Is Infant/Toddler Anemia a Problem across Rural China? A Mixed-Methods Analysis.

Lei Wang,Mengjie Li,Maggie Lee,Scott Rozelle,Yonglei Sun,Lijuan Zheng,Yu Bai,Buyao Liu,Annie Osborn

doi:10.3390/ijerph15091825

Abstract

In the past, iron-deficiency anemia in children has had a widespread presence in rural China. Given the recent economic growth in China, it is unclear if anemia among infants/toddlers remains a problem. The objective of this study is to measure the anemia rate in rural Chinese infants/toddlers across four major subpopulations and attempt to discover the sources of anemia. We use a mixed-methods approach combining quantitative data on 2909 rural Chinese infants/toddlers and their families with qualitative interviews with 84 caregivers of infants aged 6 to 30 months. Quantitative analysis indicates that the overall prevalence of anemia (43%) within sampled infants/toddlers was high, especially in comparison to the low rates of stunting (2–5%), being underweight (2%), and wasting (2–4%). These findings suggest that in rural China, anemia stems from the poor quality of the diets of infants/toddlers, rather than insufficient quantities of food being consumed. Qualitative analysis illustrates the factors that are contributing to anemia. Caregivers do not understand the causes of this condition, the symptoms that would lead one to recognize this condition, or the steps needed to treat their child with this condition. The findings offer a comprehensive understanding of the limited awareness of anemia among rural Chinese caregivers.

Highlights

Iron-deficiency anemia is a micronutrient deficiency common among infants in developing countries
We examine the relationship between anemia status and the characteristics of the infants/toddlers and households in each of the study’s four rural subpopulations
The second hypothesis can be broken down into four sub-hypotheses: (a) caregivers misunderstand the real cause of anemia; (b) caregivers misunderstand how anemia affects their child; (c) caregivers do not know how to assess whether their infants/toddlers have anemia; and/or (d) caregivers do not understand how to treat anemia

Summary

Introduction

Iron-deficiency anemia is a micronutrient deficiency common among infants in developing countries. The delays resulting from anemia can affect numerous outcomes later in life, including educational attainment, employment, and earnings [3,11,12,13,14]. Several studies have found high rates of anemia among infants in poor, remote rural areas of China, especially mountainous regions. In southern Shaanxi province, roughly half of infants aged 6–12 months living in villages located in nationally designated poverty counties were anemic (48.8% [15]; 50.5% [16]). In one autonomous Tibetan prefecture of the Qinghai province, 64.7% of children aged 6–35 months living in the prefecture’s nationally designated poverty counties suffered from anemia [17]. In poor rural areas of Guangxi province, 22.6% of children aged 0–24 months

Objectives

Methods

Results

Discussion

Conclusion