Skip to main content
SpringerLink
Log in

Prevalence and Determinants of Anaemia Among Under-Five Children in West Bengal: An Insight from the National Family Health Survey 2015–2016

  • Published:
Global Social Welfare Aims and scope Submit manuscript

Abstract

Background and Objectives

The prevalence of anaemia during childhood is a serious health problem and a major burden of disease in India. According to NFHS-4, in India, about 58.4% of children suffered from anaemia which hugely contributes to childhood illness, morbidity, and mortality. Therefore, estimating the level of anaemia during childhood, and the significant determinants of childhood anaemia at the sub-national level, is essential for the improvement of child health status in India. The main aim of the study is to determine blood haemoglobin levels, the prevalence of anaemia among children from different socio-demographic groups and geographic regions, and the significant drivers in West Bengal.

Methods

We used NFHS-4 data for this analysis. Analysis of variance (ANOVA) and the Z-test were used to examine the variation in blood haemoglobin level among children from different backgrounds. Chi-square and multinomial logistic regression were used to outline significant heterogeneity in the prevalence of anaemia across different categories of background variables and to identify significant determinants of the prevalence of anaemia during childhood in West Bengal, respectively.

Results

The study significantly identified a higher prevalence of any kind of anaemia among the children in the early age group, living with 20–29-year-old, thin, anaemic mothers, belonging to urban areas, lower economic groups, and live in the northern part of West Bengal. Besides, a higher chance of moderate or severe anaemia was noticed among smaller-sized births and the Scheduled Tribe community.

Conclusions

Policymakers must consider the major driving factors of childhood anaemia to frame adequate strategies for eliminating anaemia. The study suggests more initiatives and investments for supplying adequate nutrition and quality health and medical care to the early-aged children, undernourished mothers (thin, anaemic), ST community, and poor families in the study area. This initiative may help improve child health (Sustainable Development Goal 03) and reduce inequality (SDG 10) in health status across various socio-demographic, economic groups, and regions within the state.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The analysis has been made based on secondary data available on the DHS website. The database has been received with a request for use only research purposes. The DHS had no role in the study design and data analysis.

References

  • Adhikari, T., Yadav, J., Tripathi, N., Tolani, H., Kaur, H., & Rao, V. V. (2020). Do tribal children experience elevated risk of poor nutritional status in India? A multilevel analysis. Journal of Biosocial Science, 1–26.

  • Afroja, S., Kabir, R., & Islam, A. (2019). Analysis of determinants of severity levels of childhood anaemia in Bangladesh using a proportional odds model. Clinical Epidemiology and Global Health. https://doi.org/10.1016/j.cegh.2019.06.009

    Article  Google Scholar 

  • Agnihotri, S. B. (2001). Infant mortality variations in space and time: Analysis of West Bengal Data. Economic and Political Weekly, 36(36), 3472–3479. Retrieved September 18, 2016, from http://www.jstor.org/stable/4411090

  • Asobayire, F., Adou, P., Davidsson, L., Cook, J., & Hurrell, R. (2001). Prevalence of iron deficiency with and without concurrent anaemia in population groups with high prevalence of malaria and other infections: A study in Cote d’Ivoire. American Journal of Clinical Nutrition, 74, 776–782.

    Article  Google Scholar 

  • Balarajan, Y., Ramakrishnan, U., Ozaltin, E., Shankar, A. H., & Subramanian, S. V. (2011). Anaemia in low-income and middle-income countries. Lancet (London, England), 378(9809), 2123–2135. https://doi.org/10.1016/S0140-6736(10)62304-5

    Article  Google Scholar 

  • Bharati, S., Pal, M., & Bharati, P. (2020). Prevalence of anaemia among 6- to 59-month-old children in India: The latest picture through the NFHS-4. Journal of Biosocial Science. https://doi.org/10.1017/S0021932019000294

    Article  Google Scholar 

  • Black, M. M., Quigg, A. M., Hurley, K. M., & Pepper, M. R. (2011). Iron deficiency and iron deficiency anaemia in the first two years of life: Strategies to prevent loss of developmental potential. Nutrition Reviews, 69, S64-70.

    Article  Google Scholar 

  • Brabin, B. J., Premji, Z., & Verhoeff, F. (2001). An analysis of anaemia and child mortality. Journal of Nutrition, 131, 636S-648S.

    Article  Google Scholar 

  • Christian, P., Morgan, M. E., Murray-Kolb, L., LeClerq, S. C., Khatry, S. K., & Schaefer, B. (2011). Preschool iron-folic acid and zinc supplementation in children exposed to iron folic acid in utero confers no added cognitive benefit in early school-age. Journal of Nutrition, 141(11), 2042–2048.

    Article  Google Scholar 

  • Desai, S., & Dubey, A. (2011). Caste in 21st century India: Competing narratives. Economic and Political Weekly, 46(11), 40–49. Retrieved January 28, 2017, from https://www.jstor.org/stable/41151970

  • FAO/WHO. (1992). International conference on nutrition, Nutrition and Development – A global assessment. Rome, Italy: FAO.

    Google Scholar 

  • Ghosh, K., & Desai, G. S. (2021). Prevalence and detecting spatial clustering of anaemia among children 6–59 months in the districts of India. Clinical Epidemiology and Global Health, 12, 1–7. https://doi.org/10.1016/j.cegh.2021.100845

    Article  Google Scholar 

  • Ghosh, P. (2023). Determinants and transition of anaemia among under-five children from different social groups in India from 2005–06 to 2015–16. Social Science & Medicine., 320, 1–11. https://doi.org/10.1016/j.socscimed.2023.115702

    Article  Google Scholar 

  • Ghosh, P., Alam, A., Ghosal, N., & Saha, D. (2021). A geospatial analysis of temporary housing inequality among socially marginalized and privileged groups in India. Regional Science Policy & Practice, 13(2), 1–22. https://doi.org/10.1111/rsp3.12425

    Article  Google Scholar 

  • Ghosh, P., Hossain, M., & Sarkar, S. (2022). Inequality among social groups in accessing improved drinking water and sanitation in India: A district level spatial analysis. The Professional Geographer., 75(3), 361–382. https://doi.org/10.1080/00330124.2022.2124181

    Article  Google Scholar 

  • Gleason, G., & Scrimshaw, N. S. (2007). An overview of the functional significance of iron deficiency. In K. Kraemer (Ed.), Nutritional Anaemia (pp. 45–58). Sight and Life Press.

    Google Scholar 

  • Harding, K. L., Aguayo, V. M., Namirembe, G., & Webb, P. (2018). Determinants of anaemia among women and children in Nepal and Pakistan: An analysis of recent national survey data. Maternal & Child Nutrition, 14(S4), e12478. https://doi.org/10.1111/mcn.12478

    Article  Google Scholar 

  • Hausman, J. A., & McFadden, D. (1984). A specification test for the multinomial logit model. Econometrica, 52, 1219–1240.

    Article  Google Scholar 

  • Iannotti, L. L., Tielsch, J. M., Black, M. M., & Black, R. E. (2006). Iron supplementation in early childhood: Health benefits and risks. American Journal of Clinical Nutrition, 84, 1261–1276.

    Article  Google Scholar 

  • International Institute for Population Sciences (IIPS), & ICF. (2017a). National Family Health Survey (NFHS-4), 2015–16: India. Mumbai: IIPS.

    Google Scholar 

  • International Institute for Population Sciences (IIPS), & ICF. (2017b). National Family Health Survey (NFHS-4), India, 2015–16: West Bengal. Mumbai: IIPS.

    Google Scholar 

  • International Institute for Population Sciences (IIPS), & Macro International. (2007). National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS.

    Google Scholar 

  • Irwin, J. J., & Kirchner, J. T. (2001). Anaemia in children. American Family Physician, 64(8), 1379–1386.

    Google Scholar 

  • Jember, T. A., Teshome, D. F., Gezie, L. D., & Agegnehu, C. D. (2021). Spatial variation and determinants of childhood anaemia among children aged 6 to 59 months in Ethiopia: Further analysis of Ethiopian demographic and health survey 2016. BMC Pediatrics, 21(497), 1–14. https://doi.org/10.1186/s12887-021-02901-y

    Article  Google Scholar 

  • Khan, J. R., Awan, N., & Misu, F. (2016). Determinants of anaemia among 6–59 months aged children in Bangladesh: Evidence from nationally representative data. BMC Paediatrics, 16(1), 1–12. https://doi.org/10.1186/s12887-015-0536-z

    Article  Google Scholar 

  • Khanal, V., Karkee, R., Adhikari, M., & Gavidia, T. (2015). Moderate-to-severe anaemia among children aged 6–59 months in Nepal: An analysis from Nepal demographic and health survey, 2011. Clinical Epidemiology and Global Health. https://doi.org/10.1016/j.cegh.2015.07.001

    Article  Google Scholar 

  • Liou, L., Kim, R., & Subramanian, S. V. (2020). Identifying geospatial patterns in wealth disparity in child malnutrition across 640 districts in India. SSM - Population Health. https://doi.org/10.1016/j.ssmph.2019.100524

    Article  Google Scholar 

  • McCann, J. C., & Ames, B. N. (2007). An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral functioning. American Journal of Clinical Nutrition, 85, 931–945.

    Article  Google Scholar 

  • McLean, E., Cogswell, M., Egli, I., Wojdyla, D., & De Benoist, B. (2009). Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutrition, 12(4), 444–454.

    Article  Google Scholar 

  • McLean, E., Egli, I., Wojdyla, D., De Benoist, B., & Cogswell, M. (2007). Worldwide prevalence of anaemia in pre-school aged children, pregnant women and non-pregnant women of reproductive age. In K. Kraemer & M. Zimmermann (Eds.), Nutritional Anaemia (pp. 1–12). Sight and Life Press.

    Google Scholar 

  • Melku, M., Addis Alene, K., Terefe, B., Enawgaw, B., Biadgo, B., Abebe, M., & Melku, T. (2018). Anaemia severity among children aged 6–59 months in Gondar town, Ethiopia: A community-based cross-sectional study. Italian Journal of Paediatrics, 44(107), 1–12. https://doi.org/10.1186/s13052-018-0547-0

    Article  Google Scholar 

  • Mondal, S. (2020). Modeling the spatial pattern of household quality of living in West Bengal: An approach of hotspot and cluster analysis. Modeling Earth Systems and Environment, 6, 833–851. https://doi.org/10.1007/s40808-020-00711-2

    Article  Google Scholar 

  • MOPPP. (2019). Special Representation in Services for SC/ST. Department of Personnel and Training, Ministry of Personnel, Public grievances and Pensions, Government of India. https://dopt.gov.in/sites/default/files/ch-11.pdf

  • Ngesa, O., & Mwambi, H. (2014). Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya. PLoS ONE. https://doi.org/10.1371/journal.pone.0113756

    Article  Google Scholar 

  • Niti Aayog. (2021). National multidimensional poverty index baseline report based on NFHS-4 (2015–16). Sansad Marg, New Delhi - 110001, India: Government of India.

    Google Scholar 

  • Passi, S. J., & Vir, S. C. (2008). Functional consequence of nutritional anaemia in school age children. In U. Ramakrishnan (Ed.), Nutritional anaemias (pp. 89–109). Boca Raton, New York, Washington DC: CRC Press.

    Google Scholar 

  • Patel, K. K., Vijay, J., Mangal, A., Mangal, D. K., & Gupt, S. D. (2021). Burden of anaemia among children aged 6–59 months and its associated risk factors in India – Are there gender differences? Children and Youth Services Review, 122, 1–7. https://doi.org/10.1016/j.childyouth.2020.105918

    Article  Google Scholar 

  • Paul, P., Chouhan, P., & Zaveri, A. (2019). Impact of child marriage on nutritional status and anaemia of children under 5 years of age: Empirical evidence from India. Public Health, 177, 95–101. https://doi.org/10.1016/j.puhe.2019.08.008

    Article  Google Scholar 

  • Pongcharoen, T., DiGirolamo, A. M., Ramakrishnan, U., Winichagoon, P., Flores, R., & Martorell, R. (2011). Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: A follow-up study. American Journal of Clinical Nutrition, 93(3), 636–643.

    Article  Google Scholar 

  • Sharma, H., Singh, S. K., & Srivastava, S. (2020). Socio-economic inequality and spatial heterogeneity in anaemia among children in India: Evidence from NFHS-4 (2015–16). Clinical Epidemiology and Global Health. https://doi.org/10.1016/j.cegh.2020.04.009

    Article  Google Scholar 

  • Shenton, L. M., Jones, A. D., & Wilson, M. L. (2020). Factors associated with anaemia status among children aged 6–59 months in Ghana, 2003–2014. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-019-02865-7

    Article  Google Scholar 

  • Statistical Handbook West Bengal. (2014). Bureau of Applied Economics & Statistics Department of Statistics & Programme Implementation Government of West Bengal.

  • Stoltzfus, R. J. (2011). Iron interventions for women and children in low-income countries. The Journal of Nutrition, 141(4), 756S-S762.

    Article  Google Scholar 

  • Thorat, S., & Newman, K. S. (2007). Caste and economic discrimination: Causes, consequences and remedies. Economics and Political Weekly, 42(41), 4121–4124. Retrieved November 1, 2015, from https://www.jstor.org/stable/40276545

  • Thorat, S., & Newman, K. S. (Eds.). (2010). Blocked by caste: Economic discrimination in modern India. New Delhi: Oxford University Press.

  • West Bengal Human Development Report. (2004). Development and Planning Department, Government of West Bengal.

  • WHO. (2003). Flour fortification: Reporting accomplishments Report of a joint WHO/UNICEF/MI intercountry technical review meeting on flour fortification, Cairo, Egypt, 17–19 July 2001. World Health Organization Regional Office for the Eastern Mediterranean.

    Google Scholar 

  • WHO. (2008). Worldwide prevalence of anaemia 1993–2005. WHO global database on anaemia / Edited by Bruno de Benoist, Erin McLean, Ines Egli and Mary Cogswell. Available at: http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf.

  • Yadav, J., & Nilima, N. (2021). Geographic variation and factors associated with anaemia among under-fives in India: A multilevel approach. Clinical Epidemiology and Global Health, 9, 261–268. https://doi.org/10.1016/j.cegh.2020.09.008

    Article  Google Scholar 

Download references

Acknowledgements

The author thanks the anonymous referees for their suggestions and comments on earlier drafts of this manuscript.

Author information

Authors and Affiliations

  1. Department of Geography, Ramsaday College, Amta, Howrah, 711401, West Bengal, India

    Pritam Ghosh

  2. Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India

    Kaushik Bose

  3. Department of Geography, University of Calcutta, 35 Ballygunge Circular Road, Kolkata, 700019, West Bengal, India

    Pratima Rohatgi

Authors
  1. Pritam Ghosh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaushik Bose
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pratima Rohatgi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Pritam Ghosh: Conceptualization; data curation; formal analysis; funding acquisition; investigation; methodology; resources; software; supervision; validation; visualization; roles/writing, original draft; writing, review and editing. Kaushik Bose: Writing — review. Pratima Rohatgi: Supervision.

Corresponding author

Correspondence to Pritam Ghosh.

Ethics declarations

Ethics Approval

International Institute of Population Science conducted the National Family Health Survey-4 and the ethical review board of this institution has given the ethical clearance of these two surveys. We have operated the analysis in this research based on NFHS-4  survey data. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

Fig. 2
figure 2

Location and administrative setup and geographic regions of West Bengal

Full size image

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ghosh, P., Bose, K. & Rohatgi, P. Prevalence and Determinants of Anaemia Among Under-Five Children in West Bengal: An Insight from the National Family Health Survey 2015–2016. Glob Soc Welf 10, 399–411 (2023). https://doi.org/10.1007/s40609-023-00299-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40609-023-00299-2

Keywords

Search

Navigation