Association between gender inequality and anaemia prevention knowledge: a cross-sectional study in a Peri-urban community in Ghana

Anaemia remains a global health burden, affecting about 1.8 billion diverse groups of people worldwide. However, anaemia disproportionately impacts women and children, with nearly twice as many women as men affected. Addressing gender inequality is essential for improving knowledge and awareness of anaemia and its prevention and management. The aim of this study was to determine the association between gender and anaemia prevention/management knowledge and to assess how socioeconomic and cultural factors, including cultural permission and subordination, shape gender inequality in anaemia-related health knowledge within a Peri-urban Ghanaian community. The study adopted a cross-sectional design, involving the administration of pre-tested questionnaires to about 385 recruited participants residing in a Peri-urban community in the central region of Ghana. Participants’ socio-demographics, gender inequality assessment among socioeconomic and cultural factors, and knowledge of anaemia were assessed. Bivariate analysis using a Chi-square or Fisher’s exact test and adjusted odds ratios (AOR) with multivariate logistic regression were performed, and p-values < 0.05 were considered statistically significant. The majority of participants identified as Christian (62.3%) and belonged to the Akan ethnic group (69.6%). Most participants were also married (62.9%), and household sizes of more than five members were common (64.2%). Gender inequality was significantly associated with cultural permission (p = 0.019), defined as the ability of participants to determine daily meal preparation, and subordination (p = 0.007) which in this study was defined as requiring permission before visiting a health facility. Unemployed participants (aOR = 2.463; p = 0.028) and students (aOR = 3.253; p = 0.018) were about two and three times more likely, respectively, to require cultural permission. Similarly, unemployed individuals were about twice as likely to experience subordination compared to employed individuals (aOR = 2.410; p = 0.014). Knowledge of anaemia prevention and management was significantly associated with sex, with females demonstrating higher awareness than males regarding iron-rich foods (57% vs. 43%, p = 0.018), vitamin B12 supplementation in strictly vegan diets (60.1% vs. 39.9%, p = 0.015), and avoiding the habit of eating pica (59.2% vs. 40.8%, p = 0.048). Significant gender differences were observed in anaemia knowledge, with females demonstrating slightly better awareness of preventive measures than males. The study emphasizes the necessity for specific interventions, such as education, that tackle the intersecting factors sustaining gender inequalities in anaemia awareness. Additional research is needed to identify geographically specific factors contributing to gender inequality in anaemia knowledge within the sub-region.