{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:19:09Z","timestamp":1778869149244,"version":"3.51.4"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97\u201346.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20\u201324 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25\u201329 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30\u201334 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35\u201339 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40\u201344 years (AOR = 0.61, 95% CI: 0.43,0.87), 45\u201349 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0296747","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T17:45:38Z","timestamp":1714067138000},"page":"e0296747","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multilevel analysis of anemia and associated factors among women of reproductive age (15\u201349 years) in Liberia: Evidence from the 2019\/20 Liberia demographic and health survey data"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3670-4953","authenticated-orcid":true,"given":"Dagnew Getnet","family":"Adugna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misganaw Asmamaw","family":"Mengstie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fitalew Tadele","family":"Admasu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maritu Gebnie","family":"Teshome","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailu","family":"Aragie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadesse Asmamaw","family":"Dejenie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"pone.0296747.ref001","article-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"W.H. Organization","year":"2011","journal-title":"Vitamin and Mineral Nutrition Information System. Document Reference WHO"},{"key":"pone.0296747.ref002","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00277-010-1144-5","article-title":"Anemia\u2014still a major health problem in many parts of the world!","volume":"90","author":"N. Milman","year":"2011","journal-title":"Annals of hematology"},{"issue":"1","key":"pone.0296747.ref003","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1016\/S2214-109X(13)70001-9","article-title":"Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995\u20132011: a systematic analysis of population-representative data","volume":"1","author":"G.A. Stevens","year":"2013","journal-title":"The Lancet Global Health"},{"key":"pone.0296747.ref004","first-page":"47","article-title":"Iron deficiency anemia. assessment, prevention, and control.","author":"W.H. Organization","year":"2001","journal-title":"A guide for programme managers"},{"issue":"9","key":"pone.0296747.ref005","doi-asserted-by":"crossref","first-page":"e0238957","DOI":"10.1371\/journal.pone.0238957","article-title":"Anemia and its associated factors among women of reproductive age in eastern Africa: A multilevel mixed-effects generalized linear model.","volume":"15","author":"A.B. Teshale","year":"2020","journal-title":"Plos one"},{"issue":"1","key":"pone.0296747.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13690-021-00733-x","article-title":"Prevalence of anemia and its associated factors among married women in 19 sub-Saharan African countries.","volume":"79","author":"B. Zegeye","year":"2021","journal-title":"Archives of Public Health"},{"issue":"1","key":"pone.0296747.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-52798-y","article-title":"Prevalence of and factors related to anemia among Japanese adult women: Secondary data analysis using health check-up database","volume":"9","author":"K. Hisa","year":"2019","journal-title":"Scientific reports"},{"issue":"2","key":"pone.0296747.ref008","doi-asserted-by":"crossref","first-page":"676S","DOI":"10.1093\/jn\/131.2.676S","article-title":"Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship","volume":"131","author":"J.D. Haas","year":"2001","journal-title":"The Journal of nutrition"},{"issue":"1","key":"pone.0296747.ref009","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0306-9192(02)00070-2","article-title":"The economics of iron deficiency","volume":"28","author":"S. Horton","year":"2003","journal-title":"Food policy"},{"issue":"3","key":"pone.0296747.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4172\/2161-038X.1000187","article-title":"Iron deficiency anemia among women of reproductive age, an important public health problem: situation analysis.","volume":"5","author":"M. Mawani","year":"2016","journal-title":"Reproductive System & Sexual Disorders: Current Research"},{"key":"pone.0296747.ref011","volume-title":"Global nutrition targets 2025: breastfeeding policy brief (WHO\/NMH\/NHD14. 7)","author":"WHO, U.","year":"2014"},{"key":"pone.0296747.ref012","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/808204","article-title":"Effect of maternal iron deficiency anemia on the iron store of newborns in Ethiopia.","volume":"2015","author":"B. Terefe","year":"2015","journal-title":"Anemia"},{"issue":"2","key":"pone.0296747.ref013","first-page":"193","article-title":"Maternal anemia in various trimesters and its effect on newborn weight and maturity: an observational study.","volume":"4","author":"K.J. Kumar","year":"2013","journal-title":"International journal of preventive medicine"},{"issue":"1","key":"pone.0296747.ref014","first-page":"15","article-title":"Anemia epidemiology, patho physiology and etiology in lowand middle-income countries","volume":"1450","author":"C. Chaparvo","year":"2019","journal-title":"Ann: NY A cad. Sci"},{"issue":"11","key":"pone.0296747.ref015","doi-asserted-by":"crossref","first-page":"693","DOI":"10.3390\/nu8110693","article-title":"The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: a systematic analysis of national surveys","volume":"8","author":"N. Petry","year":"2016","journal-title":"Nutrients"},{"issue":"suppl_1","key":"pone.0296747.ref016","doi-asserted-by":"crossref","first-page":"416S","DOI":"10.3945\/ajcn.116.143073","article-title":"Predictors of anemia in women of reproductive age: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project.","volume":"106","author":"J.P. Wirth","year":"2017","journal-title":"The American journal of clinical nutrition"},{"issue":"4","key":"pone.0296747.ref017","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1017\/S1368980008002401","article-title":"Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993\u20132005.","volume":"12","author":"E. McLean","year":"2009","journal-title":"Public health nutrition"},{"key":"pone.0296747.ref018","article-title":"Anemia and associated factors in women at reproductive age in a Brazilian Northeastern municipality","volume":"21","author":"A.G.N. Bezerra","year":"2018","journal-title":"Revista Brasileira de Epidemiologia"},{"issue":"5","key":"pone.0296747.ref019","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1038\/s41430-019-0524-8","article-title":"A multilevel approach to correlates of anaemia in women in the Democratic Republic of Congo: findings from a nationally representative survey","volume":"74","author":"N.I. Kandala","year":"2020","journal-title":"European Journal of Clinical Nutrition"},{"issue":"1","key":"pone.0296747.ref020","doi-asserted-by":"crossref","DOI":"10.2174\/1874944501811010425","article-title":"Spatial distribution and analysis of risk factors associated with Anemia among women of reproductive age: case of 2014 Rwanda demographic and health survey data","volume":"11","author":"F. Habyarimana","year":"2018","journal-title":"The Open Public Health Journal"},{"issue":"4","key":"pone.0296747.ref021","doi-asserted-by":"crossref","first-page":"e027276","DOI":"10.1136\/bmjopen-2018-027276","article-title":"Spatial distribution and determinant factors of anaemia among women of reproductive age in Ethiopia: a multilevel and spatial analysis","volume":"9","author":"K.T. Kibret","year":"2019","journal-title":"BMJ open"},{"key":"pone.0296747.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-08934-9","article-title":"Individual and community level factors associated with anemia among lactating mothers in Ethiopia using data from Ethiopian demographic and health survey, 2016; a multilevel analysis","volume":"20","author":"A.M. Liyew","year":"2020","journal-title":"BMC Public Health"},{"issue":"4","key":"pone.0296747.ref023","doi-asserted-by":"crossref","first-page":"e006001","DOI":"10.1136\/bmjopen-2014-006001","article-title":"Anaemia prevalence and associated factors among lactating mothers in Ethiopia: evidence from the 2005 and 2011 demographic and health surveys","volume":"5","author":"Y. Lakew","year":"2015","journal-title":"BMJ open"},{"issue":"1","key":"pone.0296747.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-019-8019-z","article-title":"Identifying risk factors of anemia among women of reproductive age in Rwanda\u2013a cross-sectional study using secondary data from the Rwanda demographic and health survey 2014\/2015.","volume":"19","author":"D. Hakizimana","year":"2019","journal-title":"BMC public health"},{"issue":"6","key":"pone.0296747.ref025","doi-asserted-by":"crossref","first-page":"e0218288","DOI":"10.1371\/journal.pone.0218288","article-title":"Determining factors for the prevalence of anemia in women of reproductive age in Nepal: Evidence from recent national survey data","volume":"14","author":"S. Gautam","year":"2019","journal-title":"PloS one"},{"issue":"2","key":"pone.0296747.ref026","doi-asserted-by":"crossref","first-page":"107","DOI":"10.4103\/2224-3151.239422","article-title":"Geographical disparities and determinants of anaemia among women of reproductive age in Myanmar: analysis of the 2015\u20132016 Myanmar Demographic and Health Survey.","volume":"7","author":"H.H. Win","year":"2018","journal-title":"WHO South-East Asia journal of public health"},{"key":"pone.0296747.ref027","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/649815","article-title":"Reproductive and obstetric factors are key predictors of maternal anemia during pregnancy in Ethiopia: Evidence from demographic and health survey (2011).","volume":"2015","author":"T. Alemu","year":"2015","journal-title":"Anemia"},{"issue":"1","key":"pone.0296747.ref028","first-page":"66","article-title":"Anaemia in pregnancy: associations with parity, abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago.","volume":"10","author":"E. Uche-Nwachi","year":"2010","journal-title":"African health sciences"},{"issue":"3","key":"pone.0296747.ref029","first-page":"139","article-title":"Prevalence of anemia and correlated factors in the reproductive age women in rural areas of tabas","volume":"7","author":"M. Sadeghian","year":"2013","journal-title":"Journal of family & reproductive health"},{"issue":"2","key":"pone.0296747.ref030","first-page":"165","article-title":"Magnitude of anemia and associated risk factors among pregnant women attending antenatal care in Shalla Woreda, West Arsi Zone, Oromia Region","volume":"23","author":"N. Obse","year":"2013","journal-title":"Ethiopia. Ethiopian journal of health sciences"},{"key":"pone.0296747.ref031","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/1073192","article-title":"Prevalence of anemia and its associated factors among pregnant women attending antenatal care in health institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia: a cross-sectional study.","volume":"2016","author":"A. Bekele","year":"2016","journal-title":"Anemia"},{"issue":"1","key":"pone.0296747.ref032","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1136\/bmjsrh-2018-200178","article-title":"Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries.","volume":"45","author":"S. Gebremedhin","year":"2019","journal-title":"BMJ sexual & reproductive health"},{"issue":"1","key":"pone.0296747.ref033","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-019-8114-1","article-title":"Determinants of Anemia among women in Uganda: further analysis of the Uganda demographic and health surveys.","volume":"19","author":"O. Nankinga","year":"2019","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0296747.ref034","article-title":"Gender differences in household headship and level of awareness on anaemia among Ethiopian women: Evidences from a nationwide cross-sectional survey","volume":"32","author":"J.H. Ali","year":"2018","journal-title":"Ethiopian Journal of Health Development"},{"issue":"2","key":"pone.0296747.ref035","first-page":"27","article-title":"Food security as determinant of anemia at household level","volume":"1","author":"R. Nisar","year":"2013","journal-title":"Nepal. Journal of Food Security"},{"issue":"2","key":"pone.0296747.ref036","first-page":"1","article-title":"Determinants of anaemia among pregnant women in rural Uganda.","volume":"13","author":"M.A. Mbule","year":"2013","journal-title":"Rural and remote health"},{"issue":"1","key":"pone.0296747.ref037","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12963-017-0128-2","article-title":"Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences","volume":"15","author":"A.L. Adamu","year":"2017","journal-title":"Population health metrics"},{"key":"pone.0296747.ref038","unstructured":"De Benoist, B., et al., Worldwide prevalence of anaemia 1993\u20132005; WHO Global Database of anaemia. 2008."},{"key":"pone.0296747.ref039","author":"S.A. Ali","year":"2020","journal-title":"Prevalence and determinants of anemia among women of reproductive age in developing countries"},{"issue":"1","key":"pone.0296747.ref040","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4314\/ejhd.v25i1.69842","article-title":"Correlates of anemia among women of reproductive age in Ethiopia: evidence from Ethiopian DHS 2005","volume":"25","author":"S. Gebremedhin","year":"2011","journal-title":"Ethiopian Journal of Health Development"},{"issue":"8","key":"pone.0296747.ref041","doi-asserted-by":"crossref","first-page":"e0236449","DOI":"10.1371\/journal.pone.0236449","article-title":"Prevalence and factors associated with anemia among women of reproductive age in seven South and Southeast Asian countries: Evidence from nationally representative surveys.","volume":"15","author":"D.R. Sunuwar","year":"2020","journal-title":"PloS one"},{"key":"pone.0296747.ref042","article-title":"Burden and determinants of anemia in a rural population in south India: A Cross-Sectional Study","author":"M. Little","year":"2018","journal-title":"Anemia"},{"issue":"2","key":"pone.0296747.ref043","article-title":"Anaemia in pregnant, postpartum and non pregnant women in Lak district, Daklak province of Vietnam.","volume":"16","author":"L.T.T. Trinh","year":"2007","journal-title":"Asia Pacific journal of clinical nutrition"},{"key":"pone.0296747.ref044","article-title":"Prevalence of anemia and its associate factors among women of reproductive age in Lao PDR: evidence from a nationally representative survey.","author":"S. Keokenchanh","year":"2021","journal-title":"Anemia"},{"key":"pone.0296747.ref045","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/636585","article-title":"Prevalence of anemia and associated factors in child bearing age women in Riyadh, Saudi Arabia","volume":"2013","author":"A.M. AlQuaiz","year":"2013","journal-title":"Journal of nutrition and metabolism"},{"issue":"1","key":"pone.0296747.ref046","first-page":"1","article-title":"Anemia in relation to body mass index and waist circumference among Chinese women","volume":"12","author":"Y. Qin","year":"2013","journal-title":"Nutrition journal"},{"key":"pone.0296747.ref047","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2045-4015-2-50","article-title":"Health policies and the relationships between socioeconomic status, access to health care, and health","volume":"2","author":"B.H. Apouey","year":"2013","journal-title":"Israel journal of health policy research"},{"issue":"12","key":"pone.0296747.ref048","doi-asserted-by":"crossref","first-page":"e018007","DOI":"10.1136\/bmjopen-2017-018007","article-title":"Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data","volume":"7","author":"S. Soofi","year":"2017","journal-title":"BMJ open"},{"issue":"3","key":"pone.0296747.ref049","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/2150131917697439","article-title":"How socioeconomic status affects patient perceptions of health care: a qualitative study","volume":"8","author":"N.C. Arpey","year":"2017","journal-title":"Journal of primary care & community health"},{"issue":"4","key":"pone.0296747.ref050","first-page":"653","article-title":"Continuous combination oral contraceptive pills to eliminate withdrawal bleeding: a randomized trial.","volume":"101","author":"L. Miller","year":"2003","journal-title":"Obstetrics & Gynecology"},{"issue":"1","key":"pone.0296747.ref051","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0010-7824(02)00474-2","article-title":"Amenorrhea associated with contraception\u2014an international study on acceptability.","volume":"67","author":"A.F. Glasier","year":"2003","journal-title":"Contraception"},{"issue":"1","key":"pone.0296747.ref052","first-page":"50","article-title":"Association between oral contraceptive use and markers of iron deficiency in a cross-sectional study of Tanzanian women. International Journal of Gynecology &","volume":"132","author":"Z.T. Haile","year":"2016","journal-title":"Obstetrics"},{"key":"pone.0296747.ref053","volume-title":"Iron deficiency anemia in pregnancy. in Seminars in hematology","author":"C. Breymann","year":"2015"},{"issue":"05","key":"pone.0296747.ref054","doi-asserted-by":"crossref","first-page":"968","DOI":"10.29309\/TPMJ\/2020.27.05.3959","article-title":"Anemia and its association with parity","volume":"27","author":"T. Shah","year":"2020","journal-title":"The Professional Medical Journal"},{"key":"pone.0296747.ref055","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-2393-11-7","article-title":"Effect of high parity on occurrence of anemia in pregnancy: a cohort study.","volume":"11","author":"Y.M. Al-Farsi","year":"2011","journal-title":"BMC Pregnancy Childbirth"},{"issue":"12","key":"pone.0296747.ref056","doi-asserted-by":"crossref","first-page":"e0188783","DOI":"10.1371\/journal.pone.0188783","article-title":"Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study","volume":"12","author":"M. Lebso","year":"2017","journal-title":"PloS one"},{"issue":"1","key":"pone.0296747.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2326-9-7","article-title":"Iron deficiency anemia is not a rare problem among women of reproductive ages in Ethiopia: a community based cross sectional study","volume":"9","author":"J.A. Haidar","year":"2009","journal-title":"BMC Hematology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T01:57:50Z","timestamp":1731808670000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296747"}},"subtitle":[],"editor":[{"given":"Zacharie","family":"Tsala Dimbuene","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,25]]},"references-count":57,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0296747","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,25]]}}}