SRM School of Public Health, Chennai, Tamil Nadu, India.
ICMR-National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
BMC Public Health. 2024 Oct 14;24(1):2824. doi: 10.1186/s12889-024-20328-9.
Childhood anaemia remains a significant public health problem in India, as it adversely affects child development and overall health outcomes. This study aimed to analyse the prevalence of severe and moderate anaemia among children aged 6-59 months and identify consistent predictors of this condition over the past 15 years.
Data from the three most recent rounds of the NFHS were used for this analysis. The final weighted sample included 40,331 children from the NFHS-3 (2005-2006), 200,093 from the NFHS-4 (2015-2016), and 178,909 from the NFHS-5 (2019-2021). Descriptive and bivariate analyses were conducted, followed by binary logistic regression to identify factors associated with severe and moderate anaemia in children aged 6-59 months. All statistical analyses were performed using Stata version 14.
Over the past 15 years, the prevalence of severe and moderate anaemia among children in India has shown a slight decline. However, the influence of various predictors has changed over time. Young children (aged 6-23 months), those from Scheduled Caste (SC) and Scheduled Tribe (ST) communities, and children born to mothers with high parity and low educational attainment remain particularly vulnerable to anaemia. Additionally, short-term illness significantly increases the risk of anaemia. Furthermore, women's autonomy, indicated by higher education and lower fertility rates, along with maternal nutrition education, have emerged as key factors in reducing anaemia burden in the future. Notably, children whose mothers had no education were 1.4 times more likely to suffer from severe or moderate anaemia. Similarly, children born to mothers with four to five children (OR 1.1, p < 0.05) and those with six or more children (OR 1.2, p < 0.05) had an elevated risk of anaemia.
The findings highlight three key areas for programmatic focus to accelerate anaemia reduction in India: [1] targeting young children (aged 6-23 months); [2] ensuring the inclusion of SC and ST communities in all relevant interventions; and [3] promoting women's autonomy. These strategies are essential for reducing the burden of anaemia across the country.
儿童贫血仍然是印度一个重大的公共卫生问题，因为它会对儿童发育和整体健康结果产生不利影响。本研究旨在分析 6-59 个月儿童重度和中度贫血的流行情况，并确定过去 15 年来该病症的一致预测因素。
本分析使用了三次最近的 NFHS 数据。最终加权样本包括 NFHS-3（2005-2006 年）中的 40331 名儿童、NFHS-4（2015-2016 年）中的 200093 名儿童和 NFHS-5（2019-2021 年）中的 178909 名儿童。进行了描述性和双变量分析，然后进行二项逻辑回归，以确定与 6-59 个月儿童重度和中度贫血相关的因素。所有统计分析均使用 Stata 版本 14 进行。
在过去的 15 年中，印度儿童重度和中度贫血的患病率呈轻微下降趋势。然而，各种预测因素的影响随时间发生了变化。年幼的儿童（6-23 个月）、来自在册种姓（SC）和在册部落（ST）社区的儿童，以及母亲生育多胎且教育程度低的儿童仍然特别容易贫血。此外，短期患病会显著增加贫血的风险。此外，妇女的自主权（通过更高的教育和更低的生育率来表示）以及孕产妇营养教育，已成为未来减轻贫血负担的关键因素。值得注意的是，母亲没有受过教育的儿童患重度或中度贫血的可能性要高出 1.4 倍。同样，母亲生育 4-5 个孩子的儿童（OR 1.1，p<0.05）和生育 6 个或更多孩子的儿童（OR 1.2，p<0.05）患贫血的风险增加。
研究结果突出了三个重点领域，为印度加速减少贫血制定了方案重点：[1]针对 6-23 个月的幼儿；[2]确保在册种姓和在册部落社区参与所有相关干预措施；[3]促进妇女的自主权。这些策略对于减轻全国贫血负担至关重要。
