Geographical disparities and determinants of anaemia among women of reproductive age in Myanmar: analysis of the 2015-2016 Myanmar Demographic and Health Survey.

Background: Anaemia is a significant public health challenge in Myanmar. In 2015-2016, the first demographic and health survey was done in Myanmar, and showed that almost half of all pregnant women had anaemia. To inform policy decisions, this secondary analysis of the Myanmar Demographic and Health Survey 2015-16 was done to determine the geographical disparities in prevalence of anaemia and related factors among women of reproductive age.

Methods: Analyses were based on weighted samples of 12 489 eligible women aged 15-49 years. Regions and states were clustered into four geographical zones: hilly, coastal, delta and central plain zones. Baseline characteristics were analysed by descriptive statistics. Odds ratios and 95% confidence intervals (CIs) were estimated using univariable and multivariate logistic regression.

Results: The prevalence of anaemia varied by geographical zone. Compared with women in the hilly zone, women of the coastal zone had adjusted odds of having anaemia of 1.7 (95% CI 1.43-2.05), while for those in the delta and central plain zones, the adjusted odds were 1.6 (95% CI 1.41-1.92 and 1.38-1.88, respectively). Other factors that significantly raised the adjusted odds of having anaemia were being married, pregnant, underweight/thin or aged ≥40 years, and parity of more than six children. By contrast, urban residence, educational status, employment status and wealth status were not significantly associated with anaemia.

Conclusion: Anaemia among women of reproductive age is a major public health problem in Myanmar, and those in the coastal region are the most vulnerable. Introducing provision of iron tablets for non-pregnant women, and improving the current low levels of provision to pregnant women, would be a simple and effective policy. As with other health outcomes, further analyses on disparities in anaemia among women of reproductive age at the state and regional level in Myanmar are warranted.