Variable

Characteristics

Frequency and percentage in DHS Periods

GDHS 2013
 Weighted frequency (%)

GDHS 2019
Weighted frequency (%)

Region 

Banjul

31  (1.4)

26 (1.1)

Kanifing

325 (14.4)

386 (16.1)

Brikama

765 (33.9)

961 (40.1)

Mansakanko

130 (5.8)

121 (5.0)

Kerewan

269 (11.9)

277 (11.6)

Kuntaur

174 (7.7)

145 (6.0)

Janjanbureh

188 (8.3)

176 (7.3)

Basse

375 (8.3)

308 (12.8)

Place of residence

Urban 

984 (43.6)

1518 (63.3)

Rural

1273 (56.4)

881 (36.7)

Educational level of mother 

No education

1388 (61.5)

1139 (47.5)

Primary education

323 (14.3)

424 (17.7)

Secondary and above  

546 (24.2)

836 (34.8)

Source of drinking water

Unimproved 

253 (11.2)

175 (7.3)

Improved 

2005 (88.8)

2225 (92.7)

Religion

Islam

2214 (98.0)

2375 (99.0)

Christianity

44 (2.0)

24 (1.0)

Number of household members

Small (1-4)

124 (5.5)

145 (6.0)

Medium (5-9)

790 (35.0)

745 (31.1)

Large (10 and more )

1344 (59.5)

1509 (62.9)

Sex of household head

Male
Female

1859 (82.4)
398 (17.6)

2037 (84.9
362 (15.1)

Ethnicity  

Mandinka /Jahanka
Wollof
Jola/karoninka
Fula/Tukulur/Lorobo
 Serere
Serahuleh
Creole/Aku Marabout
Manjago
Bambara
Other
Non-Gambian

727 (32.2)
290 (12.9)
202 (9.0)
604(26.8)
48 (2.1)
163 (7.2)
7 (0.3)
21 (0.9)
19 (0.9)
17 (0.7)
159 (7.0)

820 (34.2)
326 (13.6)
214 (8.9)
455 (19.0)
61 (2.5)
201 (8.4)
4 (0.1)
12 (0.5)
25 (1.0)
12 (0.5)
269 (11.2)

Variable

Characteristics

Frequency and percentage in GDHS Periods

GDHS 2013
 Weighted frequency (%)

GDHS 2019
Weighted frequency (%)

Husbands educational level

No education

1386 (61.4)

1311 (54.6)

Primary education

414 (18.4)

517(21.6)

Secondary and above  

457 (20.2)

571 (23.8)

Currently breastfeeding 

No

840 (37.2)

1069 (44.5)

Yes

1418 (62.8)

1331 (55.5)

Wealth index

Poorest

483 (21.4)

569 (23.7)

Poorer

555 (24.6)

505 (21.0)

Middle 

407 (18.0)

508 (21.2)

Richer

434 (19.2)

406 (16.9)

Richest

379 (16.8)

412 (17.2)

Body mass index

Thin
Normal
Over weight

258 (11.4)
 1477 (65.4)
523 (23.2)

206 (8.6)
1241 (51.7)
952 (39.7)

Stunting

No
Yes

1766 (78.2)
491 (21.8)

2075 (86.5)
324 (13.5)

Underweight 

No
Yes

1731 (76.7)
527 (23.3)

1950 (81.3)
449 (18.7)

Wasting  

No
Yes

2001 (88.6)
257 (11.4)

2257 (94.1)
142 (5.9)

Sex of child

Male
Female 

1181 (52.3)
1076 (47.7)

1269 (52.9)
1130 (47.1)

Children age in month  

6-11
12-23
24-35
36-47
48-59

304 (13.5)
569 (25-2)
469 (20.8)
447 (19.8)
468 (20.7)

285 (11.9)
575 (24.0)
530 (22.1)
553 (23.1)
457 (19.0)

Diarrhea  

No
Yes

1848 (81.8)
410 (18.2)

1927 (80.3)
472 (19.7)

Fever

No
Yes

1983 (87.8)
274 (12.2)

2025 (84.4)
374 (15.6)

Cough 

No
Yes

1946 (86.2)
312 (13.8)

1976 (82.4)
423(17.6)

Size of child at birth

Small
Average
Large

458 (20.3)
636 (28.2)
1164 (51.5)

349 (14.6)
1030 (42.9)
1020 (42.5)

Variable

Characteristics

Frequency and percentage in GDHS Periods

GDHS 2013
 Weighted frequency (%)

GDHS 2019
Weighted frequency (%)

Child is twin

Single birth

2197 (97.3)

2297 (98.7)

Multiple birth

61 (2.7)

102 (4.3)

Birth order number

First
Two to three
Four to five
Six and more

447 (19.8)
738 (32.7)
570 (25.2)
503 (22.3)

367 (15.3)
858 (35.8)
603 (25.1)
571 (23.8)

Number of Under-five children 

Only one
2 children
3 and more

301 (13.3)
676 (30.0)
1280 (56.7)

385 (16.1)
683 (28.5)
1331 (55.5)

Mother anemia level

Not anemic
Anemic

823 (36.5)
1435 (63.5)

1264 (52.7)
1135 (47.3)

Children Anemia level

Not anemic
Anemic

635 (28.1)
1623 (71.9)

1289 (53.7)
1111 (46.3)

Variable

Characteristics

GDHSs periods

Point difference in anemia prevalence (2019/2020-2013)
Phase I

2013
(2,278)

2019
(2,399)

Region

Banjul
Kanifing
Brikama
Mansakanko
Kerewan
Kuntaur
Janjanbureh
Basse

59.4
61.8
66.3
80.2
70.6
84
79.8
81.3

36
49.2
30.6
48.8
58.1
75.9
60.8
58.8

-23.4
-12.6
-35.7
-31.4
-12.5
-8.1
-19
-22.5

Place of residence

Urban 
Rural

64.6
77.5

38.7
59.5

-25.9
-18

Educational level of mother

No education
Primary education
Secondary and above  

74.2
72.5
65.6

51.2
45.8
40

-23
-26.7
-25.6

Source of drinking water

Unimproved 
Improved 

78.3
71.1

42.5
46.6

-35.8
-24.5

Religion

Islam
Christianity

72.3
52.3

46.6
20

-25.7
-32.3

Number of household member

Small (1-4)
Medium (5-9)
Large (10 and more )

79
65.7
74.9

48.3
42.6
47.9

-30.7
-23.1
-27

Sex of household head

Male
Female

73.4
64.6

48.1
36.2

-25.3
-28.4

Currently breastfeeding

No
Yes

67.7
74.3

42
49.7

-25.7
-24.6

Ethnicity

Mandinka /Jahanka
Wollof
Jola/karoninka
Fula/Tukulur/Lorobo
Serere
Serahuleh
Creole/Aku    Marabout
Manjago
Bambara
Other
Non-Gambian

72.9
69
60.4
76.5
64.6
74.8
100
47.6
89.5
82.4
67.9

41.1
54.9
39.7
53.9
29.5
48.8
25.0
8.3
45.8
38.5
48.3

-31.8
-14.1
-20.7
-22.6
-35.1
-26
-75
-39.3
-43.7
-43.9
-19.6

Variable

Characteristics

GDHSs periods

Point difference in anemia prevalence
(2019-2013)
Phase I

2013
()

2019
()

Husbands educational level

No education

76.1

51.2

-24.9

Primary education

64.7

41.9

-22.8

Secondary and above  

65.4

39.1

-26.3

Wealth index

Poorest

76.6

63.6

-13

Poorer

78.4

47.6

-30.8

Middle 

77.1

39.6

-37.5

Richer

64.3

43.8

-20.5

Richest

59.5

31.3

-28.2

Body mass index

Thin
Normal
Over weight

72.5
74.7
63.5

55.6
48.1
41.9

-16.9
-26.6
-21.6

Stunting 

No
Yes

69.7
79.4

43.7
63

-26
-16.4

Underweight 

No
Yes

69
81

43.1
59.9

-25.9
-21.1

Wasting  

No
Yes

70.8
80.2

46.3
46.5

-24.5
-33.7

Sex of child

Male
Female 

74.6
68.9

48.9
43.5

-25.7
-25.4

Child age in months 

6-11
12-23
24-35
36-47
48-59

79.3
85.8
77.5
59.7
55.9

45.3
58.1
53
42.5
28.9

-34
-27.7
-24.5
-17.2
-27

Diarrhea

No
Yes

71.5
73.7

45.1
51.3

-26.4
-22.4

Fever 

No
Yes

71.2
77.1

45.6
49.9

-25.6
-27.2

Cough 

No
Yes

71.4
74.9

46.1
47.3

-25.3
-27.9

Size of child at birth

Small
Average
Large

69.2
73.9
71.8

54.4
46.4
43.4

-14.8
-27.5
-28.4

Child is twin

Single birth
Multiple birth

72
68.9

45.8
56.9

-11.1
-12

Variable

Characteristics

GDHSs periods

Point difference in anemia prevalence
(2019-2013)

2013

2019

Number of under-five children 

Only one
2 children
3 and more

66.8
71.9
73

39
44.4
49.4

-27.8
-27.5
-23.6

Birth order number

First
Two to three
Four to five
6 and more

74.3
69.4
72.8
72.4

47
45
46.5
47.6

-27.3
-24.4
-26.3
-24.8

Mother anemia level

Not anemic
Anemic

65.7
75.4

39.4
53.9

-26.3
-21.5

Prevalence of anemia

Cofe.

95 % CI.

Pct.

E

-0.0230

(-0.0374, -0.0087)*

11.17

C

-0.1831

(-0.2110,  -0.1553)*

88.83

R

-0.2061

(-0.2301, -0.1822)*

* Significance at 5% level of significance

Anemia prevalence

Difference due to characteristics  (E)

Difference due to coefficients (C)

Cofe. With 95 % CI

Pct.

Cofe. With 95 % CI

Pct.

Residence

Rural

Ref.

Ref.

Urban

-0.0137 (-0.0210, -0.0065)*

6.66

0.0493 (-0.0045, 0.1031)

-23.92

Education level of mother

No education

Ref.

Ref.

Primary

-0.0019 (-0.0041, 0.0002)

0.94

-0.0046 (-0.0145, 0.0053)

2.2

Secondary and +

-0.0054 (-0.0096, -0.0011)*

2.61

-0.0148 ()-0.0287, -0.0009)*

7.19

Sex of household head

Male

Ref.

Ref.

Female

0.0024 (0.0007, 0.0042)

-1.18

-0.0005 (-0.0117, 0.0011)

0.23

The educational level of the husband

No education

Ref.

Ref.

Primary

-0.0016 (-0.0031, -0.0001)*

0.79

0.0092 (-0.0014, 0.0198)

-4.45

Secondary and +

-0.0009 (-0.0024,0.0006)

0.46

0.0025 (-0.0092, 0.0141)

-1.20

Wealth status of the household

Poorest

Ref.

Ref.

Poorer

-0.0059 (-0.0090, -0.0028)*

2.87

-0.0246 (-0.0443, -0.0048)*

11.92

Middle

-0.0004 (-0.0007, -0.001)*

0.20

-0.0068 (-0.0022, 0.0085)

3.29

Richer

-0.0032 (-0.0058, -0.0006)*

1.56

0.0028 (-0.0121, 0.0178)

-1.37

Richest

-0.0014 (0.0022, -0.0005)

0.60

0.0029 (-0.0095, 0.0154)

-1.42

Stunting

No

-0.0062 (-0.0107, -0.0017)

3.02

-0.0076 (-0.0657, 0.0607)

3.71

Yes

Ref.

Ref.

Anemia prevalence

Difference due to characteristics  (E)

Difference due to coefficients (C)

Cofe. With 95 % CI

Pct.

Cofe. With 95 % CI

Pct.

Underweight

No

-0.0045 (-0.0080, -0.0010)*

2.19

0.0038 (-0.0530, 0.0607)

-1.83

Yes

Ref.

 Ref.

Wasting

No

0.0049 (0.0002, 0.0096)

-2.37

0.0856 (-0.0091, 0.1802)

-41.50

Yes

Ref.

 Ref.

Sex of children

Male

Ref.

 Ref.

Female

-0.0001 (-0.0002, -0.0001)*

0.07

-0.0075 (-0.0131, 0.0160)

3.66

Age of children in months

0 to 5

Ref.

Ref.

6 to 11

-0.0001 (-0.0002, -0.0001)*

0.05

0.0089 (-0.0135, 0.0312)

-4.29

12 to 23

0.0000 (0.0000, 0.0002)

-0.04

0.0199 (0.0004, 0.0393)*

-9.63

24 to 35

-0.0018 (-0.0034, -0.0002)*

0.87

0.0306 (0.0135, 0.0476)*

-14.83

36 to 47

-0.0004 (-0.0005, -0.0003)*

0.20

0.0120 (-0.0060, 0.0300)

-5.81

48 to 59

-0.0137 (-0.0210, -0.0065)*

6.66

-0.0148(-0.0287, -0.0009)*

7.19

Birth type

Single birth

0.0003 (-0.0006, 0.0013)

-0.16

-0.0359 (-0.1839, 0.0112)

17.44

Multiple births

 Ref.

Ref.

Size of children at birth

Small 

Ref.

Ref.

Average

-0.0075 (-0.0146, -0.0003)*

3.63

 -0.0186 (-0.0390, 0.0018)

9.03

Large

0.0047 (0.0002, 0.0091)

-2.26

-0.0340 (-0.0694, 0.0014)

16.47

* Significance at 5% level of significance

Model

AIC

BIC

Deviance

The standard binary logistic regression model

3398.525

3682.11

     3302.525

The multilevel binary logistic regression model

2941.192

    3224.557

2843.192

Random effects parameters

Null model

Full model

s²

0.296 (0.100, 0.879)

0.212 (0.069, 0.624)

ICC

0.0826 (0.029, 0.211)

0.061 (0.021, 0.165)

MOR

1.52

1.44

PCV

Ref.

0.284

LR test: LR = 295.86, p-value = <0.001

Variable

Characteristics

COR (95% CI)

P-value

AOR (95% CI)

P-value

Mother anemia level

Not anemic (0)

Ref.

Ref.

Anemic (1)

1.630 (1.377, 1.934)*

<0.001

1.577 (1.308, 1.902)*

<0.001

Number of under-five children

Only one (0)

Ref.

Ref.

2 to 3 (1)

1.281 (0.983, 1.670)

0.066

1.114 (0.827, 1.500)

0.477

3 and more (2)

1.467 (1.147, 1.878)*

0.002

1.225 (0.883, 1.698)

0.225

Birth order of children

Firs (0)

0.920 (0.699, 1.212)

0.555

1.090 (0.783, 1.517)

0.609

2 to 3 (1)

0.986 (0.788, 1.232)

0.900

1.206 (0.925, 1.574)

0.169

4 to 5 (2)

1.027 (0.808, 1.306)

0.827

1.149 (0.878, 1.504)

0.311

6 and more (3)

Ref.

Ref.

Birth type of children

Single (0)

Ref.

Ref.

Multiple (1)

2.257 (1.484, 3.432)*

<0.001

1.879 (1.181, 2.989)*

0.008

Birth size of children

Small (0)

Ref.

Ref.

Average (1)

0.754 (0.585, 0.972)*

0.030

0.900 (0.679, 1.192)

0.462

Large (2)

0.687 (0.533, 0.887)*

0.004

0.882 (0.661, 1.177)

0.392

Cough

No (0)

Ref.

 Ref.

Yes (1)

1.033 (0.829, 1.287)

0.773

1.075 (0.836, 1.384)

0.571

Fever

No (0)

Ref.

Ref.

Yes (1)

1.114 (0.884, 1.404)

0.361

1.007 (0.765, 1.302)

0.987

Diarrhea

No (0)

Ref.

Ref.

Yes (1)

1.289 (1.044, 1.592)*

0.018

1.003 (0.756, 1.214)

0.722

Age of children in month

0 to 11 (0)

2.357 (1.703, 3.261)*

<0.001

2.148 (1.488, 3.100)*

<0..001

12 to 23 (1)

4.236 (3.210, 5.591)*

<0.001

3.953 (2.909, 5.372)*

<0.001

24 to 35 (2)

3.418 (2.583, 4.522)*

<0.001

3.575 (2.661, 4.802)*

<0.001

36 to 47 (3)

2.136 (1.619, 2.818)*

<0.001

2.064 (1.546, 2.757)*

<0.001

48 to 59 (4)

Ref.

 Ref.

Variable

Characteristics

COR (95% CI.)

P-value

AOR (95% CI)

P-value

Wasting

No (0)

Ref.

Ref.

Yes (1)

1.011 (0.702,1.500)

0.926

1.840 (1.203, 2.814)*

0.005

Underweight

No (0)

Ref

Ref.

Yes (1)

1.925 (1.548, 2.393)*

<0.001

1.661 (1.241, 2.221)*

<0.001

Stunting

No (0)

Ref.

Ref.

Yes (1)

2.132 (1.656, 2.746)

1.481 (1.094, 2.004)*

0.011

Body mass index of mother

Thin (0)

Ref.

Ref.

Normal (1)

0.774 (0.568, 1.055)

0.105

0.888 (0.632, 1.248)

0.495

Overweight (2)

0.715 (0.520, 0.988)*

0.040

1.017 (0.708, 1.459)

0.929

Wealth status of the household 

Poorest (0)

Ref.

Ref.

Poorer (1)

0.660 (0.507, 0.859)*

0.002

0.682 (0.505, 0.921)*

0.013

Middle (2)

0.526 (0.397, 0.697)*

<0.001

0.559 (0.393, 0.796)*

<0.001

Richer (3)

0.665 (0.488, 0.909)*

<0.010

0.753 (0.507, 1.132)

0.172

Richest (4)

0.340 (0.287, 0.556)*

<0.001

0.449 (0.287, 0.702)*

<0.001

Ever breast feed

No (0)

Ref.

Ref.

Yes (1)

0.700 (0.591, 0.830)*

<0.001

0.789 (0.634, 0.981)*

0.033

Husband education level

No education (0)

Ref.

Ref.

Primary (1)

0.873 (0.701, 1.089)

0.227

0.990 (0.772, 1.270)

0.937

secondary + (2)

0.825 (0.665, 1.024)

0.081

1.036 (0.807, 1.331)

0.871

Sex of household head

Male (0)

Ref.

Ref.

Female (1)

0.682 (0.536, 0.867)*

0.002

0.739 (0.568, 0.962)*

0.024

Family size

Small (0)

Ref.

Ref.

Medium (1)

0.737 (0.509, 1.068)

0.107

0.739 (0.492, 1.111)

0.146

Large (2)

0.883 (0.616, 1.265)

0.496

0.829 (0.535, 1.286)

0.403

Religion

Islam (0)

Ref.

Ref.

Christianity (1)

0.305 (0.110, 0.846)*

0.022

0.779 (0.221, 2.743

0.698

Variable

Characteristics

COR (95% CI.)

p-value

AOR (95% CI)

P-value

Source of dirking water

Unimproved (0)

1.005 (0.720, 1.403)

0.976

1.023 (0.700, 1.500)

0.905

Improved (1)

Ref.

Ref.

Education level of mother

No education (0)

Ref.

Ref.

Primary  (1)

0.962 (0.760, 1.216)

0.743

0.872 (0.763, 1.130)

0.301

Secondary + (2)

0.812 (0.700, 1.034)

0.113

0.925 (0.724, 1.184)

0.537

Ethnicity

Mandinka/Jahanka (0)

Ref.

Ref.

Wollof (1)

1.305 (0.986, 1.728)

0.063

1.274 (0.936, 1.736)

0.124

Jola/Karoninka (2)

1.232 (0.854, 1.696)

0.202

1.039 (0.722, 1.497)

0.836

Fula (3)

1.241 (0.969, 1.589)

0.087

1.047 (0.795, 1.379)

0.745

Serere (4)

0.508 (0.283, 0.912)*

0.023

0.420 (0.217, 0.814)*

0.010

Serahuleh (5)

0.828 (0.580, 1.182)

0.299

0.883 (0.600, 1.300)

0.526

Creole/Aku Marabout (6)

0.210 (0.014, 3.052)

0.253

0.275 (0.015, 4.923)

0.380

Manjago (7)

0.092 (0.008, 1.061)

0.056

0.099 (0.007, 1.441)

0.091

Bambara (8)

0.889 (0.386, 2.049)

0.783

0.743 (0.308, 1.791)

0.508

Other (9)

1.020 (0.305, 3.414)

0.974

1.405 (0.376, 5.249)

0.613

Non-Gambian (10)

1.128 (0.841, 1.500)

0.432

1.000 (0.724, 1.384)

0.995

* Significance at 5% level of significance