Background
Globally, the prevalence of anemia among women of reproductive age is about 29.4%, and anemia impacts about 40% of pregnant women and more than 20% of non-pregnant women. We conducted a longitudinal observational study of anemia in pregnant and non-pregnant women, and analyzed the association between the prevalence of anemia and sociodemographic characteristics of women in southwest China.
Methods
This study was a longitudinal observational study which involved 640,672 women aged 18–49 years from 129 counties in southwest China. Data were from databases of National Free Preconception Health Examination Project (NFPHEP) and electronic medical records of local hospitals. We adjusted the diagnostic thresholds of anemia for altitude. The prevalence of anemia was expressed in percentages and 95% confidence intervals (95% CI). The association between the prevalence of anemia and sociodemographic characteristics of pregnant and non-pregnant women were analyzed using univariate and multivariate logistic regression method, expressed in crude odds ratio (cOR), adjusted odds ratio (aOR) and 95%CI.
Results
Of the 640,672 participants, 121,254 women suffered from anemia, with the prevalence of 18.9% (95%CI: 18.8–19.0%). From 2014 to 2018, the prevalence of anemia declines from 23.0–16.4%.The prevalence was 21.6% in the first trimester, higher than women in non-pregnancy (17.4%) and women in the third trimester (10.5%). Results from the multivariable logistic regression showed that women aged 18–20 (aOR = 1.28) or over 35 years old (aOR = 1.07), being farmers (aOR = 1.42), being ethnic minorities (aOR: 1.19 ~ 1.73), during the first trimester (aOR = 1.32) were more likely to be anemic.
Conclusions
Although the anemia prevalence of women of reproductive age has been decreasing in recent years, the prevalence of anemia is still high in pregnant and non-pregnant women in southwest China, especially during the first trimester. Women who were older or younger, being farmers, being ethnic minorities were at high risk of anemia. Anemia in women of reproductive age cannot be neglected.
To make environmental management decisions more executive and targeted, it is essential for decision-making to include local residents’ perceptions and preferences for ecosystem services (ES) and biodiversity (BD). This study conducted a questionnaire survey with 386 local residents to explore social perceptions for ES and BD in the Fenghe River watershed. ES contain food from agriculture (AGR), food from livestock (LIV), fresh water (FW), air purification (AP), water purification (WP), water retention (WR), soil retention (SR), aesthetics (AES), recreation (RE), and spirit (SP) in this study. Ranking and Likert scales are combined to identify residents’ preferences for ES and BD. The hypothetical market method is used to identify the willingness to pay for BD and ES. Independent sample T-test, one-way ANOVA, and Spearman correlation are used to analyze preference heterogeneity. The results show that: (1) residents prefer WP, AP, AGR, and FW; (2) 51.3% of respondents are willing to pay a fee for improving ES while 48.7% of respondents are unwilling to pay; (3) residents’ personal and residential factors affect preference heterogeneity. Last, we put forward three management suggestions on controlling environmental pollution, improving residents’ awareness of ES, and establishing a multi-channel fund based on government financial resources for improving ES in the Fenghe River watershed. Integrating stakeholders’ perceptions for ES into decision-making can promote the sustainable development in Fenghe River watershed.
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