Abstract
Anemia is highly prevalent in all strata of populations in India, with established evidence of intergenerational anemia. The state of Madhya Pradesh was selected to study childhood anemia as the population is mostly rural, with many tribal districts, and has the highest infant mortality rate in India. This study aims to understand the maternal, social and household factors that affect anemia among children aged 6 months to 5 years by analyzing the the National Family Health Survey (NFHS) conducted in 2015-2016. Children aged 6-59 months with estimated hemoglobin levels were included in this study. Bivariate and multivariable analyses were conducted to understand associations between childhood anemia and various socioeconomic factors. Two models to understand the presence of anemia and the levels of anemia were computed. Higher likelihood of having severe childhood anemia was observed among children of younger mothers (15- to 19-year-old mothers (adjusted odds ratio (aOR) 2.08, 95% confidence interval (CI): 1.06, 4.06, less educated (uneducated mothers aOR 2.25, 95% CI 1.13, 4.48) and belonged to a scheduled tribe (aOR 1.88, 95% CI 1.07, 3.29). Strong associations between anemia in mothers and their children suggest intergenerational anemia which has long-term effects. Malnourished children (severe stunting aOR 3.19, 95% CI 2.36, 4.31) and children born with very low birth weight (aOR 4.28, 95% CI 2.67, 6.87) were more likely to have anemia. These findings strongly suggest more proactive interventions including prenatal healthcare for women and monitoring of the nutrition children at the community level to combat childhood anemia. Evaluations of existing programs should be conducted to understand the gaps in reducing anemia and malnutrition in children.