Abstract
BACKGROUND: Despite extensive global and national efforts to reduce anaemia, it remains a major public health concern among Women of Reproductive Age (WRA). However, community-based studies that compare the prevalence and risk factors of anaemia using nationally representative samples are limited in Ghana. This study examines and compares anaemia prevalence and associated risk factors between nonpregnant and pregnant WRA in Ghana. METHODS: This study utilized cross-sectional data from the 2022 Ghana Demographic and Health Survey (GDHS). A total of 15,014 WRA were recruited, of whom 7,557 were screened for anaemia including 7004 nonpregnant and 553 pregnant women. Anaemia was defined as haemoglobin levels below 12 g/dL for nonpregnant and below 11 g/dL for pregnant women. Pearson chi-square and Fisher's exact tests were used to compare anaemia prevalence across groups. Poisson regressions were applied to identify risk factors for anaemia. All analyses were conducted using Stata version SE.18. RESULTS: The prevalence of anaemia was 40.4% among nonpregnant women and 51.4% among pregnant women. Aside from self-reported health status and toilet facilities being significant determinants for nonpregnant women, common factors affecting both groups included parity, BMI, wealth status, and geographic zone. Multiparous women had a higher risk of anaemia, with nonpregnant and pregnant women experiencing 23% and 43% increased risk, respectively. Underweight nonpregnant women had an 11% higher risk, while overweight pregnant women had a 34% lower risk of anaemia. In terms of wealth, women in the poorest quintile had a significantly higher risk of anaemia 36% among nonpregnant women (APR: 1.36, 95% CI 1.01-1.83, p = 0.049) and 32% among pregnant women (APR: 1.32, 95% CI 1.01-1.76, p = 0.049). Additionally, women residing in the northern zone had a higher anaemia risk compared to those in the southern zone. Among nonpregnant women, those reporting poor health status had a 51% increased risk of anaemia, while those with improved toilet facilities had a 10% lower risk (APR: 0.90, 95% CI 0.83-0.96, p = 0.004). CONCLUSIONS: The prevalence of anaemia, particularly among pregnant women, remains high in Ghana and constitutes a significant public health threat. Addressing this issue requires holistic and tailored public health strategies that improve access to healthcare, nutrition, sanitation, and economic equity.