Prevalence and Determinants of Iron Deficiency Anemia Among Pregnant Women and Adolescent Girls
DOI
https://doi.org/10.64146/gd5ad854
Keywords:
Nutritional status, socio-economic determinants, reproductive-age women, public health interventionAbstract
Anemia among women of reproductive age is one of India's most persistent nutritional problems, and its burden is not spread evenly across the country. Bihar and Uttar Pradesh, two of the most populous states, record some of the highest rates, yet few studies examine pregnant women and adolescent girls side by side in these settings. This study estimated anemia prevalence and identified its determinants in both groups. We analysed cross-sectional data from the fifth round of the National Family Health Survey (2019 to 2021), covering 4,847 pregnant women and 21,358 adolescent girls aged 15 to 19 years. Anemia was classified using standard haemoglobin thresholds measured from capillary blood, and multivariable logistic regression assessed associated factors. Anemia affected 63.1 percent of pregnant women in Bihar and 50.4 percent in Uttar Pradesh; among adolescent girls the figures were 63.5 and 49.8 percent. Low maternal education, the poorest wealth quintile, Scheduled Caste or Tribe membership, rural residence, higher parity, and short birth spacing carried higher odds of anemia. Coverage of iron and folic acid supplementation stayed low in both states. The findings support state-specific programmes that reach girls well before they become pregnant.
References
Cahyani, I. (2025). The Relationship between Diet and the Incidence of Gastroesophageal Reflux Disease in Boarding School Students. HealthSmart: Jurnal Kesehatan Masyarakat, 1(1), 1–13. https://doi.org/10.64146/WN1XN988 DOI: https://doi.org/10.64146/wn1xn988
Chakrabarty, M., Singh, A., Singh, S., & Chowdhury, S. (2023). Is the burden of anaemia among Indian adolescent women increasing? Evidence from Indian Demographic and Health Surveys (2015-21). PLOS Global Public Health, 3(9), e0002117. https://doi.org/10.1371/journal.pgph.0002117 DOI: https://doi.org/10.1371/journal.pgph.0002117
Chandratika, I. (2025). Effectiveness of Moringa Extract Liquid Supplement on Increasing Children’s Appetite in the Cerdas and Insani Playgroup. Jurnal Gizi Dan Teknologi Pangan : Nutrismart, 1(1), 36–51. https://doi.org/10.64146/3483VP48 DOI: https://doi.org/10.64146/3483vp48
Chauhan, S., Kumar, P., Marbaniang, S. P., Srivastava, S., & Patel, R. (2022). Prevalence and predictors of anemia among adolescents in Bihar and Uttar Pradesh, India. Scientific Reports, 12(1), 8197. https://doi.org/10.1038/s41598-022-12258-6 DOI: https://doi.org/10.1038/s41598-022-12258-6
Daryati, M., Hamzah, & Sari, D. L. (2026). The Relationship Between Nutrition Knowledge and Feeding Style with Nutritional Status in Early Childhood Education Institutions. Jurnal Gizi Dan Teknologi Pangan : Nutrismart, 2(1), 1–14. https://doi.org/10.64146/XN7MQ741 DOI: https://doi.org/10.64146/xn7mq741
Fadillah, & Suryadi, D. (2025). The Relationship Between Parenting Patterns and Balanced Nutritional Intake with Nutritional Status of Young Children. HealthSmart: Jurnal Kesehatan Masyarakat, 1(1), 52–65. https://doi.org/10.64146/7G6T1B06 DOI: https://doi.org/10.64146/7g6t1b06
Gutema, B. T., Sorrie, M. B., Megersa, N. D., Yesera, G. E., Yeshitila, Y. G., Pauwels, N. S., De Henauw, S., & Abbeddou, S. (2023). Effects of iron supplementation on cognitive development in school-age children: A systematic review and meta-analysis. PLOS ONE, 18(6), e0287703. https://doi.org/10.1371/journal.pone.0287703 DOI: https://doi.org/10.1371/journal.pone.0287703
Harjadinta, & Susanty, Y. E. (2025). The Role of Fast-Food Consumption Patterns in The Incidence of Obesity in Adolescents. HealthSmart: Jurnal Kesehatan Masyarakat, 1(1), 66–77. https://doi.org/10.64146/0GR58S35 DOI: https://doi.org/10.64146/0gr58s35
Jeevan, J., Karun, K. M., Puranik, A., Deepa, C., Lintu, M. K., & Barvaliya, M. (2025). Prevalence of anemia in India: A systematic review, meta-analysis and geospatial analysis. BMC Public Health, 25(1), 1270. https://doi.org/10.1186/s12889-025-22439-3 DOI: https://doi.org/10.1186/s12889-025-22439-3
Kulkarni, B., Peter, R., Ghosh, S., Pullakhandam, R., Thomas, T., Reddy, G. B., Mohan, V. R., Kurpad, A. V, & Sachdev, H. P. S. (2021). Prevalence of iron deficiency and its sociodemographic patterning in Indian children and adolescents: Findings from the Comprehensive National Nutrition Survey 2016-18. The Journal of Nutrition, 151(8), 2422–2434. https://doi.org/10.1093/jn/nxab145 DOI: https://doi.org/10.1093/jn/nxab145
Kumar, S. B., Arnipalli, S. R., Mehta, P., Carrau, S., & Ziouzenkova, O. (2022). Iron deficiency anemia: Efficacy and limitations of nutritional and comprehensive mitigation strategies. Nutrients, 14(14), 2976. https://doi.org/10.3390/nu14142976 DOI: https://doi.org/10.3390/nu14142976
Kuppusamy, P., Prusty, R. K., & Khan, S. A. (2024). Assessing the prevalence and predictors of anemia among pregnant women in India: Findings from the India National Family Health Survey 2019-2021. Current Medical Research and Opinion, 40(1), 51–58. https://doi.org/10.1080/03007995.2023.2276851 DOI: https://doi.org/10.1080/03007995.2023.2276851
Let, S., Tiwari, S., Singh, A., & Chakrabarty, M. (2024). Prevalence and determinants of anemia among women of reproductive age in Aspirational Districts of India: An analysis of NFHS 4 and NFHS 5 data. BMC Public Health, 24(1), 437. https://doi.org/10.1186/s12889-024-17789-3 DOI: https://doi.org/10.1186/s12889-024-17789-3
Maheshwari, S., Sinha, R., Patel, N., Kaiwan, O., Goyal, A., Padda, I., Uniyal, N., Suhail, M. K., Bin Emran, T., Kaka, N., & Sethi, Y. (2025). Socio-epidemiological correlates of anemia among non-pregnant females of East and West Uttar Pradesh, India: A NFHS-5 secondary data analysis. Public Health Challenges, 4(1), e70102. https://doi.org/10.1002/puh2.70102 DOI: https://doi.org/10.1002/puh2.70102
Merid, M. W., Chilot, D., Alem, A. Z., Aragaw, F. M., Asratie, M. H., Belay, D. G., & Kibret, A. A. (2023). An unacceptably high burden of anemia and its predictors among young women (15-24 years) in low- and middle-income countries. BMC Public Health, 23(1), 1292. https://doi.org/10.1186/s12889-023-16187-5 DOI: https://doi.org/10.1186/s12889-023-16187-5
Ministry of Health, & Welfare, F. (2018). Anemia Mukt Bharat: Intensified National Iron Plus Initiative - Operational guidelines for program managers.
Ministry of Health, Welfare, F., UNICEF, & Population Council. (2019). Comprehensive National Nutrition Survey (CNNS) 2016-18: National report. https://doi.org/10.21203/rs.3.rs-3456246/v1 DOI: https://doi.org/10.21203/rs.3.rs-3456246/v1
Rai, R. K., Kumar, S. S., & Kumar, C. (2022). Factors associated with minimum dietary diversity failure among Indian children. Journal of Nutritional Science, 11, e4. https://doi.org/10.1017/jns.2022.2 DOI: https://doi.org/10.1017/jns.2022.2
Sachdev, H. P. S., Porwal, A., Acharya, R., Ashraf, S., Ramesh, S., Khan, N., Johnston, R., Sarna, A., Nair, K. M., Ramakrishnan, L., Abraham, R. A., Deb, S., Khera, A., & Saxena, R. (2021). Hemoglobin thresholds to define anemia in a national sample of healthy children and adolescents aged 1-19 years in India: A population-based study. The Lancet Global Health, 9(6), e822–e831. https://doi.org/10.1016/S2214-109X(21)00077-2 DOI: https://doi.org/10.1016/S2214-109X(21)00077-2
Samson, K. L. I., Fischer, J. A. J., & Roche, M. L. (2022). Iron status, anemia, and iron interventions and their associations with cognitive and academic performance in adolescents: A systematic review. Nutrients, 14(1), 224. https://doi.org/10.3390/nu14010224 DOI: https://doi.org/10.3390/nu14010224
Sarna, A., Porwal, A., Ramesh, S., Agrawal, P. K., Acharya, R., Johnston, R., Khan, N., Sachdev, H. P. S., Nair, K. M., Ramakrishnan, L., Abraham, R., Deb, S., Khera, A., & Saxena, R. (2020). Characterization of the types of anemia prevalent among children and adolescents aged 1-19 years in India: A population-based study. The Lancet Child & Adolescent Health, 4(7), 515–525. https://doi.org/10.1016/S2352-4642(20)30094-8 DOI: https://doi.org/10.1016/S2352-4642(20)30094-8
Scott, S., Lahiri, A., Sethi, V., de Wagt, A., Menon, P., Yadav, K., Varghese, M., Joe, W., Vir, S. C., & Nguyen, P. H. (2022). Anemia in Indians aged 10-19 years: Prevalence, burden and associated factors at national and regional levels. Maternal & Child Nutrition, 18(4), e13391. https://doi.org/10.1111/mcn.13391 DOI: https://doi.org/10.1111/mcn.13391
Shinde, S., Madzorera, I., & Fawzi, W. W. (2021). Association of iron supplementation and dietary diversity with nutritional status and learning outcomes among adolescents: Results from a longitudinal study in Uttar Pradesh and Bihar, India. Journal of Global Health, 11, 4037. https://doi.org/10.7189/jogh.11.04037 DOI: https://doi.org/10.7189/jogh.11.04037
Sunuwar, D. R., Singh, D. R., Pradhan, P. M. S., Shrestha, V., Rai, P., Shah, S. K., & Adhikari, B. (2023). Factors associated with anemia among children in South and Southeast Asia: A multilevel analysis. BMC Public Health, 23(1), 343. https://doi.org/10.1186/s12889-023-15265-y DOI: https://doi.org/10.1186/s12889-023-15265-y
Talin, I. A., Abid, M. H., Samad, M. A., Dom’inguez Azpiroz, I., de la Torre Diez, I., & Ashraf, I. (2023). Exploring factors influencing the severity of pregnancy anemia in India using a proportional odds model. Scientific Reports, 13(1), 22816. https://doi.org/10.1038/s41598-023-49860-1 DOI: https://doi.org/10.1038/s41598-023-49872-x
Wangaskar, S. A., Sahu, S. K., Majella, M. G., & Rajaa, S. (2021). Prevalence of anemia and compliance with the weekly iron-folic acid supplementation program amongst adolescents in selected schools of urban Puducherry, India. Nigerian Postgraduate Medical Journal, 28(1), 44–50. https://doi.org/10.4103/npmj.npmj_336_20 DOI: https://doi.org/10.4103/npmj.npmj_336_20
World Health Organization. (2021). Anemia in women and children: WHO global anemia estimates, 2021 edition. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children
Yadav, K., Ramaswamy, G., Puri, S., Vohra, K., Achary, T., Jaiswal, A., Kumar, R., & Vatsa, R. (2024). Prevalence and determinants of anemia due to micronutrient deficiencies among children aged 12-59 months in India: Evidence from the Comprehensive National Nutrition Survey 2016-18. PLOS Global Public Health, 4(1), e0002095. https://doi.org/10.1371/journal.pgph.0002095 DOI: https://doi.org/10.1371/journal.pgph.0002095
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