New Delhi: More and more Indian women are becoming anaemic, show the statistics published in the latest ‘Women and Men in India 2022’ report by the Ministry of Statistics and Programme Implementation (MoSPI), released last week.
Citing data from the National Family Health Survey (NFHS) statistics, the MoSPI report claims that among all women aged 15-49, the prevalence of anaemia has risen to 57 per cent in 2019-21 (NFHS-5) from 53 per cent in 2015-16 (NFHS-4).
Titled Women and Men in India 2022, the report also shows that the number of states where more than half of the women (aged 15-49) were anaemic has also gone up to 25 in NFHS-5 (2019-21) from 21 in NFHS-4 (2015-16).
However, according to MoSPI data analysed by ThePrint, the trend varies across states and Union Territories (UTs), with some eastern states showing a disproportionate rise.
According to US-based academic medical research centre Penn Medicine, “Anaemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.” The number of such red blood cells is determined by looking at haemoglobin levels — usually measured in grams per decilitre (a tenth of a litre or 100 ml).
The MoSPI report’s criteria for anaemia are haemoglobin levels below 11 g per 100 ml for non-pregnant women and 12 g per 100 ml for non-pregnant women. It is adjusted for altitude and smoking habits.
The prevalence of anaemia among non-pregnant women (57.2 per cent) was higher than in pregnant women (52.2 per cent), according to NFHS-5. The ministry report cited iron and folic acid supplements given to women during pregnancy as one of the probable reasons behind the huge difference.
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According to the ministry report, Assam has witnessed the steepest rise in anaemia among women.
In 2015-16, during the fourth round of the NFHS survey, about 46 per cent of women (pregnant and non-pregnant) in Assam were anaemic, which jumped to nearly 66 per cent in 2019-21. This means that for every 100 women in Assam, there were 20 more anaemic women in the 2019-21 round of the survey compared to the previous 2015-16 round.
Assam is followed by the UT of Jammu & Kashmir, where the prevalence of anaemia among women has risen to 66 per cent from 49 per cent. Then comes Ladakh, where the figure has reason to 93 per cent from 78 per cent.
Chhattisgarh, too, recorded a steep rise of around 14 percentage points to 61 per cent in 2019-21 from 47 per cent in 2015-16 .
Barring these two states and two UTs, the sharpest rise in anaemia was noticed in eastern states — to 64.3 per cent from 51 in Odisha, to 67 per cent from 55 in Tripura, to 34.8 per cent from 24.8 in Mizoram, and to 71.4 per cent from 62.5 in West Bengal.
In the western state of Gujarat, too, the prevalence of anaemia had risen by 10 percentage points to 65 per cent from 54.9 in the successive rounds of the survey.
Overall, there were about 21 states and UTs where more than half of the women were anaemic in 2015-16, which rose to 25 in 2019-21 with the addition of Assam, Jammu & Kashmir, Rajasthan (54.4 per cent), Chhattisgarh and Maharashtra (54.2 per cent), and the removal of Delhi, in NFHS-5. More than 54 per cent women in Delhi were anaemic in 2015-16, which has come down to 49.9 per cent by 2019-21, according to the ministry report.
The Union Territories of Lakshadweep and Chandigarh showed the biggest improvements, with the prevalence of anaemia falling to 26 per cent from 46 and to 60 per cent from 76 over the same time period.
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Income levels, environmental factors
According to Penn Medicine, to carry oxygen to different parts of the body, the red blood cells need a certain amount of iron; a deficiency in this can cause anaemia. Iron is further divided into two kinds — heme and non-heme.
According to Harvard University’s School of Public Health, heme iron, mostly prevalent in meat products like certain kinds of seafood, poultry and beef, is better absorbed by the human body. Green leafy vegetables such as spinach and lentils are sources of non-heme iron.
Considering this, the anaemia numbers in Ladakh have come as a surprise to several academic experts who told ThePrint, on the condition of anonymity, that the numbers sound too bad to be true considering the relatively higher share of non-vegetarian food that the people in the UT consume.
However, a lack of nutrition diversity in meals — inclusion of quality sources of proteins, micronutrients — in Indian households could be one of the main reasons behind anaemia, according to professor Aparajita Chattopadhyay of the International Institute of Population Sciences (IIPS), a Mumbai-based population research institute.
Poverty engenders anaemia, Chattopadhyay told ThePrint Tuesday. “If you look towards the eastern states, there is a higher prevalence of poverty.”
“Unlike the western states, they do not have quality resources of proteins, and survive mostly on carbohydrates. Besides that, the groundwater quality in the region is also bad.”
Even being richer doesn’t guarantee a lower level of anaemia, she added. “When people climb up the income levels, they also start consuming junk food and forget nutrition.”
Besides income levels, Chattopadhyay said that there are more overall environmental factors that could explain high levels of anaemia.
Citing her ongoing study (related to anaemia) with Professor Lobsang Bhutia, a research fellow at IIPS, Chattopadhyay told ThePrint that preliminary findings show that anaemia is also linked to viral infectious diseases which are highly prevalent in riverine areas.
“Early findings from our research show that places where anaemia levels are high also report having higher viral infections,” Chattopadhyay said. “Hence, it’s not just the food habits that we need to look at when aiming to reduce anaemia. The goal should be to change the overall macro-environment that improves food diversity and reduces the burden of viral diseases.”
Besides food, one needs to consider other factors like birth spacing, menstrual issues and use of specific contraceptives to help curb/reduce prevalence of anaemia among women, Chattopadhyay adds.
(Edited by Anumeha Saxena)
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