Burden and influencing factors of anemia among women in India: A systematic review

Abstract

Background: Anemia is a critical public health issue among Indian women. Its high prevalence is driven by various factors including nutrition, socioeconomic status, environment, and healthcare system issues. This review synthesizes findings from 25 Indian studies over 15 years to understand the burden and influencing factors of anaemia among women. Methods: We systematically searched adering to the PRISMA protocol, observational studies published between 2010 and 2023 evaluating prevalence and determinants of anemia among Indian women aged 15-49 years. Studies were independently screened, extracted, and appraised for quality by the reviewers using the JBI checklist. Data were summarized narratively and in tabular form, highlighting regional, methodological, and population-specific insights. Results: Anemia prevalence ranged from about 30% in some urban pockets to over 80% in marginalized or rural settings, as confirmed by nationally representative and regional studies. Key influencing factors comprised iron and other micronutrient deficiencies, suboptimal dietary practices particular to plant-based diets, low socioeconomic and educational status, early marriage and repeated pregnancies, gaps in health service utilization, poor sanitation, and entrenched cultural norms. Severity and distribution show marked heterogeneity by geography, wealth, and education. Despite multipronged public health interventions, uptake and compliance remain suboptimal, especially for women outside maternal care. Conclusion: The review underscores the complex, entrenched nature of anemia among Indian women-demanding context-tailored, multisectoral policy and programmatic responses. Addressing both direct nutritional shortfalls as well as broader social determinants is essential for meaningful and sustainable reduction in anemia burden.