Determinants of anemia clustering among mothers and children in Indonesia

Objectives: To describe risk factors for clustering of anemia among mothers and children in Indonesia. Methods: An anemia cluster was defined as hemoglobin <12 g/dl in the mother and <11 g/dl in the youngest child, aged 6-59 months. Results: Anemia clustering occurred in 4907 (18.3%) of 26 809 urban families and 12 756 (15.5%) of 82 291 rural families. Maternal overweight/obesity, older child age, consumption of fortified milk by the child, use of iodized salt, vitamin A supplementation, paternal smoking and greater expenditure on animal and plant source foods were associated with lower odds of anemia clustering. Older maternal age, maternal underweight, ≥2 children in the family and >4 individuals eating from the same kitchen were associated with greater odds of anemia clustering. Conclusion: Fortified milk, iodized salt, vitamin A supplementation and greater expenditure on plant and animal foods are among modifiable risk factors associated with lower risk of anemia clustering in Indonesia.