South Asia has some of the highest rates of anaemia in the world, mirroring overall levels of malnutrition. Researchers from the University of North Carolina, USA, studied social and economic factors linked to anaemia in Andhra Pradesh, a southern Indian state. They found that anaemia is most common among poor urban women.

More than half of all Indian women are anaemic. This is due to poor diet, malaria and other infections, and frequent childbearing that depletes iron stores. It leads to:

• increased risk of low birth weight or premature birth
• higher infant mortality
• poor iron stores for newborn babies
• greater risk of maternal morbidity and mortality
• lower physical activity, mental concentration and productivity.

Researchers looked at data from the National Family Health Survey 1998/99 on 4 032 women aged 15-49 from 3 872 households. They found that:

• Anaemia is very common. 32.4 per cent of all women have mild, 14.2 per cent have moderate and 2.2 per cent have severe anaemia.
• Factors linked to lower rates of anaemia are Muslim religion, consumption of pulses or alcohol, having at least a high school education and higher socio-economic status.
• Poor urban women have the highest rates of anaemia.
• Anaemia is also more common in thinner women.

Anaemia in this large, southern Indian state affects all kinds of women – rich or poor, fat or thin, urban or rural. Even women who have no apparent resource constraints may have a deficiency due to hookworm or malaria, acute infections, micronutrient deficiency that interferes with iron metabolism, or poor diet. While most health indicators show that rural women are worse off than urban women, these findings for anaemia suggest a more complex picture influenced by socio-economic status.

Many of the risk factors are not easy to change. However, the researchers recommend that policy-makers tackling the high anaemia rates in Indian women should:

• develop combined food and iron supplementation programmes to address both anaemia and under-nutrition in the short term
• target rural and urban women in all socio-economic groups, but particularly very poor urban women
• report separately the levels of mild, moderate and severe anaemia, to allow evaluation of programme effectiveness, reveal changes over time and identify vulnerable populations
• aim to improve women’s overall nutritional status and access to resources
• integrate programmes for hookworm eradication, malaria prophylaxis and other micronutrient deficiencies
• investigate why previous iron supplementation programmes have not been effective in reducing anaemia prevalence
• devise new and innovative strategies to improve the overall health and nutrition status of adolescent girls before they enter their reproductive years
• improve household socio-economic status and maternal education.

Source(s):
‘The burden of anaemia among women in India’, European Journal of Clinical Nutrition 57: 52-60, by M. Bentley and P. Griffiths, 2003 Full document.

Funded by: Ford Foundation, India; Andrew Mellon Foundation

id21 Research Highlight: 10 April 2003

Further Information:
Margaret E. Bentley
Professor of Nutrition and
Associate Dean of Global Health
School of Public Health
4115C McGavran-Greenberg
University of North Carolina
Chapel Hill, North Carolina 27516

Tel:   +1 919 843 9962
Fax: +1 919 966 8392
Contact the contributor: mbentley@sph.unc.edu

University of North Carolina, USA

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