In a study of 15 low- to middle-income countries, researchers found that none of the evaluated nations were expected to reach a global nutrition target of a 50% reduction in anemia prevalence in reproductive-age women by 2025. Results of this study were recently reported in the Bulletin of the World Health Organization.

“Annually, more than 115 000 maternal deaths are attributed to anaemia worldwide,” the researchers wrote in their report. They undertook this study to characterize anemia prevalence trends and projections in low- to middle-income countries. The countries included in the analysis were Albania, Armenia, Benin, Burundi, Ethiopia, Haiti, India, Jordan, Malawi, Nepal, Senegal, Timor-Leste, Togo, Uganda, and the United Republic of Tanzania.

The researchers used Demographic and Health Survey data involving reproductive-age women, defined by an age range of 15 through 49 years. Anemia was defined as a hemoglobin level below 11 g/dL in pregnant women, or below 12 g/dL in women who were not pregnant. The researchers used data from these surveys to identify patterns in anemia prevalence from 2000 through 2018. They also estimated how likely each nation is to reach a World Health Assembly global nutrition target for a reduction in anemia prevalence in reproductive-age women of 50% by 2025, compared with 2012 levels.

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The study population consisted of 1,092,512 reproductive-age women. They were mostly living in rural environments (64.9%), and nearly half (47.8%) had an education level that was below the secondary-school education level. The poorest wealth quintile included 17.8% of the women.

Across the countries in this study, 9 countries showed reduced anemia prevalence over time from 2000 through 2018. The strongest decrease in anemia prevalence in this population was seen in Malawi, where the prevalence decreased by 2.5% during the study period.

Increased anemia prevalence was seen in 6 countries over the period from 2000 through 2018. The largest increase was found in Burundi, where anemia prevalence rose by 10.9% during the study period. Additionally, the researchers found that nearly half of the nations currently have anemia prevalence levels for reproductive-age women of 40% or more.

The researchers considered none of the evaluated countries to be likely to reach the global nutrition target, with anemia prevalence projected to be ≥15% in reproductive-age women by 2025 in each if current patterns remain unchanged. The highest projected anemia prevalence in reproductive-age women is expected to occur in Burundi, where it is projected to be 66.8% by 2025.

The researchers also identified disparities in anemia prevalence rates within countries. Factors that appeared linked to variation in anemia prevalence included wealth, rural versus urban residence, educational level, and age. “No country is likely to achieve the global target of reducing anaemia unless the inequalities are minimized and effective interventions are implemented,” the researchers concluded in their report.


Hasan MM, Soares Magalhaes RJ, Garnett SP, et al. Anaemia in women of reproductive age in low- and middle-income countries: progress towards the 2025 global nutrition target. Bull World Health Organ. 2022;100(3):196-204. doi:10.2471/BLT.20.280180