Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
Health Systems Research India Initiative (HSRII), Trivandrum, Kerala, India.
PLoS One. 2023 Jun 1;18(6):e0286464. doi: 10.1371/journal.pone.0286464. eCollection 2023.
Anaemia is a serious global public health problem that disproportionally affects children, adolescent girls, and women of reproductive age, especially pregnant women. Women of reproductive age are more vulnerable to anaemia, particularly severe and moderate anaemia leads to adverse outcomes among pregnant women. Despite continuous Government efforts, anaemia burden still poses a serious challenge in India. The objective of this study is to assess the trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age between 15 and 49 years.
We used three rounds of the large-scale National Family Health Survey (NFHS) India, conducted on a representative sample of households using a cross-sectional design across the country in 2005-06, 2015-16 and 2019-2021. We included all the women aged 15 to 49 years in our analysis. We used the same haemoglobin (Hb) cut-off values for all the three rounds of surveys to ensure comparability. Generalized linear regression analyses with log link were done. Survey weights were incorporated in the analysis.
The prevalence of severe or moderate Anaemia (SMA) in non-pregnant women was 14.20%, 12.43% and 13.98%; it was 31.11%, 25.98% and 26.66% for pregnant women in 2006, 2016 and 2021 respectively. The decline in SMA prevalence was 1.54% in non-pregnant women, whereas it was 14.30% in pregnant women in 15 years. Women who were poor, and without any formal education had a higher risk for severe and moderate Anaemia.
Despite the intensive anaemia control program in India, SMA has not declined appreciably in non-pregnant women during the last two decades. Despite the decline, the prevalence of SMA was about 26% in pregnant women which calls for a comprehensive review of the existing anaemia control programmes and there must be targeted programmes for the most vulnerable and high-risk women such as rural, poor and illiterate women of reproductive age to reduce the burden of anaemia among them.
贫血是一个严重的全球公共卫生问题,尤其影响儿童、少女和育龄妇女,尤其是孕妇。育龄妇女更容易贫血,尤其是严重和中度贫血会导致孕妇不良后果。尽管政府不断努力,但贫血负担在印度仍然是一个严重挑战。本研究旨在评估 15 至 49 岁育龄妇女中严重和中度贫血的流行趋势及其决定因素。
我们使用了三轮印度大规模家庭健康调查(NFHS)的数据,这些数据是在 2005-06 年、2015-16 年和 2019-2021 年期间在全国范围内使用代表性样本进行的横断面设计。我们将所有年龄在 15 至 49 岁的妇女纳入分析。我们使用相同的血红蛋白(Hb)截断值进行所有三轮调查,以确保可比性。使用对数链接的广义线性回归分析进行分析。在分析中纳入了调查权重。
非孕妇中严重或中度贫血(SMA)的患病率为 14.20%、12.43%和 13.98%;孕妇中的患病率分别为 31.11%、25.98%和 26.66%,分别为 2006 年、2016 年和 2021 年。非孕妇中 SMA 患病率下降了 1.54%,而孕妇中则下降了 14.30%,在 15 年内。贫困且没有任何正规教育的妇女患严重和中度贫血的风险更高。
尽管印度有密集的贫血控制计划,但在过去二十年中,非孕妇的 SMA 并没有明显下降。尽管患病率有所下降,但孕妇中 SMA 的患病率仍约为 26%,这需要对现有的贫血控制计划进行全面审查,必须针对最脆弱和高风险的妇女制定有针对性的计划,例如农村、贫困和文盲的育龄妇女,以减少她们的贫血负担。