Distribution and Determinants of Anemia Among Reproductive Age Group Women in India: An Insight From the Fifth Round of the National Family Health Survey (2019–21)

Background and Objective: As per the National Family Health Surveys (NFHS) rounds four and five, the proportion of women of reproductive age affected by anemia has risen from 53.1% in 2015-16 to 57% in 2019-21. Despite extensive governmental interventions, this upward trend suggests evolving determinants contributing to anemia. Therefore, the present study seeks to examine the sociodemographic, maternal, reproductive, behavioral, and environmental factors linked to anemia among women of reproductive age. Methods: A secondary analysis was performed using data from NFHS-5, encompassing 724,115 women aged 15-49 years. The severity of anemia was classified into categories, and binary logistic regression was applied to determine the adjusted odds ratios (aORs) along with their corresponding 95% confidence intervals. Sample weights were calculated, and a complex sampling design was applied to present the results. Results: A high prevalence of anemia, 57% (56.8%-57.3%), was observed among the reproductive age group females in India. Younger age females (35 years [aOR = 0.94 (0.92-0.96). Having three or more under-five children [aOR: 1.05 (1.01-1.09)], lactation [aOR: 1.17 (1.15-1.20)], and a history of termination of pregnancy [aOR: 1.04 (1.02-1.06)] were the significant factors, and use of modern contraceptive methods was a protective factor [aOR: 0.97 (0.96-0.99)] for anemia. Interpretation and Conclusions: This study shows a higher prevalence of anemia among reproductive-age group females. Addressing these identified risk factors through an innovative targeted approach will better address anemia among Indian women during their reproductive years.