Anemia Among Children Under 5 Years in India: A District-Level Spatial Analysis Using NFHS-5 Data

Puranik, Amitha; Shreya, N

doi:10.1177/10105395211058288

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…The frequency and percentage of variation of results between the haematology analyzer and EzeCheck devices are presented with a range of differences such as 0, less than 1, 1-1.9, 2-2.9, 3-3.9, and 4 and above in g/dL. We presented the anaemia classification as followed by the National Family Health Survey [12] and the World Health Organization (WHO) classification of anaemia according to age and severity [13].…”

Section: Data Management and Analysismentioning

confidence: 99%

Diagnostic Validation and Feasibility of a Non-invasive Haemoglobin Screening Device (EzeCheck) for 'Anaemia Mukt Bharat' in India

Sahoo,

Sinha,

Sahoo

et al. 2024

Cureus

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Anaemia remains a major public health issue in India despite several efforts. It is crucial to introduce technology-based innovations for the mass screening and early diagnosis of anaemia. Traditional anaemia screening requires drawing blood and laboratory analysis and can be logistically expensive in resourceconstrained settings. A non-invasive haemoglobin test for mass screening in such settings is vital which can quickly and efficiently screen large populations. This study validated the haemoglobin estimation between the invasive haematology analyzer and the non-invasive EzeCheck (EzeRx Health Tech Pvt. Ltd., Bhubaneswar, Odisha, India) in the community setting. We conducted a cross-sectional study among 416 urban slum members in Bhubaneswar, India. We used inter-rater reliability (kappa statistic) of haemoglobin estimation between the haematology analyzer and EzeCheck devices. The finding showed a moderate agreement between both devices (kappa=0.4221). Between both devices, 91.59% of the results were with +/-1.5 difference; 43.51%, no difference; 33.65%, less than one difference; and 14.42%, +/-1 to +/-1.5 difference of haemoglobin estimation. There was no significant difference in overall anaemia status estimates between the devices. Mass screening in schools and communities with non-invasive haemoglobin tests can help identify anaemic people for early diagnosis and bring patients for timely treatment, which can be used in remote areas to support 'Anaemia Mukt Bharat'.

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Section: Data Management and Analysismentioning

confidence: 99%

Diagnostic Validation and Feasibility of a Non-invasive Haemoglobin Screening Device (EzeCheck) for 'Anaemia Mukt Bharat' in India

Sahoo,

Sinha,

Sahoo

et al. 2024

Cureus

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“…Child malnutrition is a global health concern that requires prompt and effective interventions. Several authors (Aheto, 2019; Ameye & De Weerdt, 2020; Augsburg & Rodriguez‐Lesmes, 2018; Boah et al, 2019; Bora et al, 2019; Cash‐Gibson & Benach, 2017; De & Chattopadhyay, 2019; Dhami et al, 2019; Puranik, 2021; Singh et al, 2019) have extensively examined the issues concerning child malnutrition, the most prevalent context studied being health of children under the age of five. Children can experience different forms of malnutrition, including stunting, wasting, and overweight, all of which have severe health implications.…”

Section: Literature Reviewmentioning

confidence: 99%

Malnourished children? Child health disparities and its causes in Eastern India

Patra,

Dutta

2024

Journal of Public Affairs

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The disparity in child health outcomes across Indian districts, particularly in Eastern India, is alarming. Approximately half of the districts in this region exhibit very poor child health outcomes, evidenced by alarmingly high neonatal, infant, and under‐five mortality rates. This study analyses the existing levels and patterns of child health outcomes across 112 districts of Eastern India, a region known for its low levels of child health status. To do this, we have constructed a composite child health index (CHI) using nationally representative data from the National Family Health Survey (NFHS‐5). Using Principal Component Analysis, the study uses the CHI values to categorize the districts into high, moderate, and low‐performing districts. The results show a significant variation in CHI outcomes across the districts, with striking regional disparities. Notably, all high‐performing districts were located only in the state of Odisha. In contrast, a substantial proportion of the low‐performing districts were in the state of Bihar, suggesting systemic healthcare deficiencies. Using discriminant function analysis, we obtain the critical determinants of CHI to be sanitation facilities, mother's education, marriage before 18 years, and low body mass index of the mother. Our findings confirm that improvements in these areas are crucial for enhancing child health outcomes and ending intergenerational transmission of poor health outcomes. The implications of this study extend beyond eastern India, offering valuable insights into similar challenges in global low‐ and middle‐income regions.

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“…( 18 ). While previous studies have examined the risk factors for anemia among children in a geographic (spatial) multilevel model, none have parsed out the relative difference in variations across the geographies ( 19 – 21 ).…”

Section: Introductionmentioning

confidence: 99%

Small area variation in severe, moderate, and mild anemia among women and children: A multilevel analysis of 707 districts in India

Rajpal

Kumar

Rana

et al. 2022

Front. Public Health

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India is home to the highest global number of women and children suffering from anemia, with one in every two women impacted. India's current strategy for targeting areas with a high anemia burden is based on district-level averages, yet this fails to capture the substantial small area variation in micro-geographical (small area) units such as villages. We conducted statistical and econometric analyses to quantify the extent of small area variation in the three grades of anemia (severe, moderate, and mild) among women and children across 36 states/union territories and 707 districts of India. We utilized data from the fifth round of the National Family Health Survey conducted in 2019–21. The final analytic sample for analyses was 183,883 children aged 6–59 months and 690,153 women aged 15–49 years. The primary outcome variable for the analysis was the three anemia grades among women and children. We adopted a three-level and four-level logistic regression model to compute variance partitioning of anemia among women and children. We also computed precision-weighted prevalence estimates of women and childhood anemia across 707 districts and within-district, between-cluster variation using standard deviation (SD). For severe anemia among women, small area (villages or urban blocks) account for highest share (46.1%; Var: 0.494; SE: 0.150) in total variation followed by states (39.4%; Var: 0.422; SE: 0.134) and districts (12.8%; Var: 0.156; SE: 0.012). Similarly, clusters account for the highest share in the variation in severe (61.3%; Var: 0.899; SE: 0.069) and moderate (46.4%: Var: 0.398; SE: 0.011) anemia among children. For mild and moderate anemia among women, however, states were the highest source of variation. Additionally, we found a high and positive correlation between mean prevalence and inter-cluster SD of moderate and severe anemia among women and children. In contrast, the correlation was weaker for mild anemia among women (r = 0.61) and children (0.66). In this analysis, we are positing the critical importance of small area variation within districts when designing strategies for targeting high burden areas for anemia interventions.

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Anemia Among Children Under 5 Years in India: A District-Level Spatial Analysis Using NFHS-5 Data

Cited by 5 publications

References 28 publications

Diagnostic Validation and Feasibility of a Non-invasive Haemoglobin Screening Device (EzeCheck) for 'Anaemia Mukt Bharat' in India

Diagnostic Validation and Feasibility of a Non-invasive Haemoglobin Screening Device (EzeCheck) for 'Anaemia Mukt Bharat' in India

Malnourished children? Child health disparities and its causes in Eastern India

Small area variation in severe, moderate, and mild anemia among women and children: A multilevel analysis of 707 districts in India

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