How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6–59 Months Old Children in India?

Abstract

Objectives: The study sought to identify whether iron and folic acid supplementation of pregnant women and preschool children is associated with child's anemia status and the predictors of anemia among children in India. Design: Secondary data analysis was performed using the National Family Health Survey 4 data. Multivariable logistic regression was used to identify the adjusted associations between child's anemia status and iron supplementation, both during pregnancy and childhood. Also, a model of significant predictors of anemia among children was fitted. Setting: India. Participants: Youngest children (6-59 months) in families. Results: The adjusted association between supplementation during pregnancy and child's anemia status was significant (p = 0.010), whereas the adjusted association between supplementation during childhood and child's anemia status was insignificant (p = 0.16). The variables independently associated with anemia status of the child included younger age (95% CI 2.67-2.86), child's recent diarrhea (95% CI 1.02-1.14), low birth weight (95% CI 1.17-1.27), current underweight (95% CI 1.14-1.28), diet diversity score (95% CI 0.96-0.98), higher birth order (95% CI 1.01-1.05), mother's current anemia (95% CI 1.68-1.81), months of breastfeeding (95% CI 0.99-1.00), no/primary education (95% CI 1.23-1.35), family's low wealth index (95% CI 1.11-1.23), and backward caste (95% CI 1.04-1.14). Conclusions: The National Iron Plus Initiative strategy of child's iron supplementation should be evaluated to identify the reasons of its ineffectiveness in anemia reduction. In addition, vulnerable groups of children, i.e., children from poor and less educated families and those with low birth weight, higher birth order, and poor nutritional status, should be targeted first with anemia reduction interventions.

Regional Differences in the Prevalence of Anaemia and Associated Risk Factors among Infants Aged 0–23 Months in China: China Nutrition and Health Surveillance

“…Our study found that a higher level of maternal education and residence in economically developed areas were associated with lower odds of developing anaemia. This observation is in concordance with findings from Ghana [ 21 ], Guinea [ 22 ], India [ 23 , 24 ] and other studies in China [ 25 ]. Although the socioeconomic indicators for China (e.g., food expenditure, average disposable income and gross domestic product per capita) have increased in both urban and rural areas over the past decades [ 26 , 27 ], holistic socioeconomic conditions remain better in urban and Eastern/Central areas than in rural and Western areas [ 28 ].…”

“…Many studies have demonstrated that maternal and reproductive health (e.g., premature birth, LBW, low maternal birth age) are associated with a higher risk of developing childhood anaemia [ 23 , 29 , 30 ]. Consistent with these results, our study showed that these risk factors were strongly associated with higher odds of developing anaemia among Chinese infants aged 0–23 months.…”

Anemia Among Children Under 5 Years in India: A District-Level Spatial Analysis Using NFHS-5 Data

“…A positive association between the proportion of three or four births in 5 years and childhood anemia was observed in the districts of Gujarat, Maharashtra, Goa, Karnataka, and Kerala. As reported by Thomas et al, 18 children in the anemic group had higher mean birth order compared with those in the nonanemic group. With each unit increase in the birth order, a child was at a 3.0% increased likelihood of being anemic.…”

“…Varghese et al 17 attribute this continuing burden of anemia to dietary and environmental reasons. Thomas et al 18 reported a significant association between supplementation during pregnancy and child's anemia status. Based on the results in our study, districts belonging to Kerala, Himachal Pradesh, and Jammu & Kashmir showed a highly negative association between proportion of mothers who consumed IFA for 100 days or more when they are pregnant and the outcome.…”

“…Primary and Secondary SaTScan Analysis Result of Children Aged 6 to 59 Months Who Are Anemic. ,30, 35, 29, 54, 55, 57, 42, 31, 50, 39, 36, 28, 56, 41, 32, 33, 37, 38, 40,14,17,18,19,25,24,23, 34,16,20,15,22,21, 44, 43, 221, 53, 67, 68, 92, 227, 91, 229, 242, 49, 77, 94, 65, 231, 230, 61, 237, 223, 241, 45, 222, 234, 46, 238, 93, 62, 52, 228, 209, 232, 99, 218, 235, 225, 63, 236, 47, 69, 246, 351, 75, 216, 64, 233, 245, 226, 60, 224, 219, 74, 76, 344, 243, 350, 72, 169, 239, 212, 164,357, 220, 48, 240, 168, 377, 66, 89, 244, 73, 340, 211, 71, 180, 165, 215, 359, 210, 353, 355, 349, 217, 70, 247, 90, 58, 335, 182, 59, 331, 95, 354, 181, 342, 361, 178, 339, 363, 174, 347, 167, 173, 362, 674, 341, 186, 332, 356, 446, 170, 376, 343, 172, 360, 424, 675, 676, 366, 429, 171, 443 …”