Anemia and its determinants from 2015-16 to 2019-21 in India
Data Note provides an update on the prevalence of anemia and its determinants in India
This Data Note provides an update on the prevalence of anemia and its determinants in India at state and district levels, as well as coverage of nutrition-specific and nutrition-sensitive interventions. Data were from the National Family Health Surveys in 2005-06, 2015-2016 and 2019-21. We first report national trends for 8 population groups (Figure 1 below). For each population group, we show anemia prevalence by severity category and at state and district levels using the two latest rounds of data. Lastly, we show recent trends in determinants of anemia and, nutrition and health interventions.
Causes and consequences of anemia
Anemia is a condition defined by low haemoglobin (Hb) levels in the blood, which results in inadequacies to meet the body’s physiological needs of oxygen. Anemia is caused by nutritional and non-nutritional factors, which include deficiencies in micronutrients (iron, folate, and B12), infection and disease, genetic abnormalities, and blood loss. Anemia has been associated with losses in productivity and suboptimal cognition, thus has consequences for human capital and the economy.
India’s strategy to reduce anemia
India has an evidence-based strategy to reduce anemia, Anemia Mukt Bharat (AMB, or Anemia Free India), launched in 2018. Part of the National Health Mission of the Government of India, AMB includes six interventions including:
- iron and folic acid supplementation
- deworming
- behaviour change communication
- testing and treating anemia
- provision of fortified foods through public health programmes
- addressing non-nutritional causes such as malaria, hemoglobinopathies, and fluorosis.
Anemia continues to be a significant public health concern in India among children, adolescent girls, and women. Anemia prevalence among children increased between 2015-16 and 2019-2021, and this was driven by an increase in the prevalence of moderate anemia. Anemia prevalence among other groups changed very little.
Factors that drive anemia reduction — Diet practices require substantial improvement. Only half of women consume dark green leafy vegetables (DGLV) daily and animal source protein at least once per week. Consumption of IFA remains low, with just over one quarter of women consuming 180+ IFA during pregnancy. Sanitation improved substantially at the household level, but women’s educational attainment remains low.
Coverage of anemia interventions differs by intervention type and population group. Nearly 90% of women received IFA during pregnancy in 2019-21. Despite improvements between 2015-16 and 2019-21, deworming during pregnancy failed to reach two-thirds of women in 2019-21. Coverage of IFA and deworming among children improved in most states
Future efforts are needed to improve dietary diversity among women and children. While the provision of IFA is high among women during pregnancy, consumption remains low. Data gaps on anemia interventions targeted towards adolescents and WRA, behaviour communication change, and fortification should be addressed. It is imperative to continue to monitor haemoglobin in the population through large-scale surveys, especially for groups missed by NFHS, such as children aged 6-14 years.
