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<p>Anaemia is a major global public health challenge and remains disproportionately high among women of reproductive age. Assam is among India’s highest-burden states and continues to record one of the country’s highest maternal mortality ratios, with anaemia as a major contributor. Despite this burden, district-level spatial heterogeneity and determinants of anaemia remain insufficiently examined. This study analyses spatial and temporal patterns of anaemia among women aged 15–49 years in Assam and identifies key socio-demographic, behavioural, and health-related predictors using NFHS-5 (2019–21) data. Spatial variation was assessed using choropleth mapping, Global Moran’s I, and LISA, while multivariate logistic regression and Principal Component Analysis identified significant determinants. Findings show that anaemia prevalence in Assam (65.9%) exceeded the national average and displayed high-prevalence clusters in northern, eastern, and parts of central Assam, particularly in districts with socio-economically vulnerable tea-garden populations. Logistic regression revealed several significant predictors. Muslim women had lower odds of anaemia (AOR = 0.58; 95% CI: 0.49–0.69), whereas rural women had higher odds (AOR = 1.21; 95% CI: 1.03–1.43). Women from the richest wealth quintile had reduced risk (AOR = 0.58; 95% CI: 0.41–0.82) compared with the poorest. Primary education lowered anaemia likelihood (AOR = 0.85; 95% CI: 0.72–1.00). Weekly egg consumption significantly reduced odds (AOR = 0.60; 95% CI: 0.38–0.92). Nutritional status was also influential, with normal BMI (AOR = 0.74; 95% CI: 0.65–0.84) and overweight women (AOR = 0.57; 95% CI: 0.48–0.69) showing lower odds than underweight women. Overall, the findings highlight persistent socio-economic, geographic, and nutritional inequities shaping anaemia patterns in Assam. District-specific, equity-oriented strategies, especially targeting rural and tea-garden communities, are essential to improve women’s nutritional and reproductive health outcomes.</p>

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Spatial patterns and determinants of anaemia among women of reproductive age in Assam in Northeast India based on the National Family Health Survey 2019–2021

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  • 发表日期：

    2026年7月6日

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  • Princi Gogoi,
  • Manash Jyoti Nath

摘要

Anaemia is a major global public health challenge and remains disproportionately high among women of reproductive age. Assam is among India’s highest-burden states and continues to record one of the country’s highest maternal mortality ratios, with anaemia as a major contributor. Despite this burden, district-level spatial heterogeneity and determinants of anaemia remain insufficiently examined. This study analyses spatial and temporal patterns of anaemia among women aged 15–49 years in Assam and identifies key socio-demographic, behavioural, and health-related predictors using NFHS-5 (2019–21) data. Spatial variation was assessed using choropleth mapping, Global Moran’s I, and LISA, while multivariate logistic regression and Principal Component Analysis identified significant determinants. Findings show that anaemia prevalence in Assam (65.9%) exceeded the national average and displayed high-prevalence clusters in northern, eastern, and parts of central Assam, particularly in districts with socio-economically vulnerable tea-garden populations. Logistic regression revealed several significant predictors. Muslim women had lower odds of anaemia (AOR = 0.58; 95% CI: 0.49–0.69), whereas rural women had higher odds (AOR = 1.21; 95% CI: 1.03–1.43). Women from the richest wealth quintile had reduced risk (AOR = 0.58; 95% CI: 0.41–0.82) compared with the poorest. Primary education lowered anaemia likelihood (AOR = 0.85; 95% CI: 0.72–1.00). Weekly egg consumption significantly reduced odds (AOR = 0.60; 95% CI: 0.38–0.92). Nutritional status was also influential, with normal BMI (AOR = 0.74; 95% CI: 0.65–0.84) and overweight women (AOR = 0.57; 95% CI: 0.48–0.69) showing lower odds than underweight women. Overall, the findings highlight persistent socio-economic, geographic, and nutritional inequities shaping anaemia patterns in Assam. District-specific, equity-oriented strategies, especially targeting rural and tea-garden communities, are essential to improve women’s nutritional and reproductive health outcomes.