Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries.

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. © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.