Barriers and Facilitators Contributing to Anemia among women in Northeast India: A multilevel modelling approach

Abstract

Anemia, characterized by reduced hemoglobin or red blood cell count, diminishes oxygen transport
in the blood and is a significant public health issue in India's Northeast region, particularly among women,
with one in two affected. This study assessed the prevalence of anemia among reproductive women in
Northeast India, considering socio-economic, demographic, and dietary factors using a multilevel logistic
regression model. The analysis, which examined determinants across individual, district, and state levels,
found that socioeconomic status and standard of living were key determinants of anemia, with urban, welleducated

women from higher socioeconomic backgrounds having lower odds of anemia. High-birthrate
women and adolescents were more likely to be anemic, while non-pregnant women were more anemic than
pregnant ones. Unexpectedly, not consuming vegetables reduced anemia risk, whereas abstaining from
aerated beverages increased it. The multilevel analysis revealed significant variance attributable to state-level
differences, indicating varied anemia prevalence across states. Efforts to address higher-order births and
enhance women's economic and educational status are crucial, alongside ensuring universal access to nutrition
and healthcare. Further research should explore region-specific factors to better understand the observed
variations and improve health outcomes for women across Northeast India.