Regional disparities in concurrent anaemia and overweight/obesity among women in Ghana: a nationally representative analysis of the 2022 Ghana Demographic and Health Survey

Abstract Background Ghana is experiencing persistent anaemia alongside a high and rising burden of excess adiposity among women. These conditions may coexist within the same woman, yet contemporary evidence on how this intraindividual double burden is distributed across Ghana’s current 16 administrative regions is limited. We estimated the prevalence and regional distribution of concurrent anaemia and overweight/obesity and examined its socioeconomic and dietary patterning. Methods We conducted a secondary cross-sectional analysis of the 2022 Ghana Demographic and Health Survey among 5,611 non-pregnant women aged 20–49 years with valid haemoglobin and body mass index measurements. The complex survey design was incorporated using sampling weights, primary sampling units and strata. Survey-weighted prevalence estimates, ecological Spearman correlations across 16 regions, design-based modified Poisson regression and marginal standardisation were used. Results Anaemia affected 39.77% (95% CI 38.00–41.53) of women, overweight/obesity 50.22% (48.25–52.18), and concurrent anaemia and overweight/obesity 17.71% (16.24–19.19). Concurrent prevalence ranged from 6.10% (3.24–8.96) in North East to 26.88% (20.99–32.78) in Western Region. Across 16 unweighted regional point estimates, concurrent prevalence correlated with overweight/obesity (ρ = 0.921, p < 0.001) but not clearly with anaemia (ρ=−0.159, p = 0.557); anaemia and overweight/obesity were also not significantly correlated (ρ=−0.385, p = 0.141). Compared with women aged 20–29 years, aPRs were 1.58 (1.29–1.93) at ages 30–39 and 2.08 (1.69–2.55) at ages 40–49. The richest versus poorest quintile aPR was 2.84 (1.95–4.15). Conclusions Concurrent anaemia and overweight/obesity affected 17.71% of non-pregnant Ghanaian women aged 20–49 years, approximately one in 5.6 women, with substantial regional variation. The strong regional correlation with overweight/obesity partly reflects the mathematical construction of the concurrent phenotype and should not be interpreted causally. Older age and higher household wealth were associated with higher concurrent prevalence. Integrated and geographically responsive nutrition and NCD-service approaches merit consideration.