The Determinants of Coexisting Anemia and Undernutrition Among Pregnant Women in Southern Ethiopia: A Multi-Level Analysis
Bibliographic record
Abstract
Background/Objectives: Anemia and undernutrition are severe public health concerns in Ethiopia. These are the two most common nutritional disorders in pregnant women and frequently coexist. However, to our knowledge, there is little evidence of the coexistence of anemia and undernutrition among pregnant women. Therefore, this study aimed to examine the prevalence of coexisting anemia and undernutrition (CAU) and associated factors among pregnant women. Methods: A community-based cross-sectional study was conducted from 1 to 25 June 2024, on 515 pregnant women in the Hawela Lida district of Sidama, Ethiopia. We utilized a multi-stage sampling method to choose eligible study participants. A pre-tested and structured questionnaire was used to collect data via the online Open Data Kit mobile tool. We controlled the effect of confounders and clustering by using a multi-level mixed-effect modified Poisson regression analysis model. Results: The prevalence of CAU among pregnant women was 25.4% (95% CI: 21.9–28.9). The prevalence of CAU was associated with household food insecurity (adjusted prevalence ratio [APR]: 2.17; 95% CI: 1.43–3.28), training on model family (APR: 0.66; 95% CI: 0.45–0.96), inadequate dietary diversity (APR: 1.51; 95% CI: 1.18–1.95), and having poor knowledge of nutrition (APR: 1.55; 95% CI: 1.06–2.26) at individual levels. Low community-level women’s autonomy (APR: 6.19; 95% CI: 3.42–11.22) and community-level road accessibility (APR: 0.65; 95% CI: 0.43–0.98) were the identified determinants of CAU at the community level. Conclusions: One in four pregnant women had CAU in the study area. Household food insecurity, inadequate dietary diversity, and poor nutrition knowledge were associated with an increased likelihood of CAU, while participation in model family training and improved road accessibility were associated with reduced CAU. We have also indicated that low community-level women’s autonomy significantly increased the risk of CAU. Therefore, inter-sectorial collaboration should be required to comprehensively address CAU’s determinants at different levels. Additionally, any CAU prevention and intervention programs should provide model family training explicitly targeting women with poor nutritional knowledge and low autonomy in healthcare decision-making.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".