Abstract:
Background: Anemia during pregnancy is a major public health problem with serious
consequences for both mothers and their newborns. Despite the availability of antenatal care
(ANC) services in Ethiopia, the burden of anemia remains high, and its determinants vary
across settings. However, evidence on factors contributing to anemia among pregnant women
in Gambella town is limited.
Objective: To identify the determinants of anemia among pregnant women attending antenatal
care at public health facilities in Gambella Town, 2025.
Methods: An institution-based unmatched case–control study was conducted from May to July
2025 among 250 pregnant women (125 cases and 125 controls) attending ANC at public health
facilities of Gambella Town. The cases were pregnant women with hemoglobin concentration
<11 g/dl, and controls were those with hemoglobin ≥11 g/dl. Data were collected using
interviewer-administered questionnaires and laboratory measurements. Data were entered
into Epi Info 7.2.2.6 and analyzed using SPSS version 27. Bivariate and multivariable logistic
regression analyses were performed, and Adjusted Odds Ratios (AOR) with 95% Confidence
Intervals (CI) were used to identify determinants of anemia. Statistical significance was
declared at p < 0.05.
Results: A total of 250 pregnant women participated with a 100% response rate. Key factors
associated with anemia among pregnant women included rural residence (AOR = 3.65, 3.65,
95% CI: 1.03–12.9), no formal education (AOR = AOR = 3.78 95% CI: (1.72,8.33), history of
blood loss during pregnancy (AOR =4.6 95% CI: 1.16,18.04), history of malaria (AOR =
4.0495% CI: 1.66–9.87), chronic disease (AOR = 5.82 95% CI: 1.81,18.74), and low (AOR =
7.10, 95% CI: 1.31–38.6) or medium (AOR = 2.52,95% CI: 1.17–5.41) dietary diversity.
Conclusion and recommendation: Anemia among pregnant women in Gambella town was
significantly associated with rural residence, illiteracy, history of blood loss, malaria infection,
chronic diseases, and poor dietary diversity. Strengthening health education, improving dietary
practices, preventing and treating malaria and chronic illnesses, and promoting maternal
education should be prioritized to reduce the burden of anemia in this population.
