The urban–rural differential in the association between household wealth index and anemia among women in reproductive age in Ethiopia, 2016

Background: Anemia is more prevalent among women, and it is a moderate public health problem in Ethiopia. The wealth status and place of residence of a woman have implications on the intervention of anemia. Studies that examined the relationship between women’s wealth index status and residency in Ethiopia are scarce. We aimed to identify the urban–rural differential in the association between household wealth index and anemia among women of childbearing age in Ethiopia. Method: A cross-sectional design was employed with a nationally representative sample of 14,100 women aged 15–49-year-old from the Ethiopian demographic and health survey conducted in 2016. We used the two-stage sampling method to select the sample size. The primary outcome was anemia in women of childbearing age. A hemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was the indicator of anemia. Using a three-level random intercept model to explore associated factors at the individual and household levels quantified the observed and unobserved variations between household wealth index and residence on anemia. Results: Women belonging to a lower household wealth index category were more anemic (29.6%) than those middle and above wealth index categories. Women who lived in rural areas (25.5%) were prone to anemia than those who lived in urban areas (17.5%). The odds of anemia were significantly higher in women of the low household wealth category who living in rural compared to women of the middle and above household wealth category who living in urban (AOR = 1.37, 95% CI 1.14–1.65, P < 0.001). Conclusion: In this study, anemia is more common among women who live in rural with the low house wealth category. Therefore, novel public health interventions should target women who live in rural areas with the lowest household wealth status.