Document Type : Original Article
Authors
Abstract
BACKGROUND: Anemia is a major public health problem among reproductive‑aged women in India.
Despite many programs implemented for decades to fight anemia, still the prevalence of anemia is
high because its associated factors vary among different regions. This exploratory study was carried
out to find the prevalence of anemia and factors influencing it among nonpregnant reproductive‑aged
women (15–49 years) in a rural area of Coimbatore.
MATERIALS AND METHODS: The study was conducted in the field practice area of Rural Health
Training Centre, PSG IMSR, Coimbatore, during March 2016 to August 2016. Participants were
recruited by two‑staged random sampling method and 426 participants were enrolled. A predesigned
semi‑structured questionnaire was used to collect the data pertaining to the factors influencing the
prevalence of anemia, and their hemoglobin level was measured using a hemoglobin photometer.
The data were analyzed using SPSS‑24. (IBM Corporation, SPSS Inc., Chicago, IL, USA) Univariate
analysis was done using Chi‑square test and the strength of association was estimated by odds
ratio. Those factors which were found to be significant by univariate analysis were further subjected
to multivariate logistic regression analysis. P < 0.05 was considered statistically significant.
RESULTS: The prevalence of anemia was estimated as 64.8% (95% confidence interval: 60%–69%).
Significant predictors for anemia among the study participants were less frequent intake of green
leafy vegetables (adjusted odds ratio [AOR] = 3.65, confidence interval [CI]: 2.17–6.12), low
socioeconomic status (AOR = 3.36, CI: 1.93–5.84), illiteracy (AOR = 3.09, CI: 1.09–5.24), birth
spacing <2 years (AOR = 2.49, CI: 1.19–5.25), excessive menstrual bleeding (AOR = 2.27, CI:
1.09–4.76), and inadequate knowledge regarding anemia (AOR = 2.03, CI: 1.19–3.44).
CONCLUSION: Anemia is still prevalent in high magnitude in reproductive‑aged women, and
measures to prevent and control it are not optimum. Hence, its multifactorial determinants have to
be addressed to alleviate its burden.
Keywords
Worldwide prevalence of anaemia, WHO Vitamin and Mineral
Nutrition Information System, 1993‑2005. Public Health Nutr
2009;12:444‑54.
2. Kaur K. Anaemia ‘A Silent Killer’ among women in India: Present
scenario. Eur J Zoolog Res 2014;3:32‑6.
3. International Institute for Population Sciences (IIPS) and ICF
National Family Health Survey (NFHS‑4), 2015–16: India.
Available from: http://mohfwnicin/nfhsfactsheethtm. [Last
accessed on 2020 Sep 02].
4. DeMaeyer E, Adiels‑Tegman M. The prevalence of anaemia in
the World. World Health Stat Q 1985;38:302‑16.
5. National Nutrition Monitoring Bureau. Hyderabad NNMB. Diet
& nutritional status of population and prevalence of hypertension
among adults in rural areas. National Institute of Nutrition,
2006. Available from: https://www.nin.res.in/downloads
/NNMBReport06Nov20.pdf. [Last accessed on 2021 Mar 26].
6. USAID. United States Agency International Development.
Geneva, Switzerland: Health Report, USAID; 2013.
7. Gopalan C, Rama S, Balasubramanian S. Nutritive Value of
Indian. Foods‑Revised ed. Hyderabad, India: National Institute
of Nutrition, Indian Council of Medical Research; 1989. p. 50.
8. World Health Organization. Physical Status: The Use of and
Interpretation of Anthropometry, Report of a WHO Expert
Committee. Geneva, Switzerland: World Health Organization;
1995.
9. Johns W, Lewis SM. Primary health screening by
haemoglobinometry in a tropical community. Bull World Health
Organ 1989;67:627.
10. Akhtar K, SherwaniRK, Rahman K, Hasan J, Shahid M. HemoCue
photometer: A better alternative of hemoglobin estimation in
blood donors? Indian J Hematol Blood Transfus 2008;24:170‑2.
11. World Health Organization. United Nations Children’s
Fund (2004) Focusing on Anaemia: Towards an Integrated
Approach for Effective Anaemia Control. Joint Statement by the
World Health Organization and the United Nations Children’s
Fund Geneva: World Health Organization; 2011.
12. YipR. Forging effective strategies to combat iron deficiency‑plenary
papers‑prevention and control of Iron deficiency: Policy and
Strategy Issues. J Nutr 2002;132:802S.
13. Thankachan P, Muthayya S, Walczyk T, Kurpad AV, Hurrell RF.
An analysis of the etiology of anemia and iron deficiency in young
women of low socioeconomic status in Bangalore, India. Food
Nutr Bull 2007;28:328‑36.
14. Ramachandran P. Food fortification: A public health approach to
bridge the gap between requirement and intake of micronutrients.
Proceed Indian Natl Sci Acad 2018;84:913‑22.
15. Rao S, Joshi S, Bhide P, Puranik B, Kanade A. Social dimensions
related to anaemia among women of childbearing age from rural
India. Public Health Nutr 2011;14:365‑72.
16. Ramachandran P. Nutrition in Pregnancy. In: Gopalan C, Kaur S,
editors. Women and nutrition in India, Special Publication No. 5.
New Delhi: Nutrition Foundation of India; 1989. p. 153‑93. 19.
17. Balarajan YS, Fawzi WW, Subramanian SV. Changing patterns
of social inequalities in anaemia among women in India:
Cross‑sectional study using nationally representative data. BMJ
Open 2013;3:e002233.
18. Rajaratnam J, Abel R, Ganesan C, Jayaseelan SA. Maternal
anaemia: A persistent problem in rural Tamil Nadu. Natl Med J
India 2000;13:242‑5.
19. Venkatachalam J, Muthu R, Singh Z, Madhanraj K, Sathya G.
Determinants of anemia among women in the age group of 11‑49‑A
case control study in a rural area of Kancheepuram district, Tamil
Nadu. EXCEL Int J Multidisci Manage Stud 2014;4:218‑23.
20. Gebremedhin S, Enquselassie F. Correlates of anemia among
women of reproductive age in Ethiopia: Evidence from Ethiopian
DHS 2005. Ethiop J Health Dev 2011;25:22‑30.
21. Ngnie‑Teta I, Kuate‑Defo B, Receveur O. Multilevel modelling of
sociodemographic predictors of various levels of anaemia among
women in Mali. Public Health Nutr 2009;12:1462‑9.
22. Swarnlatha N. Prevalence of anaemia and its socio demographic
determinants among pregnant women attending government
maternity hospital, Tirupati, AP. Sudan J Public Health
2013;8:104‑6.
23. Alquaiz AM, Gad Mohamed A, Khoja TA, Alsharif A, Shaikh SA,
Al Mane H, et al. Prevalence of anemia and associated factors in
child bearing age women in Riyadh, Saudi Arabia. J Nutr Metab
2013;1‑7. https://doi.org/10.1155/2013/636585.
24. Asghari S, Mohammadzadegan‑Tabrizi R, Rafraf M, Sarbakhsh P,
Babaie J. Prevalence and predictors of iron‑deficiency anemia:
Women’s health perspective at reproductive age in the suburb
of dried Urmia Lake, Northwest of Iran. J Educ Health Promot
2020;9:332.
25. Kaur S, Deshmukh P, Garg B. Epidemiological correlates of
nutritional anemia in adolescent girls of rural Wardha. Indian J
Commun Med 2006;31:255‑8.
26. Ahmad N, Kalakoti P, Bano R, Syed MMA. The prevalence
of anaemia and associated factors in pregnant women in a
rural Indian community. AMJ 2010; 3:276-280. Doi 10.4066/
AMJ.2010.286.
27. Mamta K, Vibha B. Anaemia: Impact assessment of dietary
intervention on iron status of college going girls. Food Sci Res J
2011;2:76‑9.
28. Adib Rad H, Sefidgar SA, Tamadoni A, Sedaghat S, Bakouei F,
Bijani A, et al. Obesity and iron‑deficiency anemia in women of
reproductive age in northern Iran. JEduc Health Promot 2019;8:115.
29. Agarwal DK, Agarwal KN, Roychoudhry S. Targets in National
Anemia Prophylaxis Programme for pregnant women. Indian
Pediatr 1988;25:319‑22.