Correlates and prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone. A secondary data analysis of the demographic health survey of 2019
Authors: Atim Pamela Okot , Alema Nelson Onira , Pebolo Francis Pebalo , Okot Christopher , Ochula Denis , Okot Smart Geoffrey , Ikoona Eric Nzirakaindi , Toure Mame Awa , Namulemo Lucy , Kamara Kassim , Oyat Freddy Wathum Drinkwater , Aloyo Judith , Njenga Amon , Kaluya Ronald , Matovu John Bosco , Olal Emmanuel , Kitara David Lagoro 
Published: July 2023

Abstract
Background: Overweight and obesity are emerging public health problems globally and are independent risk factors for heart, blood vessels, reproductive health, and metabolic disorders.
This study aimed to determine the correlates and prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone using secondary data analysis of the Demographic Health Survey of 2019.
Methods: This study was based on the 2019 Sierra Leone Demographic Health Survey (SLDHS) that used a two-stage stratified cluster sampling technique. A total of 7514 non-pregnant women of reproductive age (15-49 years) were used in the analysis. Simple descriptive, bivariable, and multivariable regression analyses were conducted with a significant p-value set at <0.05.
Results: The prevalence of overweight and obesity among women of reproductive age in Sierra Leone was 19.7% and 7.4%, respectively. Overweight was more likely among women of 15-19 age group (adjusted Odds Ratios, aOR=1.933,95%CI:1.532-2.348;p<0.001); women from the north (aOR=1.308,95%CI:1.104-1.581;p<0.006); women without formal education (aOR=1.211,95%CI:1.009-1.454;p<0.040); in poorest (aOR=1.501,95%CI:1.231-1.853;p<0.001) and poorer (aOR=1.419,95%CI:1.154-1.745;p=0.001) wealth indices. However, overweight was 39.9% less likely among 30-39-year (aOR=0.601,95%CI:0.507-0.713;p<0.001) and 49% less likely among 40-49-year (aOR=0.510,95%CI:0.415-0.628;p<0.001) age-groups. It was 27.3% less likely among married women (aOR=0.727,95%CI:0.613-0.863;p<0.001), 24.9% less likely in the south (aOR=0.751,95%CI:0.623-0.911;p=0.002), 38.2% and 48.7% less likely in richer (aOR=0.618,95%CI:0.494-0.773;p<0.001) and richest (aOR=0.513,95%CI:0.389-0.677;p<0.001) wealth indices, respectively.
Also, obesity was more likely among women 15-19-year (aOR=2.051,95%CI:1.316-3.198;p=0.002); from the north (aOR=1.426,95%CI:1.038-1.958;p=0.044); in poorest (aOR=2.390,95%CI:1.618-3.532;p<0.001) and poorer (aOR=1.667,95%CI:1.151-2.415;p=0.007) wealth indices. However, it was 68.3% and 79.6% less likely among women 30-39-year (aOR=0.317,95%CI:0.241-0.419;p<0.001) and 40-49-year (aOR=0.204,95%CI:0.149-0.278;p<0.001) age-groups, respectively. It was 36.8% less likely among female-headed households (aOR=0.732,95%CI:0.590-0.909;p=0.005) and 24% less likely among married women (aOR=0.760,95%CI:0.580-0.995;p=0.046); 26.2% less likely in the south (aOR=0.738,95%CI:0.550-0.992;p=0.044); 62.1% and 75.9% less likely in richer (aOR=0.379,95%CI:0.266-0.540;p<0.001) and richest (aOR=0.241,95%CI:0.159-0.367;p<0.001) wealth indices, respectively; and 39.9% less likely among women who listened to radios (aOR=0.601,95%CI:0.507-0.713;p<0.001).
Conclusion: The prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone was higher compared to world data. Younger age groups, northern region, poorest and poorer wealth indices, and women without formal education were more likely to be overweight and obese. However, overweight and obesity were less likely among older age-groups, married, southern region, richer and richest wealth indices, female-headed households, and listening to radios. There is an urgent need for policymakers in Sierra Leone to tackle overweight and obesity among women of reproductive age (15-49 years) if the current trends are to be reversed.