# Regional Burden of Anemia among Adolescent girls in India: A systematic review and meta-analysis

## TL;DR

This study finds that anemia is a major issue among Indian adolescent girls, especially in the East, and suggests targeted interventions are needed.

## Contribution

The study provides a comprehensive regional analysis of anemia prevalence among Indian adolescent girls using a systematic review and meta-analysis.

## Key findings

- The pooled prevalence of anemia among Indian adolescent girls is 65%.
- East India has the highest anemia prevalence at 81%.
- Mild and moderate anemia are more common than severe anemia.

## Abstract

Among Indian adolescent girl’s anemia remains a major public health concern due to rapid growth, menstrual blood loss, and nutritional deficiencies. This systematic review and meta-analysis aim to assess the prevalence and severity of anemia among Indian adolescent girls.

This review (2004–2024) integrated data from 32 studies (14,053 persons) from PubMed, Embase, and Scopus, adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)/ Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Observational studies with the prevalence of anemia in Indian adolescent girls based on WHO criteria were included. The data was pooled using a random-effects model, and subgroup analyses were conducted by Indian region. Heterogeneity was assessed using the I2 statistic.

The pooled anemia prevalence was 65% (95% CI: 54%–74%), showed notable regional variations. The burden was highest in East India (81%; 39%–97%), then North India (65%), West India (61%), and South India (52%). The mean hemoglobin levels varied by region, ranging from 10.24 g/dL in the East to 11.20 g/dL in the South. Mild anemia (29%) and moderate anemia (25%) were more common than severe anemia (1%). The substantial heterogeneity (I2=98.7%) indicated differences in socioeconomic status, diet, and healthcare access.

Anemia affects disproportionate number of Indian adolescents’ girls, particularly in the country's east, which highlights the need for context-specific interventions. The initiatives must be linked to national programs like Anemia Mukt Bharat to ensure equitable progress towards India's public health objectives and to avoid long-term health and developmental consequences.