ABSTRACT
Introduction:
Anaemia is one of the significant public health problems faced by developing countries. It occurs more frequently in women of childbearing age. Anaemia causes poor work capacity, and severe forms may even cause cardiac failure. In pregnant women, anaemia may lead to preterm labour, low-birth-weight babies, and increased risk of maternal mortality due to post-partum haemorrhage. Even though there are national programmes to supply iron free of cost and other measures to tackle anaemia, it is still prevalent in our country. Anaemia prevalence has increased between NFHS-4 and NFHS-5, from 53% in 2015–16 to 57% in 2019–21 among women. Poor perception about anaemia is the main reason for failure of these programmes. Through this study, we evaluate the perceptions about anaemia in urban women, which is not widely studied unlike in rural women.
Aim:
To study the sociodemographic factors and perception of women in the reproductive age group with anaemia in an urban population.
Objectives:
To assess sociodemographic factors contributing to anaemia and their association with severity of anaemia. 1. To assess their perception about anaemia and factors associated with it.
Material and Methods:
We studied 100 participants who fitted the inclusion criteria (women in the age group 15–49 years) attending various departments diagnosed with anaemia based on laboratory results. A brief introduction was given to the participants regarding the purpose of study by the primary researcher. After receiving their informed consent, sociodemographic factors and clinical and lab results were noted. A pre-tested, semi-structured validated questionnaire was administered to the participants to elicit awareness and perception about anaemia and its health impacts. To eliminate repeats, caution was taken not to include previously recorded data if such a situation arose where previously the interviewed person came for subsequent visit during the study period.
Results and Conclusions:
A total of 100 women in the reproductive age group (15–49 years of age) were taken up for study. Almost half(44%) of the study participants belonged to the age group of > 40 years. Almost half (41%) of the study participants were Hindus. With respect to distribution of Hb levels, we observed that around 2/3rd of the study participants (61%) had moderate anaemia and 32% had severe anaemia. Regarding overall perception regarding anaemia among reproductive age group women, only 9% have excellent perception. 50% have good perception, and 41% only have poor perception. There is no significant association between age group, symptoms, body mass index, parity, number of family members, and socioeconomic status with anaemia severity (P value > 0.05). Moderate and severe anaemia were more common in women who had birth interval ≤ 3 years, and it is statistically significant (P = 0.007). There is no significant association between age group, education, and socioeconomic status with perception of anaemia (P value > 0.05). With respect to profession and prior treatment status, we observed a significant association (P value < 0.05), where it was observed that study participants who were unemployed or unskilled and who had not received prior treatment had poorer perception regarding anaemia.
Keywords: Anaemia, perception, sociodemographic factors, women of reproductive age group
Introduction
Anaemia is one of the significant public health problems faced by developing countries. It occurs more frequently in women of childbearing age. Anaemia adversely affects cognitive and motor development in children and work capacity in adults, thus delaying nations’ economic growth. Anaemia in pregnancy requires special attention as it results in preterm delivery, low-birth-weight infants, and decreased iron stores for the baby, leading to impaired development. Anaemia is an indicator of both poor nutrition and poor health.[1]
According to the World Health Organization (WHO), the average prevalence of anaemia is 56%, ranging between 35 and 100% among different regions worldwide. The prevalence of anaemia in India is reported to be between 33 and 100% by various studies.[2] In the National Family Health Survey-5 (2019–21), the prevalence of anaemia among women of the reproductive age group in our country is 57%.[3] Anaemia causes up to 20% of maternal deaths in India, and it is the second most common cause of maternal deaths.[2]
Most developing countries have policies to give women iron alone or combined with folate. In India, the Intensified National Iron Plus Initiative provides 180 tablets, each containing 60 mg elemental iron and 0.5 mg folic acid for all women during pregnancy and lactation. In addition, a weekly tablet of 60 mg of elemental Iron and 0.5 mg of folic acid is provided to all women in the reproductive age group.[4]
Despite these policies, the prevalence of anaemia has not declined significantly. The anaemia prevalence has increased between NFHS-4 and NFHS-5, from 53% in 2015–16 to 57% in 2019–21 among women.[3] Experts believe that one of the main reasons national iron supplementation programmes have failed is women’s non-compliance/non-adherence with taking iron supplements daily because of gastrointestinal side effects that sometimes occur when taking iron.[4] Poor perception of anaemia among women is also a leading cause of the failure of these programmes.
In this study, select 100 women in the reproductive age group with anaemia in a tertiary care centre in Kochi, an urban area in Kerala. Through this study, we aimed to evaluate the perceptions about anaemia in urban women, which is not widely studied, unlike in rural women. Though there are many studies on anaemia in pregnancy, anaemia in women of the reproductive age group, in general, is not often studied. This study also aims to understand the clinical presentations and causes of anaemia in urban women and to assess how far the government programmes have reached out to them.
Aim and Objectives
Aim
To study the sociodemographic factors and perception of women in the reproductive age group with anaemia in an urban population.
Objectives
To assess sociodemographic factors contributing to anaemia and their association with severity of anaemia.
To assess their perception of anaemia and factors associated with it.
Material and Methods
This observational study was conducted in a tertiary care centre, Kochi, Kerala, from October 2020 to March 2022, with approval from the Institutional Ethics Committee and informed written consent obtained from all participants. The study focused on women in the reproductive age group (15–49 years) who were diagnosed with anaemia based on laboratory results. Participants were selected using purposive sampling, with a final sample size of 100 (determined by the formula n > z2xqxp/d2, where P is the prevalence rate of 57%,[3] z is the confidence coefficient for a 95% confidence interval, and d is the error of estimate set at 10%). Data collection included administering a pre-tested, semi-structured, validated questionnaire to assess participants’ awareness and perceptions of anaemia. Sociodemographic factors and laboratory results were recorded. Statistical analysis involved Student’s independent t-test for continuous variables and the Chi-square test for qualitative variables. Inclusion criteria were women aged 15–49 with diagnosed anaemia, while exclusion criteria included those who did not consent or had known psychiatric conditions. The study adhered to ethical standards, with no additional financial burden placed on participants, as data were collected from routine questionnaires and laboratory reports.
Definition of variables
Women of reproductive age were defined by the WHO as those between 15 and 49 years old.
Pregnant women with a haemoglobin level less than 11 g/dl and nonpregnant women with less than 12 g/dl are considered to have anaemia.[1]
The severity of anaemia is categorized as mild (haemoglobin levels of 10.0–10.9 g/dl for pregnant women and 10.0–11.9 g/dl for nonpregnant women), moderate (7.0–9.9 g/dl), or severe (less than 7.0 g/dl).[1]
Perception is categorized as excellent for those who answer 80% or more correctly, good for those who answer between 50% and 79% correctly, and poor for those who answer less than 50% correctly.
Results
A total of 100 participants who fitted the inclusion criteria and were attending various departments diagnosed with anaemia based on laboratory results were recruited for the study. Consent was gained from all patients and their relatives to participate in the study, which accounted for a response rate of 100%.
The sociodemographic characteristics of the study participants are depicted in Table 1. We could see that 44% of the study participants belonged to the age group of > 40 years, with a mean age of 38.4 (8.3) years. 41% of the study participants were Hindu by religion. 61% were graduate/postgraduate by education status. With respect to occupation, 47% of them were unemployed. There was equal representation from income groups of (₹ 5001–₹ 10000) and (Greater than ₹ 10000). 91% of the study participants consumed a non-vegetarian diet. 70% of the study participants were multiparous, and the birth interval between the last two childbirths was ≤3 years in 50%. Upon looking into the menstrual history, 50% had menorrhagia and 6% had polymenorrhoea.
Table 1.
Sociodemographic characteristics of the study participants (n=100)
| Characteristics | Frequency (%) |
|---|---|
| Age group | |
| <30 years | 23 (23.0) |
| 31-40 years | 33 (33.0) |
| >40 years | 44 (44.0) |
| Religion | |
| Christian | 37 (37.0) |
| Hindu | 41 (41.0) |
| Muslim | 22 (22.0) |
| Education | |
| Illiterate/Primary school | 10 (10.0) |
| Secondary school | 29 (29.0) |
| Graduate | 39 (39.0) |
| Postgraduate/Professional | 22 (22.0) |
| Occupation | |
| Professional | 15 (15.0) |
| Clerical/Shop owner/Farmer | 22 (22.0) |
| Unemployed | 47 (47.0) |
| Semiskilled/skilled | 16 (16.0) |
| Number of family members | |
| ≤3 | 9 (9.0) |
| 4-5 | 45 (45.0) |
| >5 | 46 (46.0) |
| Per capita income | |
| ₹ 1001- ₹ 5000 | 17 (17.0) |
| ₹ 5001- ₹ 10000 | 44 (44.0) |
| Greater than ₹ 10000 | 44 (44.0) |
| Dietary pattern | |
| Vegetarians | 9 (9.0) |
| Nonvegetarians | 91 (91.0) |
| Parity | |
| Nulliparous | 11 (11.0) |
| Primipara | 19 (19.0) |
| Multiparous | 70 (70.0) |
| BMI | |
| High | 39 (39.0) |
| Low | 18 (18.0) |
| Normal | 43 (43.0) |
| Birth Interval | |
| Nulliparous/Primipara | 31 (31.0) |
| ≤3 | 50 (50.0) |
| >3 | 19 (19.0) |
| Menstrual history | |
| Normal | 43 |
| Menorrhagia | 50 |
| Oligomenorrhoea/Amenorrhoea | 1 |
| Polymenorrhoea | 6 |
Regarding the distribution of Hb levels, we observed that 61% of the study participants had moderate anaemia and 32% had severe anaemia [Figure 1].
Figure 1.
Classification of anaemia among the study participants
Table 2 describes the distribution of perception about anaemia and its health impacts among study participants.
Table 2.
Distribution of perception about anaemia and its health impacts among study participants, n=100
| Question, Response distribution | absolute number (%) |
|---|---|
| Overall perception regarding anaemia | |
| Excellent perception | 9 (9.0) |
| Good perception | 50 (50.0) |
| Poor perception | 41 (41.0) |
| Do you know what anaemia is? | |
| Correct answer | 95 (95.0) |
| Wrong answer | 5 (5.0) |
| Do you know the symptoms of anaemia? | |
| Correct answer | 75 (75.0) |
| Wrong answer | 25 (25.0) |
| Do you know complications due to anaemia? | |
| Correct answer | 33 (33.0) |
| Wrong answer | 67 (67.0) |
| Do you know that women of reproductive age group are more likely to have anaemia? | |
| Yes | 86 (86.0) |
| No | 14 (14.0) |
| Do you know what the foods rich in Iron are? | |
| Correct answer | 63 (63.0) |
| Wrong answer | 37 (37.0) |
| Do you include iron rich diet in your food? | |
| Yes | 46 (60.0) |
| No | 54 (40.0) |
| Have you ever taken iron tablets? | |
| Yes | 71 (71.0) |
| No | 29 (29.0) |
| If yes, when? (n=71) | |
| During pregnancy | 43 (60.5) |
| During pregnancy and post-partum | 11 (15.4) |
| During pregnancy and when anaemia was diagnosed earlier | 5 (7.0) |
| During pregnancy, during post-partum and when anaemia was diagnosed | 9 (12.6) |
| When anaemia was diagnosed | 4 (5.4) |
| Have you taken iron tablet as much duration as advised? (n=71) | |
| Yes | 14 (19.7) |
| No | 57 (80.3) |
| If no, why? (n=57) | |
| Due to side effects | 45 (79) |
| Got better symptomatically | 9 (16) |
| Both | 3 (5) |
| Do you know government supplies iron tablet? | |
| Yes | 25 (25.0) |
| No | 75 (75.0) |
| If yes, have you taken part in the programme? (n=25) | |
| Yes | 8 (32.0) |
| No | 17 (68.0) |
| Do you know what is considered as excessive bleeding during menstruation.? | |
| Correct answer | 99 (99.0) |
| Wrong answer | 1 (1.00) |
| Do you know that excessive bleeding during menstruation cause anaemia? | |
| Correct answer | 97 (97.0) |
| Wrong answer | 3 (3.0) |
| Have you ever been educated about anaemia and its health impacts? | |
| Yes | 45 (45.0) |
| No | 55 (55.0) |
| If yes by whom? (n=45) | |
| Doctor | 19 (42.0) |
| Family/Friends | 9 (20.0) |
| Media | 4 (8.8) |
| Other health workers | 13 (28.8) |
| Do your family members take due care about your food intake and habits? | |
| Yes | 16 (16.0) |
| No | 84 (84.0) |
| Were you aware that you might be suffering from anaemia before coming to this hospital? | |
| Yes | 37 (37.0) |
| No | 63 (63.0) |
| Are you aware that multiple pregnancies can lead to anaemia? | |
| Yes | 86 (86.0) |
| No | 14 (14.0) |
| Have you ever undergone blood transfusion? | |
| Yes | 28 (28.0) |
| No | 72 (72.0) |
| Have you ever checked your blood Hb level without doctor’s advice? | |
| Yes | 26 (26.0) |
| No | 74 (74.0) |
| Are you feeling better after visiting hospital? | |
| Yes | 96 (96.0) |
| No | 4 (4.0) |
Regarding the overall perception of anaemia among reproductive age group women, only 9% had an excellent perception. 50% had good perception, and 41% only had poor perception.
We observed that 95% of the women knew what anaemia is correctly, while 75% knew what were the symptoms of anaemia, but only 33% were aware of the complications of anaemia. When asked a question about women of the reproductive age group are more likely to have anaemia, 86% answered yes. Almost everyone (99%) knew excessive bleeding during menstruation can cause anaemia and what exactly is excess bleeding. 86% knew that multiple pregnancies could be a reason for anaemia.
63% knew about the common iron-rich food, but only 46% adhered to it and added iron-rich foods in their diet. Only 16% said that their family members take due care about their food intake and habits. 71% consumed iron tablets before, of which 61% admitted it was during their pregnancy. Around 20% of the patients consumed it as advised by physicians, while the rest did not, and the common reason for non-consumption was side effects (79%). 25% knew that government supplies iron tablets free of cost, while only 32% of them availed of the programme.
Only 45% admitted they had been educated regarding anaemia and its health impacts, of whom 42% were informed by doctors. 37% admitted that they were aware they might be suffering from anaemia before coming to this hospital. 28% admitted they had undergone blood transfusions before, while 26% had checked Hb prior without even a physician advising them, and 96% are feeling better after visiting the hospital.
Table 3 describes the association of age group, symptoms, body mass index (BMI), parity, and socioeconomic status with anaemia severity. We observed that there was no significant association between age group, symptoms, BMI, parity, number of family members, and socioeconomic status with anaemia severity (P value > 0.05). It was found that moderate and severe anaemia were more common in women who had birth interval ≤ 3 years and it was statistically significant (P = 0.007).
Table 3.
Association of age group, symptoms, BMI, parity, number of family members, socioeconomic status, and interval between last two child births with anaemia severity
| Characteristics | Mild anaemia | Moderate anaemia | Severe anaemia | P |
|---|---|---|---|---|
| Age group | ||||
| <30 years | 0 | 17 (73.9) | 6 (26.1) | |
| 31-40 years | 2 (6.1) | 21 (63.6) | 10 (30.3) | 0.330 |
| >40 years | 5 (11.4) | 23 (52.3) | 16 (36.4) | |
| Symptomatic | ||||
| Yes | 6 (12.5) | 27 (56.2) | 15 (31.2) | |
| No | 1 (2.2) | 28 (62.2) | 16 (35.5) | 0.171 |
| BMI | ||||
| High | 5 (12.8) | 21 (53.8) | 13 (33.3) | |
| Low | 0 (0.0) | 10 (55.5) | 8 (44.5) | 0.208 |
| Normal | 2 (4.6) | 30 (69.7) | 11 (25.5) | |
| Parity | ||||
| Nulliparous | 1 (11.0) | 6 (54.5) | 4 (45.5) | |
| Primipara | 1 (5.3) | 12 (63.2) | 6 (31.6) | 0.196 |
| Multi | 5 (7.4) | 43 (61.4) | 22 (31.4) | |
| Family members | ||||
| ≤3 | 1 (11.1) | 6 (66.6) | 2 (22.2) | |
| 4-5 | 2 (4.4) | 27 (60.0) | 16 (35.5) | 0.127 |
| >5 | 4 (8.2) | 28 (60.8) | 14 (30.4) | |
| Socioeconomic status | ||||
| ₹ 1001- ₹ 5000 | 3 (5.1) | 25 (64.1) | 12 (30.8) | |
| ₹ 5001- ₹ 10000 | 0 (5.3) | 12 (70.6) | 5 (29.4) | 0.507 |
| Greater than ₹ 10000 | 5 (11.3) | 24 (54.5) | 15 (34.1) | |
| Interval between last two child births | ||||
| Nulliparous/primipara | 2 (6.4) | 18 (58.1) | 11 (35.5) | |
| ≤3 years | 3 (6.0) | 31 (62.0) | 16 (32.0) | |
| >3 years | 3 (15.0) | 12 (60.0) | 5 (25.0) |
Table 4 describes the association of age group, education, profession, previous treatment, and socioeconomic status with perception of anaemia. We observed that there was no significant association of age group, education, and socioeconomic status with perception of anaemia (P value > 0.05). With respect to profession and prior treatment status, we observed a significant association (P value < 0.05), where it was observed that study participants who were unemployed or unskilled and who had not received prior treatment had poorer perception regarding anaemia.
Table 4.
Association of age group, education, profession, socioeconomic status, and previous treatment with perception of anaemia
| Characteristics | Excellent perception | Good perception | Poor perception | P |
|---|---|---|---|---|
| Age group | ||||
| <30 years | 0 (0.0) | 14 (60.8) | 9 (39.2) | |
| 31-40 years | 4 (12.2) | 16 (48.5) | 13 (39.4) | 0.473 |
| >40 years | 5 (11.4) | 20 (45.5) | 19 (43.2) | |
| Profession | ||||
| Professional | 5 (33.3) | 9 (60.0) | 1 (6.7) | |
| Clerical/Shopowner/Farmer | 1 (4.5) | 16 (72.7) | 5 (22.7) | 0.001 |
| Unemployed | 3 (6.4) | 17 (36.2) | 27 (57.2) | |
| Semiskilled/Skilled | 0 (0.0) | 8 (50.0) | 8 (50.0) | |
| Education | ||||
| Illiterate/Primary school | 5 (12.8) | 21 (53.8) | 13 (33.3) | |
| Secondary school | 0 (0.0) | 10 (55.5) | 8 (44.5) | 0.208 |
| Graduate | 2 (4.6) | 30 (69.7) | 11 (25.5) | |
| Postgraduate/Professional | 1 (5.3) | 12 (63.2) | 6 (31.6) | |
| Have you ever been treated before | ||||
| Yes | 7 (17.5) | 29 (72.5) | 4 (10.0) | |
| No | 1 (1.7) | 20 (34.5) | 37 (63.8) | 0.001 |
| Socioeconomic status | ||||
| ₹ 1001- ₹ 5000 | 4 (10.3) | 22 (56.4) | 13 (33.3) | |
| ₹ 5001- ₹ 10000 | 1 (5.3) | 7 (41.2) | 9 (52.9) | 0.720 |
| Greater than ₹ 10000 | 4 (9.1) | 21 (47.7) | 19 (43.2) |
Discussion
Anaemia is a major public health problem, especially in women of the reproductive age group. Studies conducted in different states of India revealed high prevalence of anaemia in women of the reproductive age group, especially in pregnant women.[2,5,6,7,8,9,10] In this study, we selected 100 women in the age group of 15 to 49 years with anaemia presented in a tertiary care centre in an urban area and studied the lab profile, sociodemographic factors contributing to anaemia, and their perception about anaemia and its health impacts.
Among 100 participants, 44% belonged to the age group of more than 40 years with a mean age of 38.4 (S.D 8.3). This age predilection was similar to a previous study done by Majid Sadeghian.[11] However, in some other studies, the younger age group were more affected.[12,13] Regarding the religion of this participants, more (41%) were Hindus, followed by Christian (37%) and Muslim (22%). Muslims were less affected in a previous study which was done in Andhra Pradesh.[10] This religious difference seen could be due to the difference in their dietary pattern as Muslims and Christians include more meat in their diet.
Most of the previous studies showed prevalence of anaemia had a significant association with education. A higher proportion of participants belonged to less educated.[5,6,14,15] But in this study, most of them were well educated, probably because this study was conducted in an urban setting. Out of 100 participants, 39 had completed their graduation, 29% had secondary education, 22% were postgraduates or professionals, and only 10 were illiterate.
47% of them were unemployed, 22% were clerical/shop owner/farmer, 16% were skilled/semi-skilled, and 15% were professional. There was almost equal representation with respect to income groups of ₹5001–₹10000 (44%) and greater than ₹10000 (44%) per-capita. Only 17% belonged to the income group of ₹1001–₹5000. However, this was different from most of the previous studies,[5,15,16] which showed low socioeconomic status as a risk factor for developing anaemia. This difference could be because our study was done in an urban population.
46% belonged to joint families with family members more than 5 persons, 45% with 4 or 5 persons, and 9% with ≤3 persons in the family. Increased risk of anaemia in women living in families with more members was observed in previous studies also.[13,14,15] This could be due to the social setting in developing countries where the priority for nutritious meal is given to men and children in families with more members.
70% of them were multiparous, 19% primipara, and 11% were nulliparous. Parity had a clear effect on the prevalence of anaemia in other studies also. Women with more than two pregnancies had a significantly higher rate of anaemia in a study conducted in rural areas of Tabas,[11] while a study in South India[2] has reported a higher rate of anaemia for the parity index more than 4. This might be caused by the increase in women’s nutritional needs during pregnancy. It also highlights the importance of contraception education.
18% of study participants had low BMI, 43% had normal BMI, and 39% had high BMI. A significantly low haemoglobin level in both underweight and obesity was noticed, suggesting U-shaped relationship between BMI and anaemia in a study done in West Bengal.[6] No association was found between BMI and anaemia in a study conducted in Bursa.[17]
Regarding the interval between last two child births, 50% were with birth interval ≤ 3 years, 19% were with birth interval > 3 years, and 31% were either nulliparous or with one child. These findings were similar to previous studies,[2,5,13] which observed that those with a short inter-conceptional period of less than 2 years were more affected.
We observed that there is no significant association between age group, symptoms, BMI, parity, number of family members, and socioeconomic status with anaemia severity (P value > 0.05). It is found that moderate and severe anaemia are more common in women who had birth interval ≤3 years and it is statistically significant (P = 0.007). In a study done in West Bengal by Pritam Ghosh et al., different levels of anaemia were significantly associated with higher age and lower socioeconomic group. A significantly low haemoglobin level in both underweight and obesity was noticed, suggesting U-shaped relationship between BMI and anaemia.[6]
With regard to overall perception regarding anaemia among reproductive age group women, only 9% had excellent perception, 50% had good perception, and 41% only had poor perception.
With respect to the knowledge regarding anaemia among reproductive age women, we observed that 95% of the women knew what anaemia is correctly, while 75% knew what the symptoms of anaemia were, but only 33% were aware of the complications of anaemia. Almost everyone (99%) knew excessive bleeding during menstruation can cause anaemia and what exactly is excess bleeding. 86% knew that multiple pregnancies could be a reason for anaemia.
63% knew about the common foods that are rich in iron, but only 46% adhere to it and add iron-rich foods in diet. Only 16% said that their family members take due care about their food intake and habits. 71% consumed iron tablets before, of which 61% admitted it was during their pregnancy. Around 20% alone consumed it as advised by physicians, while the rest did not and the common reason for non-consumption was side effects (79%). Only 25% knew that government supplies iron free of cost, while only 32% of them availed of the programme. Only 45% admitted they had been educated regarding anaemia and its health impacts, of whom 42% were informed by doctors. 37% admitted that they were aware that they might be suffering from anaemia before coming to this hospital. 28% admitted they had undergone blood transfusions before, while 26% had checked Hb prior without even a physician advising them, and 96% are feeling better after visiting the hospital. In a study conducted in Tunisian women, the majority of the women attributed anaemia to the following causes: malnutrition, lack of hygiene, heavy workload, and responsibilities in the household. Many women connected anaemia with hypotension. A few established a relationship between iron deficiency and anaemia. They were confident in the treatment provided by their doctor, although many complained they were not given sufficient information.[18] Another study also showed a poor perception of anaemia in women, which was done by Rae Galloway et al.[19]
There is no significant association between age group, education, and socioeconomic status with the perception of anaemia (P value > 0.05). We observed a significant association of profession and prior treatment status with the perception of anaemia (P value < 0.05), where it was observed that study participants who were unemployed or unskilled and who had not received prior treatment had poorer perception regarding anaemia.
Limitations of this study
The study’s limitations include its focus on women who visited the hospital, potentially overlooking the perceptions of those who chose not to seek care, and the differing anaemia severity profiles in the general population compared to those seeking medical help.
Conclusion
This study found that 41% of women had a poor perception of anaemia. Even in this urban population, where most of the women were highly educated, only 25% knew that the government supplies iron tablets free of cost, and only 32% of them availed themselves of the programme. Hence, healthcare workers must educate women about anaemia and the need for taking iron.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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