Supplementary file 1_Regional and socioeconomic inequalities and factors associated with low birth weight in Ghana: a multilevel analysis of the 2022 Ghana Demographic and Health Survey.docx

Prevalence was highest among births in the poorest and poorer wealth quintiles (13%) and lowest in the richest quintile (6%). Regionally, prevalence was highest in Ashanti (15%) and Northern (14%) and lowest in Greater Accra (6%). In the fully adjusted multilevel model (n = 3,421), multiple pregnancy was associated with substantially higher odds of LBW (AOR = 10.09, 95% CI: 6.19–16.44), while adequate ANC attendance (≥8 visits) was associated with lower odds of LBW (AOR = 0.46, 95% CI: 0.32–0.66).

The association between household wealth and LBW was not statistically significant after adjustment. Cluster-level ICC was 11.1% in the final model, indicating meaningful between-cluster variation.</p>Conclusions<p>LBW prevalence varied across socioeconomic and regional groups in Ghana. Multiple pregnancy and adequate ANC attendance were the principal factors associated with LBW in the fully adjusted model, while household wealth was not statistically significant after adjustment.

The findings support strengthening quality ANC, particularly for pregnancies at higher risk, alongside equity-oriented maternal and newborn health services.</p>