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印度不同社会群体育龄妇女贫血患病率的横断面研究:基于全国代表性数据。

Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data.

机构信息

Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University (JNU), New Delhi, India.

Department of Geography, Serampore Girls' College, University of Calcutta, Kolkata, West Bengal, India.

出版信息

PLoS One. 2023 Feb 2;18(2):e0281015. doi: 10.1371/journal.pone.0281015. eCollection 2023.

Abstract

BACKGROUND

The common cause of anemia in the general population is iron deficiency. Anemia is adversely affecting women of reproductive age and child health which in turn results in increased morbidity and maternal death, and also hamper social-economic growth. Reproductive women are more prone to anemia due to inadequate dietary intake and iron loss during menstruation and pregnancy.

OBJECTIVES

This study examined the level and trend of anemia prevalence among the socially disadvantaged group (SC&ST, OBC) of women as compared to the other women (general) and identified the main responsible factors behind this.

DATA AND METHODS

The data for this analysis has been taken from three rounds of National Family Health Survey (NFHS) conducted during 2005-2006 (NFHS 3), 2015-16 (NFHS 4) and 2019-21 (NFHS 5). Univariate and bivariate analyses were used to assess the level of anemia among reproductive age group women of different social groups. The regression model represents the relative risk of different confounding factors on the occurrence of anemia. GIS technique used for graphical representation of anemia prevalence rate among different social groups of women in different states of India.

RESULT

In India more than 15 states belong to the high prevalence (>%55) of anemia among socially backward groups in 2019-21. The anemia prevalence was high (>55%) in all social groups (SC & ST, OBC, general) observed in 7 states in NFHS-3, 4 in NFHS-4 and 11 states in NFHS-5. The overall result reveals that the SC&ST women were more prone to any anemia than OBC and general women and the prevalence rate slightly increased from 2005-06 to 2019-21. Among all variables, economic status dominantly controls the anemia level in all social groups. Anemia prevalence of the poor and poorest group of general women were much worse than the women of richer and richest groups of SC&ST, OBC. The odds of women having anemia were lower among higher educated and urban women as compared to the non educated and rural women, irrespective of social group. The prevalence of anemia decreases with increased age of women and increases with the number of child bearing. All differences were statistically significant.

CONCLUSIONS

The problem of iron deficiency remains a major issue in India, where the majority of the states (eastern, north-eastern and central) suffer from high anemia prevalence rate and it increases over time. It is observed that multiple socio-demographic factors ranging from poor economic and educational status, rural residence to higher childbearing of women are responsible for predicting anemia levels among the social groups of women in India. To eradicate this problem India should improve women's overall nutrition status and their income. Meanwhile, GOI should be more focused on the existing policies related to anemia and on their actual implementation on grassroots level.

摘要

背景

缺铁是导致普通人群贫血的常见原因。贫血会对育龄妇女和儿童的健康产生不利影响,从而导致发病率和产妇死亡率上升,也会阻碍社会经济的发展。由于饮食摄入不足和月经及怀孕期间的铁流失,育龄妇女更容易贫血。

目的

本研究比较了社会弱势群体(SC&ST、OBC)与其他妇女(普通妇女)的贫血患病率水平和趋势,并确定了造成这种情况的主要原因。

数据和方法

本分析的数据来自于 2005-2006 年(NFHS3)、2015-16 年(NFHS4)和 2019-21 年(NFHS5)三次全国家庭健康调查(NFHS)。采用单变量和双变量分析评估不同社会群体育龄妇女的贫血水平。回归模型代表不同混杂因素对贫血发生的相对风险。GIS 技术用于表示印度不同邦不同社会群体妇女贫血患病率的图形。

结果

2019-21 年,印度有 15 个以上邦属于社会弱势群体贫血患病率高(>55%)的邦。在 NFHS-3 中,7 个邦的所有社会群体(SC&ST、OBC、普通)都观察到贫血患病率较高(>55%),NFHS-4 中有 4 个邦,NFHS-5 中有 11 个邦。总体结果表明,SC&ST 妇女比 OBC 和普通妇女更容易患任何类型的贫血,而且从 2005-06 年到 2019-21 年,贫血患病率略有上升。在所有变量中,经济状况在所有社会群体中均为主导贫血水平的因素。一般妇女中贫困和最贫困群体的贫血患病率比 SC&ST、OBC 中较富裕和最富裕群体的妇女更差。与非教育和农村妇女相比,受教育程度较高和城市妇女的贫血患病风险较低,无论社会群体如何。妇女的贫血患病率随年龄的增长而降低,随生育子女数的增加而升高。所有差异均具有统计学意义。

结论

缺铁问题仍然是印度的一个主要问题,印度大多数邦(东部、东北部和中部)贫血患病率较高,且随着时间的推移呈上升趋势。观察到,从经济和教育状况差、居住在农村到妇女生育子女多等多种社会人口因素都与印度妇女社会群体的贫血水平有关。为了消除这一问题,印度应改善妇女的整体营养状况和收入。同时,印度政府应更加关注与贫血相关的现有政策,并在基层实际实施这些政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/9894404/bb78a9cc9a43/pone.0281015.g001.jpg

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