Trends in Prevalence and Predictors of Anemia in Adolescents Between the Ages of 15 and 19 Years in India and Its States: Evidence From the National Family Health Survey 2015-16 and 2019-21.

Abstract

Limited research has been conducted on trends in anemia among a nationally representative sample of adolescents in India. We aimed to determine the trends in anemia prevalence and predictors of anemia among adolescents aged between 15 and 19 years in India and its different states. We utilized data from India's National Family Health Survey (NFHS-4) conducted during 2015-16 and NFHS-5 conducted during 2019-2021, comprising 237,446 adolescents aged between 15 and 19 years. The prevalence of anemia was 54% (95% CI 53.8-54.4) in NFHS-4 and 59.2% (CI 58.9-59.5) in NFHS-5. Twenty-one of 28 Indian states and five of eight union territories (UTs) reported an increase, depicting state-wise variation. While Assam, Jammu and Kashmir showed a substantial rise, the UTs of Lakshadweep, Andaman and Nicobar Islands recorded great declines. Younger age and rural residence were significant predictors of anemia (p<0.05) in NFHS-5 but not in NFHS-4. Anemia prevalence among adolescents in India increased significantly in NFHS-5 compared to NFHS-4. Strategies to reduce anemia among adolescents need to focus on affected states and UTs, pregnant adolescents, those with unimproved sanitation, no education, and rural residents.