Regional Disparities in the Decline of Anemia and Remaining Challenges among Children in Tanzania: Analyses of the Tanzania Demographic and Health Survey 2004-2015.

The burden of child anemia is on the decline globally but remains prevalent in low- and middle-income countries, including Tanzania. Evidence suggests regional variation and a slow pace of decline even in areas with high food production. The factors behind such decline and remaining challenges behind child anemia remain understudied in Tanzania. This secondary data analysis utilized data including 7361 and 7828 children from the Tanzania Demographic and Health Surveys (TDHS) conducted in 2004-2005 and 2015-2016 separately to examine the decline of child anemia and regional variation thereof. We used a geographic information system (GIS) to visualize the changes and differences between regions and the two study periods, and used regression analyses to examine the recent determinants of child anemia. Anemia has declined among children under five in Tanzania by 42% over a one-decade period, but remained high in relatively high food-producing regions. The risk of anemia is still higher among boys compared to girls (AOR = 1.39, = 0.005), 41% higher among children lived in households with more than three under-five children compared to those households with only one child ( = 0.002); lower among children whose mothers were educated ( < 0.001) or had first given birth when aged over 25 ( = 0.033); and 34% less among children in the wealthiest households ( < 0.001). Efforts are needed to address social determinants of health, especially targeting women's empowerment through decreasing the number of children and encouraging child spacing, and poverty reduction, particularly in high food producing regions.