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Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries
  1. Samson Gebremedhin,
  2. Anteneh Asefa
  1. School of Public Health, Hawassa University, Hawassa, Ethiopia
  1. Correspondence to Dr Samson Gebremedhin, School of Public Health, Hawassa University, Awasa, Ethiopia; samsongmgs{at}


Background Little is known whether contraceptive methods differentially modify women’s risk of anaemia or not. We compared the haemoglobin status of women currently using different fertility regulation methods in sub-Saharan Africa (SSA) where anaemia is a major concern.

Methods We conducted the study based on the secondary data of 24 nationally representative demographic and health surveys carried out recently in SSA. The data of 105 532 women were included in the analysis. In the original surveys, respondents were selected using multistage sampling techniques and haemoglobin was determined using the HemoCue analyser. The association between method of contraception and anaemia status was determined via a mixed-effects logistic regression model adjusted for potential confounders. The outputs are presented using adjusted odds ratio (AOR) with 95% CI.

Results The mean (±SD deviation) haemoglobin was 12.3 (±1.7) g/dl and 36.7% of the women had anaemia. Current use of modern contraceptives, as compared with non-use, was associated with a 25% reduction (AOR=0.75 (95% CI: 0.73 to 0.78)) in the odds of anaemia. Comparison among individual modern methods showed, as compared with current barrier methods users, use of injectables (AOR=0.62 (95% CI: 0.57 to 0.67)), oral contraceptive pills (OCP) (AOR=0.62 (95% CI: 0.57 to 0.66)) and implants (AOR=0.63 (95% CI: 0.58 to 0.70)) were significantly associated with reduced odds of anaemia. With reference to women with less than 12 months of use, the odds were significantly reduced by about a quarter among women with more than 12 months of OCP or injectables use.

Conclusion The use of hormonal contraceptives is associated with lower odds of anaemia.

  • anemia
  • contraceptives
  • Sub-saharan Africa
  • demographic and health survey
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  • Contributors Both of the authors were equally involved in the conception, development and analysis of the study, and the writing of the manuscript. Both authors read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval In all of the original surveys, ethical clearances were obtained from the institutional review boards (IRB) of ORC Macro and national level IRBs of all host countries.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The DHS data of each country is freely available from the DHS Program webpage (

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