Spatial analysis of childhood anemia in Peru, 2022: construction of district-level maps for public policy

Objective. To estimate the prevalence of anemia in children under five in districts with small or null sample size, and to construct an anemia map at the district level in Peru. Materials and methods. An ecological study was conducted utilizing the data from the Encuesta Demográfica y de Salud Familiar 2022 and the National Census 2017.The association between the prevalence of anemia and auxiliary variables was determined using the spatial Fay-Herriot model. Results. The national prevalence of anemia is 33.6% (95%CI:32.8–34.4). Departments with severe anemia clusters are Puno, Madre de Dios, Ucayali and Loreto. There is a significant spatial correlation between districts, being stronger in the case of the poorer districts. Higher-altitude districts have higher prevalence of anemia. Districts where the predominant language is Spanish have a lower percentage of anemic children. The variables associated with a good district’s infrastructure and access to healthcare services have a negative impact. Conclusions. The spatial Fay-Herriot model is a tool that provides a full perspective on the prevalence of anemia at district level in Peru.Anemia among children under five is an important public health problem, especially in rural areas of the mountainous regions of the central and southern parts of Peru, as well as the Peruvian Amazonia.