Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data

PLoS One. 2023 Feb 2;18(2):e0281015. doi: 10.1371/journal.pone.0281015. eCollection 2023.


Background: The common cause of anemia in the general population is iron deficiency. Anemia is adversely affecting women of reproductive age and child health which in turn results in increased morbidity and maternal death, and also hamper social-economic growth. Reproductive women are more prone to anemia due to inadequate dietary intake and iron loss during menstruation and pregnancy.

Objectives: This study examined the level and trend of anemia prevalence among the socially disadvantaged group (SC&ST, OBC) of women as compared to the other women (general) and identified the main responsible factors behind this.

Data and methods: The data for this analysis has been taken from three rounds of National Family Health Survey (NFHS) conducted during 2005-2006 (NFHS 3), 2015-16 (NFHS 4) and 2019-21 (NFHS 5). Univariate and bivariate analyses were used to assess the level of anemia among reproductive age group women of different social groups. The regression model represents the relative risk of different confounding factors on the occurrence of anemia. GIS technique used for graphical representation of anemia prevalence rate among different social groups of women in different states of India.

Result: In India more than 15 states belong to the high prevalence (>%55) of anemia among socially backward groups in 2019-21. The anemia prevalence was high (>55%) in all social groups (SC & ST, OBC, general) observed in 7 states in NFHS-3, 4 in NFHS-4 and 11 states in NFHS-5. The overall result reveals that the SC&ST women were more prone to any anemia than OBC and general women and the prevalence rate slightly increased from 2005-06 to 2019-21. Among all variables, economic status dominantly controls the anemia level in all social groups. Anemia prevalence of the poor and poorest group of general women were much worse than the women of richer and richest groups of SC&ST, OBC. The odds of women having anemia were lower among higher educated and urban women as compared to the non educated and rural women, irrespective of social group. The prevalence of anemia decreases with increased age of women and increases with the number of child bearing. All differences were statistically significant.

Conclusions: The problem of iron deficiency remains a major issue in India, where the majority of the states (eastern, north-eastern and central) suffer from high anemia prevalence rate and it increases over time. It is observed that multiple socio-demographic factors ranging from poor economic and educational status, rural residence to higher childbearing of women are responsible for predicting anemia levels among the social groups of women in India. To eradicate this problem India should improve women's overall nutrition status and their income. Meanwhile, GOI should be more focused on the existing policies related to anemia and on their actual implementation on grassroots level.

MeSH terms

  • Anemia* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • India / epidemiology
  • Iron Deficiencies*
  • Pregnancy
  • Prevalence
  • Social Group

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.