Abstract
OBJECTIVE: To determine the prevalence of anaemia in women and children in refugee settings globally. DESIGN: Population-representative cross-sectional surveys were conducted by the United Nations High Commissioner for Refugees (UNHCR) and partner organisations. SETTING: Refugee sites in East and Southern Africa (ESA), West and Central Africa (WCA) and South Asia. PARTICIPANTS: UNHCR conducted routine programmatic surveys evaluating the needs of non-pregnant women and children in refugee sites, globally. OUTCOME MEASURE: Haemoglobin levels were measured using the HemoCue Hb 301+System (Fischer Scientific, Pittsburgh, Pennsylvania, USA). Anaemia was defined as mild, moderate or severe based on the 2011 WHO guidelines. RESULTS: The median total prevalence of anaemia in children was 41.5%. WCA had the highest median total prevalence of anaemia in children (56.8%), and South Asia had the lowest (37.6%). Globally, the median total prevalence of anaemia in non-pregnant women of reproductive age was 28.2%. WCA had the highest median total prevalence of anaemia in women (39.4%), and ESA had the lowest (27.7%). Anaemia is highly correlated between women and children, even though the prevalence is much lower in women. The mean total prevalence of anaemia in children increased by 15.9% (95% CI 2.04% to 29.7%) in WCA but decreased by 7.9% (95% CI -20.1% to 4.24%) in ESA after the COVID-19 pandemic. CONCLUSIONS: WCA have particularly high rates of anaemia, worsening since 2020. ESA, as well as South Asia, have seen reductions in anaemia in recent years. There is wide variability within refugee settings, indicating variability in the implementation of successful interventions to reduce and prevent anaemia. Improving feeding practices and preventing and treating anaemia-causing infections may improve prevalence of anaemia.