Abstract
BACKGROUND: Anaemia poses a significant barrier to a child’s growth and development, particularly in urban slums. Additionally, anaemia frequently co-exists with other forms of undernutrition, exacerbating health risks. The present analysis sought to determine the burden of anaemia, examine its co-existence with undernutrition, and identify its associated factors among children aged 9–36 months residing in the urban slums of Belagavi city. METHODS: This cross-sectional study analysed baseline data from a larger community-based study involving 137 mother-child pairs. Data on child, maternal, and household characteristics were gathered using a pre-structured questionnaire. Venous blood samples were analysed to determine haemoglobin levels, and anthropometric measurements were used to assess nutritional status. Descriptive statistics, univariate, and multivariable analyses were conducted to assess associations between potential risk factors, anaemia, and its co-existence with undernutrition. RESULTS: The prevalence of anaemia among children residing in urban slums was 62%. Co-existence of anaemia with stunting, wasting, and underweight was observed among 26.8%, 6.5%, and 17.4%of the children, respectively. Maternal height ≥ 150 cm was associated with higher odds of anaemia (AOR 2.70; 95% CI 1.04–7.01); given the small short-stature subgroup (n = 29), this estimate is imprecise and should be interpreted cautiously. Additionally, low birth weight and lower maternal education were associated with the co-existence of anaemia and undernutrition. CONCLUSIONS: A high burden of anaemia was reported among children living in urban slums of Belagavi. The frequent co-occurrence of anaemia with stunting is concerning and underscores the need for future research. An unexpected, imprecise association between maternal height ≥ 150 cm and anaemia warrant cautious interpretation and confirmation in larger studies. Normal birth weight and higher maternal education were protective against the co-existence of anaemia and undernutrition. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26404-6.