Reducing Anemia Prevalence in Afghanistan: Socioeconomic Correlates and the Particular Role of Agricultural Assets

This research aims to examine the socio-economic correlates of anemia in women, and potential sources of iron in household diets in Afghanistan. It also examines whether ownership of agricultural (particularly livestock) assets and their use in food production has a role in alleviating anaemia, especially where local markets may be inadequate. We analyse data from the 2010/11 Afghanistan Multiple Indicator Cluster Survey, estimating a logistic regression to examine how anemia status of women is associated with socio-economic covariates. A key result found is that sheep ownership has a protective effect in reducing anemia (prevalence odds ratio of sheep ownership on anemia of 0.83, 95% confidence interval (CI): 0.73–0.94) after controlling for wealth and other covariates. This association is found to be robust to alternative model specifications. Given the central role of red meat in heme iron provision and absorption of non-heme iron, we hypothesise that sheep ownership promotes mutton consumption from own-production in a setting where market-sourced provision of nutritious food is a challenge. We then use the 2011/12 National Risk and Vulnerability Assessment household data to understand the Afghan diet from the perspective of dietary iron provision, and to understand interactions between own-production, market sourcing and mutton consumption. Sheep ownership is found to increase the likelihood that a household consumed mutton (odds ratio of 1.27, 95% CI: 1.15–1.42), the number of days in the week that mutton was consumed (prevalence rate ratio of 1.24. 95% CI: 1.12–1.37) and the quantity of mutton consumed (7 grams/person/week). In the subsample of mutton consumers, households sourcing mutton mostly from own production consumed mutton 1.5 days more frequently on average than households relying on market purchase, resulting in 100 grams per person per week higher mutton intake. Thus this analysis lends support to the notion that the linkage between sheep ownership and anemia risk is at least partly due to consumption arising from own-production in the presence of market incompleteness.

本研究旨在探究阿富汗女性贫血的社会经济关联因素，以及家庭膳食中铁的潜在来源。同时，本研究亦考察了农业（尤其是畜禽）资产的持有状况及其在粮食生产中的应用，是否能够缓解贫血问题，尤其是在当地市场供给不足的情形下。我们采用2010/11年阿富汗多指标类集调查（Afghanistan Multiple Indicator Cluster Survey）的数据，通过构建逻辑回归模型，分析女性贫血状态与社会经济协变量之间的关联。核心研究结果显示：在控制财富水平与其他协变量后，持有绵羊可产生降低贫血风险的保护效应（绵羊持有对贫血的患病率优势比为0.83，95%置信区间（CI）：0.73–0.94），且该关联在不同模型设定下均表现出稳健性。鉴于红肉在血红素铁供给与非血红素铁吸收中发挥核心作用，我们提出如下假说：在市场难以获取营养食品的背景下，持有绵羊可促进家庭自产羊肉的消费。随后，我们利用2011/12年全国风险与脆弱性评估（National Risk and Vulnerability Assessment）的住户数据，从膳食铁供给的角度剖析阿富汗的膳食结构，并探究自产食品、市场采购与羊肉消费之间的相互作用。研究发现，持有绵羊可提升家庭食用羊肉的可能性（优势比为1.27，95% CI：1.15–1.42）、每周食用羊肉的天数（患病率比率为1.24，95% CI：1.12–1.37）以及羊肉的消费量（每人每周7克）。在羊肉消费者子样本中，主要自产羊肉的家庭比依赖市场采购的家庭平均每周多食用1.5天羊肉，人均每周羊肉摄入量高出100克。综上，本研究结果支持如下观点：在市场供给不完善的情境下，绵羊持有与贫血风险之间的关联，至少部分源于家庭自产羊肉带来的消费提升。