Socio-demographic factors associated with anaemia among non-pregnant and non-lactating women from low-income families in two selected districts of Madhya Pradesh state of India: a random forest analysis
Keywords:Anaemia, IFA supplementation, NPNLW, Mass media, Food fortification, low-income families, National iron plus initiative program
Background: Anaemia is one of the most common public health challenges. The objective of this paper was to estimate the prevalence of anaemia among non-pregnant and non-lactating women (NPNLW) (15-49 years) from low-income families and to assess the associations between socio-demographic and economic factors, and the prevalence of anaemia.
Methods: Primary data of non-pregnant and non-lactating women of reproductive age (15 to 49 years) from low-income families collected from two selected districts of Madhya Pradesh state, India were used. Inferential statistical tools like; multiple binary logistic regressions and random forest analysis were adopted to assess the socio-demographic and economic factors associated with anaemia.
Results: The results revealed that prevalence of anaemia in both the districts are quite high at 60.8% (95% CI: 58.6%, 62.9%) in Vidisha to 63.7% (95% CI: 61.6%, 65.7%) in Raisen with mean haemoglobin levels of 11.27±1.92 g/dl in Vidisha to 11.24±1.70 g/dl in Raisen, which is close to <12 g/dl cut-off based on WHO categorization. It was also found that those who are from the scheduled caste and other castes were less likely to be anaemic compared to those who were from scheduled tribes in Vidisha district. Majority of women not consuming iron supplements were found to be anaemic.
Conclusions: Education was observed to be the most predominant factor inversely associated with anaemia. Age and the type of household were also found to be associated factors. Along with supplementation and nutrition education, fortification of foods is also recommended in addressing the anaemia burden.
Benoist B, McLean E, Egli I, Cogswell M. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. Available at: https://www.who. int/publications/i/item/9789241596657. Accessed on 20 November 2021.
National Family Health Survey 2017 (NFHS-4). Available at: https://www.rchiips.org/nfhs/nfhs4. shtml. Accessed on 20 November 2021.
Kalaivani K. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res. 2009;130(5):627-33.
Special Bulletin on Maternal Mortality in India 2014-16. Available at: http://www.censusindia.gov.in/vital_ statistics/SRS_Bulletins/MMR%20Bulletin-2014-16.pdf. Accessed on 20 November 2021.
Kumar A. National nutritional anaemia control programme in India. Indian J of Public Health. 1999;43(1):3-5.
Rai RK, Fawzi WW, Barik A, Chowdhury A. The burden of iron-deficiency anaemia among women in India: how have iron and folic acid interventions fared?. WHO South-East Asia J Public Health. 2018;7(1):18-23.
Horton S, Mannar V, Wesley A. Second copenhagen consensus: micronutrient fortification best practice. Available at: https://www.copenhagenconsensus. com/. Accessed on 20 November 2021.
India: Census 2011 office of the registrar general & census commissioner, India. Available at: http://censusindia.gov.in/. Accessed on 20 November 2021.
District level population projections in eight selected states of India 2006-2016. Available at: https:// District_level_population_projections_in_selected_staties_of_India_-_2006_to_2016. Accessed on 20 November 2021.
Little M, Zivot C, Humphries S, Dodd W, Patel K, Dewey C. Burden and determinants of anemia in a rural population in south india: a cross-sectional study. Anemia. 2018;2:34-8.
Lokare PO, Karanjekar VD, Gattani PL, Kulkarni AP. A study of prevalence of anemia and sociodemographic factors associated with anemia among pregnant women in Aurangabad city, India. Ann Nigerian Med. 2012;6:30-4.
Titaley CR, Rahayu E, Damayanti R, Dachlia D, Sartika RAD, Ismail A, et al. Association between knowledge and compliance of taking iron/folic acid supplements during pregnancy. Asian J Pharm Clin Res. 2017;22:159-65.
Bentley ME and Griffiths PL. The burden of anemia among women in India. EJCN. 2003;57:52-60.
Gautam VP, Bansal Y, Taneja DK, Saha R. Prevalence of anemia amongst pregnant women and its socio-demographic associates in a rural area of Delhi. IJCM. 2002;27(4):157-60.
Balarajan Y, Fawzi W, Subramanian SV. Changing patterns of social inequalities in anaemia among women in India: cross-sectional study using nationally representative data. CMJ. 2013;3:23-9.
Coffey D, Geruso M, Spears D. Sanitation, disease externalities and anaemia: evidence from Nepal. EJ. 2017;12:1395-432.
Patil SR, Arnold BF, Salvatore AL, Criceno B, Ganguly S, Colford JM, et al. The effect of India’s total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: A cluster randomized controlled trial. PLOS. 2017;11(8):e1001709.
Lone FA, Qureshi RN, Emanuel F. Maternal anemia and its impact on perinatal outcome. Trop Med Int Health. 2004;9(4):12-8.
Arora H, Dixit V, Srivastava N. Evaluation of knowledge, practices of vitamin D and attitude toward sunlight among Indian students. Asian J Pharm Clin Res. 2016;9(1):23-9.
Ahluwalia N. Intervention strategies for improving iron status of young children and adolescents in India. Nutr Res. 2002;60(5):23-9.
Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Available at: https://www.who.int/vmnis/indicators/haemoglobin.pdf. Accessed on 20 November 2021.