severity and determinants of anemia among adolescent girls in Africa is crucial for developing appropriate interventions, yet evidence remains scarce.Objective
To assess the severity and determinants of anemia among adolescent girls in Africa using nationally representative data.Methods
Data were obtained from the most recent Demographic and Health Surveys (DHS) of 25 African countries, including 41,662 adolescent girls aged 15-19 years. The severity of anemia was determined using descriptive statistics based on proportions. Anemia severity was modeled as a four-level ordinal outcome (none, mild, moderate, and severe) using survey-weighted multilevel ordinal (proportional-odds) logistic regression with a random intercept at the cluster level. Chi-square tests assessed initial associations, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported from the final model.Results
The overall magnitude of anemia among adolescent girls was 42.3% (95% CI: 41.96-44.20). In the multivariable analysis, factors significantly associated with lower odds of anemia included primary education (AOR = 0.84; 95% CI: 0.75-0.94), secondary and above education (AOR = 0.86; 95% CI: 0.75-0.98), rich and richer wealth status (AOR = 0.77; 95% CI: 0.65-0.91), employment (0.86; 95% CI: 0.78-0.94), hormonal contraceptive use (AOR = 0.44; 95% CI: 0.38-0.51), parity (0.85; 95% CI: 0.76-0.95), and normal and overweight/obese nutritional status (AOR = 0.84; 95% CI:0.73-0.97 and AOR = 0.75; 95% CI: 0.62-0.91), respectively.Conclusion
Anemia affects a substantial proportion of adolescent girls in Africa and is influenced by educational, economic, reproductive, and nutritional factors. Interventions should focus on keeping girls in school, encouraging employment opportunities, and maintaining healthy bodyweight. Addressing these determinants is vital for improving adolescent girls' health and achieving sustainable development goals.
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BibTeX
@article{ejigu2026severity,
title = {{Severity and Determinants of Anemia Among Adolescent Girls in Africa: A Multicountry and Multilevel Analysis of 25 Countries.}},
author = {Bedilu Alamirie Ejigu and Getnet Bogale Begashaw and Fentanesh Nibret Tiruneh},
journal = {Anemia},
year = {2026},
month = oct,
doi = {10.1155/anem/1066665},
url = {https://europepmc.org/article/MED/42898564},
note = {CC BY},
}
RIS
TY - JOUR
TI - Severity and Determinants of Anemia Among Adolescent Girls in Africa: A Multicountry and Multilevel Analysis of 25 Countries.
AU - Bedilu Alamirie Ejigu
AU - Getnet Bogale Begashaw
AU - Fentanesh Nibret Tiruneh
PY - 2026
DA - 2026/10/18
JO - Anemia
DO - 10.1155/anem/1066665
UR - https://europepmc.org/article/MED/42898564
AB - Background Anemia remains a major public health concern in Africa, with substantial health and developmental consequences. Adolescents, particularly girls, are at increased risk due to rapid growth, menstruation, and inadequate dietary intake. Identifying the severity and determinants of anemia among adolescent girls in Africa is crucial for developing appropriate interventions, yet evidence remains scarce.Objective To assess the severity and determinants of anemia among adolescent girls in Africa using nationally representative data.Methods Data were obtained from the most recent Demographic and Health Surveys (DHS) of 25 African countries, including 41,662 adolescent girls aged 15-19 years. The severity of anemia was determined using descriptive statistics based on proportions. Anemia severity was modeled as a four-level ordinal outcome (none, mild, moderate, and severe) using survey-weighted multilevel ordinal (proportional-odds) logistic regression with a random intercept at the cluster level. Chi-square tests assessed initial associations, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported from the final model.Results The overall magnitude of anemia among adolescent girls was 42.3% (95% CI: 41.96-44.20). In the multivariable analysis, factors significantly associated with lower odds of anemia included primary education (AOR = 0.84; 95% CI: 0.75-0.94), secondary and above education (AOR = 0.86; 95% CI: 0.75-0.98), rich and richer wealth status (AOR = 0.77; 95% CI: 0.65-0.91), employment (0.86; 95% CI: 0.78-0.94), hormonal contraceptive use (AOR = 0.44; 95% CI: 0.38-0.51), parity (0.85; 95% CI: 0.76-0.95), and normal and overweight/obese nutritional status (AOR = 0.84; 95% CI:0.73-0.97 and AOR = 0.75; 95% CI: 0.62-0.91), respectively.Conclusion Anemia affects a substantial proportion of adolescent girls in Africa and is influenced by educational, economic, reproductive, and nutritional factors. Interventions should focus on keeping girls in school, encouraging employment opportunities, and maintaining healthy bodyweight. Addressing these determinants is vital for improving adolescent girls' health and achieving sustainable development goals.
SN - 2090-1267
SN - 2090-1275
ER -