South Asian countries need to accelerate progress towards meeting the World Health Assembly goal of halving anemia among women of reproductive age (WRA) by 2025. The purpose of this study was to examine determinants of anemia among WRA in Nepal and Pakistan.
Secondary data analysis of the Nepal Demographic and Health survey 2011 and the Pakistan National Nutrition Survey 2011 was conducted to identify risk factors of anemia (hemoglobin <120g/dL) among WRA using modified Poisson regression models to identify predictors and backwards stepwise processes to identify parsimonious models to explain predictors of anemia (all p<0.05) in each country.
Anemia was prevalent among 34% of Nepalese women (n=5,794) and 54% of Pakistani women (n=9,448). In both countries, the season of the interview, geographic location and BMI < 18.5 kg/m2 (compared with 18.5-24.9 kg/m2 PR; CI95% Nepal: 1.08; 0.99-1.19; Pakistan: 1.03; 0.98-1.08) were predictors of anemia. In Pakistan, iron deficiency (1.49; 1.44-1.55) and vitamin A deficiency (1.09; 1.05-1.13) were co-morbidities with anemia. Egg consumption, improved water sources and literacy were protective against anemia in Pakistan, living in a home with a toilet was protective in Nepal, and higher BMI was protective in both countries.
These findings, in combination with similar evaluations in India and Bangladesh, provide important details on the patterns of anemia across South Asia. While some factors are consistently associated with anemia (e.g. BMI, season, geographic location), others are more context specific (e.g. religion, age, wealth indicators). These findings can be used to develop more tailored interventions to reduce anemia.