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ANEMIA AMONG CHILDREN AND ADOLESCENTS
State Fact Sheet
March 2022
Odisha
About this factsheet and the Comprehensive National Nutrition Survey (CNNS, 2016-18)
About this factsheet:
This factsheet was created to assist state-level decision-making on anemia reduction strategies and policies.
As you read this factsheet, we encourage you to ask the following questions:
1. What is the status of anemia in our state and who is affected the most?
2. What are the key risk factors for anemia in our state?
3. How well is Anemia Mukt Bharat working in our state?
4. Which areas need attention to combat anemia?
5. Are we doing enough to address non-nutritional/ underlying risk factors of anemia?
6. What are the top 3-5 key actions for anemia reduction in the next 6 months?
About Comprehensive National Nutrition Survey (CNNS, 2016-18):
• All data included in this factsheet are from the Comprehensive National Nutrition Survey (CNNS, 2016-2018), conducted by the
Ministry of Health and Family Welfare, UNICEF, and Population Council.
• CNNS is the first nationally representative nutrition survey of children and adolescents aged 0-19 years in India, and the largest
micronutrient survey ever implemented globally.
• CNNS covered all the states of India, using a multi-stage survey design in both rural and urban households.
• Three target population groups were covered: preschoolers (1–4 years), school-age children (5–9 years) and adolescents (10–
19 years). Data in this factsheet are disaggregated by these three groups.
• To assess anemia, hemoglobin was measured in venous blood using the cyanmethemoglobin method. This is considered the
gold standard laboratory method for hemoglobin measurement.
Information available in this factsheet
Anemia is caused by many factors, which is why it is so hard to tackle. Addressing a single factor will not fully address the
problem of anemia. In this factsheet we provide information about the burden and types of anemia, nutrition-specific and nutrition-
sensitive determinants of anemia, IFA coverage and suggested key action points to aid decision-making. The following figure
illustrates the information in this factsheet.
Burden and
1. Micronutrient deficiencies
Nutrition-specific factors
1
2.1
2. Dietary factors
types of anemia
(Directly related to nutrition)
3. Anthropometry
Determinants of
2
anemia
1. Socio-demography
2. Water, sanitation & hygiene
Nutrition-sensitive factors
2.2
3. Genetic hemoglobin disorders
IFA coverage
(Non-nutritional/ underlying factors)
3
4. Infection & inflammation
5. Health services & programs
Key action
4
points
Statistical tests were not conducted. Only descriptive statistics are reported. IFA – Iron Folic Acid
1. Burden and types of anemia - based on age and gender
FIGURE 1.1 Prevalence of anemia by age, gender and severity
10-19 years
5-9 years
1-4 years
10%
22%
25%
17%
0%
15%
14%
India: 24.7%
India: 39.6%
India: 40.5%
2%
1%
Odisha: 28%
Odisha: 41%
Odisha: 38%
15%
15%
25%
3%
0%
11%
0%
9%
2%
India: 40.6% India: 22.3% India: 17.6%
Odisha: 36% Odisha: 27% Odisha: 18 %
Mild Anemia Severe Anemia No Anemia
Moderate Anemia
RESULTS SUMMARY
• Compared to the national average of India, anemia prevalence in Odisha is slightly less for all children aged 1-4 years
• Prevalence of anemia is higher than national figure for children aged 5-9 years and adolescents.
• Anemia prevalence is high in girls compared to boys for all age groups especially adolescent girls.
FIGURE 1.2 Types of anemia by age and gender
1-4 years
10-19 years
5-9 years
8
5
22
0
40
9
39
Iron deficiency
2
25
5
Anemia
0
Dimorphic Anemia
35
16
33
Folate/Vit. B12
deficiency Anemia
27
16
Anemia of
15
inflammation
4
Anemia of
hemoglobinopathies
17
18
37
3
Anemia from
12
1
other causes
6
7
1
23
67
41
10
29
8
11
7
2
RESULTS SUMMARY
• Anemia due to deficiency of either iron or folate or vitamin B12 or their combination is the primary reason for anemia among
all the age and gender groups.
• Anemia due to deficiency of either folate or vitamin B12 deficiency is the primary reason for anemia amongst children aged
5-9 years and adolescents
• Multiple types of anemia exists for all age and sex groups.
2. Determinants of anemia
2.1 Nutrition specific factors (directly related to nutrition)
FIGURE 2.1a Prevalence of anemia by micronutrient deficiencies
Indicators
10-19 years
1-4 years 5-9 years
No
22
28
28
Iron
Fe
Yes
deficiency
60 66
44
1 Example
No
36
28
26
Zinc
Zn
interpretation:
deficiency
yes
40
33
Among
33
adolescents
10-19 years old
in Odisha, 22%
no
38
Vitamin B12
31
30
B12
of those without
deficiency
yes
iron deficiency
71
23
39
are anemic and
66% of those
with iron
no
36
26
Folate
30
deficiency are
B
9
deficiency
anemic.
yes
40
28
29
% Anemic % Anemic
% Anemic
RESULTS SUMMARY
• Anemia prevalence is higher among children and adolescents with iron deficiency vs those without iron deficiency.
• Anemia prevalence is higher among children and adolescents with zinc deficiency vs. those without this deficiency.
• Almost 71% and 39% anemic children aged 1-4 years and adolescents respectively, were also identified with vitamin B12
deficiency.
FIGURE 2.1b Prevalence of anemia by dietary factors
Indicators
1-4 years
5-9 years 10-19 years
Minimum dietary
no
39
29
diversity
30
yes
36
30
22
veg
39
29
32
Types of diet
veg + egg
44
37
27
non veg
26 28
36
Consumed green
20
22
no
36
leafy vegetables
28
30
yes
38
29
Consumed animal
32
no
37
source food
26
28
yes
38
(except eggs)
27
32
no
36
Consumed eggs
0
28
yes
42
1
Sample size <26
% Anemic
% Anemic
% Anemic
RESULTS SUMMARY
• Anemia is slightly more prevalent among children aged 1-4 years with no diet diversity, vegetarians, those consuming
green leafy vegetables, animal source food, and eggs.
• Anemia is more prevalent among children aged 5-9 years with no diet diversity, consuming vegetarian diet, green leafy
vegetables, and not consuming animal source food, and eggs.
• Anemia is more prevalent among adolescents aged 10- 19 years who consumed vegetarian diet with eggs, green leafy
vegetables, not consumed animal source food items and eggs.
FIGURE 2.1c Prevalence of anemia by anthropometry indicators
Indicators
10-19 years
1-4 years
5-9 years
27
24
No
33
36
Stunted
38
Yes
45
31
26
No
37
Thinness
24
34
Yes
48
(MUACZ<-2)
23
32
Underweight
27
Body mass
33
28
Normal weight
38
index
1 11 19
Overweight
35
% Anemic
% Anemic
% Anemic
1
Sample size <26.
2
MUAC:Mid-Upper Arm Circumference z-score less than 2 standard deviations from the age- and sex-specific mean in a healthy population
RESULTS SUMMARY
• Anemia prevalence is higher in children and adolescents who are stunted vs those who are not.
• Anemia prevalence is higher among children aged 1-4 years and 5-9 years who are thin vs those who are not.
2. Determinants of anemia
2.2 Nutrition sensitive factors (non-nutritional/ underlying factors)
FIGURE 2.2a Prevalence of anemia by water, sanitation and hygiene
5-9 years
Indicators 1-4 years
10-19 years
Access to
No
30
32
41
improved sanitation
20 28
32
Yes
facility
No
42 28
32
Availability of soap
Yes
for handwashing
27
25
24
% Anemic % Anemic
% Anemic
RESULTS SUMMARY
• Anemia prevalence is higher among children and adolescents lacking access to improved sanitation facilities and soap
for handwashing vs those who have access to these.
• More than 98% of the population had access to improved water sources. (data not shown for anemia prevalence based
on access to improved water source)
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