Asian Research Thesis Index

Abstract

Anemia is an endemic public health problem affecting approximately two billion people worldwide. The global prevalence of anemia is estimated to be 25%, with 43% in developing and 9% in developed countries. The most vulnerable groups are pre-school children (42.6%), pregnant women (38.2%) and nonpregnant women (29.0%). In Pakistan, anemia is a neglected health problem and females are more susceptible to develop anemia at different stages of life span. Globally, anemia prevalence has decreased by 12% from 1995 to 2011, whereas in Pakistan it has increased from 28% to 50% among WRA from 2001 to 2011. The high prevalence of anemia in non-pregnant women poses a significant challenge to meet global target of 50% reduction in anemia among WRA by 2025 in Pakistan. To achieve target, better understanding of societal determinants of anemia and appropriate large-scale interventions are needed right from adolescence. The present study was conducted to assess recent trends of anemia among adolescent girls (10-19 years) and married women (20-49 years) in AJK to identify more prevalent societal determinants and their drivers. A cross-sectional study was conducted on a sample size of 1529 respondents comprising of 626 adolescent girls and 903 married women in the Muzaffarabad division for understanding etiology of anemia and its societal determinants. The direct information from respondents was collected through the self-constructed interview schedule. Data sheet was prepared in SPSS 14.0 and responses were analyzed using univariate, bivariate, multiple linear regression (MLR) and data mining techniques. The results revealed that anemia is a severe public-health problem among both adolescent girls and married women in AJK. Bivariate analysis of socio-economic variables (respondent’s and her husband’s education, respondent and her husband’s occupation, respondent and her family monthly income, household and environmental factors), demographic variables (age at marriage, prenatal care, heavy blood loss (HBL), number of pregnancies, average birth interval and communicable diseases (CDs)), cultural variables (family relationships, violence and knowledge about anemia) and nutritional variables nutritional variables (knowledge of balanced diet, meals regularity, iron supplementation and pica) were significantly associated with anemia among women. Among adolescent girls, socio-economic variables (parental education, parental and family monthly income, father’s profession and sewerage type), demographic variables (healthcare utilization, HBL and CDs), cultural variables (exercise and knowledge about anemia) and nutritional variables (meals regularity and food supplementation) were significantly associated with anemia. The MLR analysis revealed that knowledge about barriers in anemia treatment, meals regularity, family monthly income, average birth interval and household structure showed positive effect, whereas, violence, HBL, CDs, pica intake and exacerbate family relations showed negative effect on the Hb level of married women. The respondent education, family monthly income, meals regularity and exercise showed positive effect, whereas, menstruation duration and CDs showed negative effect on the Hb level of the adolescent girls. All the classification algorithm classified anemic and non-anemic respondents with almost 100% accuracy except k-nearest neighbor approach. It is suggested that all the stakeholders should collaborate and synchronize efforts to combat anemia for meet global target of its 50% reduction among WRA by 2025.

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