Epidemiology of anaemia among children in Ethiopia: trends, inequalities, determinants, and implementation

This thesis investigated the burden, determinants, and inequality of childhood anaemia. The focus areas of this thesis were the trends and geospatial and wealth related inequalities and their contribution to iron deficiency anaemia, focussing on Ethiopia. The prevalence of anaemia remains alarmingly high in Ethiopia, affecting more than 1 out of 2 children. Infants, malnourished children, children of poor families, and children with maternal anaemia are disproportionately affected. This thesis reveals the geospatial inequality of anaemia; hotspots of anaemia are concentrated in the eastern marginalised pastoralist community of Ethiopia. For this pastoralist community, it was found that inadequate dietary iron intake and iron deficiency are highly prevalent (50% and 72% respectively). Most of the anaemic children (92.7%) were iron deficient. Furthermore, key barriers to effective implementation of nutrition interventions in Ethiopia were identified, such as lack of resources (e.g., anthropometric equipment), poor staff commitment and motivation, falsification of reports, non-functioning/closed health posts, lack of priority to nutrition services, and poor leadership engagement.