Background: Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, falls below established cut-off values. This study aimed to assess the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Methods: A community-based cross-sectional study design was carried out among 367 pregnant women from June 1-30, 2020. Systematic random sampling was used to select study subjects. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the assumptions were checked. The Un-standardized beta (β) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependent variables. Statistical significance was declared at P-value < 0.05. Results: The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia (hemoglobin level < 11g/dl) among pregnant women was found to be 23.16%, [(95% CI: 18.3% - 27.5%)]. Meal frequency [β = 0.40, (95% CI: 0.12, 0.69), P = 0.005], inter-pregnancy interval [β = 0.08, (95% CI: 0.02, 0.15), P = 0.007], mid-upper arm circumference measurement [β = 0.13, (95% CI: 0.07, 0.20), P = < 0.001], Own fruits/ vegetable [β = 0.55, (95% CI: 0.79,0.31),P =< 0.001], coffee consumption [β = -1.00,(95% CI: -1.31, -0.68), P = < 0.001], and having history of still birth [β = - 0.63, (95% CI: -1.06, -0.20), P = 0.004] were significantly associated with the hemoglobin level of pregnant women. Conclusions: Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, and promotion of fruits/vegetable consumption, of the women during antenatal care follow-up.
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