Postpartum anemia in India within 6 months of delivery: Prevalence, socioeconomic inequalities, and regional disparities: A secondary analysis of NFHS-5 (Fifth National Family Health Survey, 2019-2021).

Objective

To estimate the prevalence and severity of postpartum anemia among Indian women within 6 months of delivery and identify associated socioeconomic, healthcare, and geographic factors.

Methods

This cross-sectional secondary analysis used data from NFHS-5 (Fifth National Family Health Survey, 2019-2021). Women aged 15 to 49 years who had a live birth within 6 months before the survey, were not pregnant at interview, and had hemoglobin measurements were included. Postpartum anemia was defined as hemoglobin <11.0 g/dL. Survey-weighted prevalence estimates were calculated, and associated factors were examined using survey-weighted Poisson regression with robust variance to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs).

Results

Among 24 700 postpartum women, the prevalence of postpartum anemia was 34.7%. Mild, moderate, and severe anemia affected 19.1%, 14.7%, and 0.9% of women, respectively. Prevalence declined from 38.1% during the first 2 months postpartum to 31.3% at 5 to 6 months. Higher prevalence was observed among women with no education (aPR 1.25 [95% CI, 1.13-1.39]), those in the poorest wealth quintile (aPR, 1.19 [95% CI, 1.06-1.35]), Scheduled Tribe women (aPR, 1.21 [95% CI, 1.11-1.31]), underweight women (aPR, 1.11 [95% CI, 1.05-1.17]), and women who delivered at home (aPR, 1.15 [95% CI, 1.08-1.22]). Geographic disparities were evident, with higher prevalence in eastern, northeastern, and central India.

Conclusion

One in three Indian women experiences postpartum anemia within 6 months of childbirth. Strengthening postpartum screening, nutrition support, and targeted maternal health interventions may reduce disparities and improve maternal health outcomes.