To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021)
Abstract Background Despite unprecedented socio-economic growth experienced by Indians in the past few decades, and a long history of anti-anaemia public health measures, prevalence of anaemia in Indian non-pregnant women of reproductive age group (NPWRA) has not declined. This warrants a firm under...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-05-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-15838-x |
| _version_ | 1797827303040876544 |
|---|---|
| author | Jyoti Ghosal Madhusmita Bal Manoranjan Ranjit Arundhuti Das Manas Ranjan Behera Sudhir Kumar Satpathy Ambarish Dutta Sanghamitra Pati |
| author_facet | Jyoti Ghosal Madhusmita Bal Manoranjan Ranjit Arundhuti Das Manas Ranjan Behera Sudhir Kumar Satpathy Ambarish Dutta Sanghamitra Pati |
| author_sort | Jyoti Ghosal |
| collection | DOAJ |
| description | Abstract Background Despite unprecedented socio-economic growth experienced by Indians in the past few decades, and a long history of anti-anaemia public health measures, prevalence of anaemia in Indian non-pregnant women of reproductive age group (NPWRA) has not declined. This warrants a firm understanding of what explains the anaemia situation over time, preferably by sub-populations. Therefore, we aimed to examine the trends of anaemia in tribal NPWRA (least privileged) and compare with the trends in the NPWRA of general caste (most privileged) between 1998 to 2021. Additionally, the study also explored explanation of any decline and tribal/general narrowing of these trends. Methods We studied four rounds of National Family Health Survey (1998–99, 2005–06, 2015–16, 2019–21). We examined the trend of anaemia (haemoglobin < 12 g/dl) and its possible determinants in tribal and general NPWRA and estimated the portion of “decline” and “narrowing” that could be explained by the underlying and intermediate determinants (wealth, education, residence, parity and food security) using multiple logistic regression. Results The distribution of determinants improved over 23 years in both the groups but more in tribals. But anaemia either remained unchanged or increased in both except 7.1 points decline in tribals between 2006–2016, leading also to 7 points narrowing of tribal/general gap. The modest attenuation of beta coefficients representing the change of anaemia prevalence (log of odds) in tribals from -0.314(-0.377, -0.251) to -0.242(-0.308, -0.176) after adjustment with determinants could explain only 23% of the decline. Similarly, only 7% of the narrowing of the tribal/general anaemia gap could be explained. Conclusions The structural determinants wealth, education, food security, parity and urban amenities improved immensely in India but anaemia did not decline in this 23-year period. This implies that the “usual suspects” – the structural determinants are not the main drivers of anaemia in the country. The main driver may be absolute and/or functional deficiency status of micronutrients including iron attributable to inadequate uptake and absorption of these elements from Indian diets; and therefore, their effects are noticeable in every socio-economic stratum of India. Future research for aetiologies and new interventions for anaemia alleviation in India may focus on these factors. |
| first_indexed | 2024-04-09T12:46:32Z |
| format | Article |
| id | doaj.art-bcbe42a2967f4269a55ce45c1d5a4681 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-09T12:46:32Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-bcbe42a2967f4269a55ce45c1d5a46812023-05-14T11:30:18ZengBMCBMC Public Health1471-24582023-05-0123111210.1186/s12889-023-15838-xTo what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021)Jyoti Ghosal0Madhusmita Bal1Manoranjan Ranjit2Arundhuti Das3Manas Ranjan Behera4Sudhir Kumar Satpathy5Ambarish Dutta6Sanghamitra Pati7School of Public Health, KIIT Deemed to be UniversityICMR-Regional Medical Research CenterICMR-Regional Medical Research CenterICMR-Regional Medical Research CenterSchool of Public Health, KIIT Deemed to be UniversitySchool of Public Health, KIIT Deemed to be UniversityIndian Institute of Public Health, Public Health Foundation of IndiaICMR-Regional Medical Research CenterAbstract Background Despite unprecedented socio-economic growth experienced by Indians in the past few decades, and a long history of anti-anaemia public health measures, prevalence of anaemia in Indian non-pregnant women of reproductive age group (NPWRA) has not declined. This warrants a firm understanding of what explains the anaemia situation over time, preferably by sub-populations. Therefore, we aimed to examine the trends of anaemia in tribal NPWRA (least privileged) and compare with the trends in the NPWRA of general caste (most privileged) between 1998 to 2021. Additionally, the study also explored explanation of any decline and tribal/general narrowing of these trends. Methods We studied four rounds of National Family Health Survey (1998–99, 2005–06, 2015–16, 2019–21). We examined the trend of anaemia (haemoglobin < 12 g/dl) and its possible determinants in tribal and general NPWRA and estimated the portion of “decline” and “narrowing” that could be explained by the underlying and intermediate determinants (wealth, education, residence, parity and food security) using multiple logistic regression. Results The distribution of determinants improved over 23 years in both the groups but more in tribals. But anaemia either remained unchanged or increased in both except 7.1 points decline in tribals between 2006–2016, leading also to 7 points narrowing of tribal/general gap. The modest attenuation of beta coefficients representing the change of anaemia prevalence (log of odds) in tribals from -0.314(-0.377, -0.251) to -0.242(-0.308, -0.176) after adjustment with determinants could explain only 23% of the decline. Similarly, only 7% of the narrowing of the tribal/general anaemia gap could be explained. Conclusions The structural determinants wealth, education, food security, parity and urban amenities improved immensely in India but anaemia did not decline in this 23-year period. This implies that the “usual suspects” – the structural determinants are not the main drivers of anaemia in the country. The main driver may be absolute and/or functional deficiency status of micronutrients including iron attributable to inadequate uptake and absorption of these elements from Indian diets; and therefore, their effects are noticeable in every socio-economic stratum of India. Future research for aetiologies and new interventions for anaemia alleviation in India may focus on these factors.https://doi.org/10.1186/s12889-023-15838-xAnaemiaTrendWomen of reproductive age groupTribalsNFHSIndia |
| spellingShingle | Jyoti Ghosal Madhusmita Bal Manoranjan Ranjit Arundhuti Das Manas Ranjan Behera Sudhir Kumar Satpathy Ambarish Dutta Sanghamitra Pati To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) BMC Public Health Anaemia Trend Women of reproductive age group Tribals NFHS India |
| title | To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) |
| title_full | To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) |
| title_fullStr | To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) |
| title_full_unstemmed | To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) |
| title_short | To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998–2021) |
| title_sort | to what extent classic socio economic determinants explain trends of anaemia in tribal and non tribal women of reproductive age in india findings from four national family heath surveys 1998 2021 |
| topic | Anaemia Trend Women of reproductive age group Tribals NFHS India |
| url | https://doi.org/10.1186/s12889-023-15838-x |
| work_keys_str_mv | AT jyotighosal towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT madhusmitabal towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT manoranjanranjit towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT arundhutidas towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT manasranjanbehera towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT sudhirkumarsatpathy towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT ambarishdutta towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 AT sanghamitrapati towhatextentclassicsocioeconomicdeterminantsexplaintrendsofanaemiaintribalandnontribalwomenofreproductiveageinindiafindingsfromfournationalfamilyheathsurveys19982021 |