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Indian Journal of Community Medicine

Socio-Demographic Correlates of Anaemia Among Adolescent Girls in Rural Area of District Meerut (U.P.)

Author(s): C.M.S. Rawat, S.K. Garg, J.V. Singh, M. Bhatnagar, H. Chopra, S.K. Bajpai

Vol. 26, No. 4 (2001-10 - 2001-12)

Deptt. of Community Medicine, LLRM Medical College, Meerut - 250 004

Abstract:

Research question: What is the prevalence of anaemia and its socio-demographic correlates among adolescent girls in rural area of district Meerut (U.P.).

Objectives: 1. To find out prevalence of anaemia among adolescent girls in rural Meerut. 2. To study socio-demographic characteristics in relation to anaemia.

Study design: Cross-sectional study.

Setting: Subcentre villages of P.H.C. Daurala, rural field practice area under Deptt. of Community Medicine, LLRM Medical College Meerut.

Participants: 504 adolescent girls (10-18 years).

Study period: June to December 1999.

Study variables: Age, religion, caste, family type, socio-economic status, parental education and occupation, family size, haemoglobin.

Statistical analysis: Chi-square test, odds ratio.

Results: Among 504 adolescent girls, 174(34.5%) were found to be anaemic. Significant association of anaemia was found to be with type of family, socio-economic status, father's occupation, mother's education and family size.

Keywords: Adolescent girl, Anaemia, Rural

Introduction:

Among adolescents, girls constitute a more vulnerable group, particularly in developing countries where they are traditionally married at an early age and exposed to greater risk of reproductive morbidity and mortality1. Developmentally it is a crucial period particularly with reference to reproductive health. The young women who are at the brink of womanhood constitute the most crucial segment of our population from the point of view of the quality of our future generation. Adolescence a period of peak growth for boys and girls2. Food and nutrient needs are proportionately higher during the growth spurt. Anemia is a worldwide problem most commonly due to widespread nutritional deficiencies. It has been reported that iron is required for growth in adolescents and that in adolescent girls on marginal diet, iron deficiency may be consequence of growth and skeletal development. Further, low iron stores throughout childhood may contribute to a delayed age of menarche and anaemia in adolescents may impair immune response3. The present study was planned to highlight the problem of anaemia in adolescent girls in the light of scarcely available literature for this high risk group.

Material and Methods:

The study was carried out in Daurala block, the rural field practice area of Deptt. of Community Medicine, LLRM Medical College, Meerut. Sample consisted of 504 adolescent girls (10-18 years) covering 21 girls from each of 24 subcentre villages under Daurala PHC. In order to have an effective coverage, the study was conducted through randomly selected house to house visit till 21 girls between the age group of 10-18 years in each subcentre village were covered.

Detailed information was collected on a predesigned and pretested proforma about socio-demographic characteristics for anaemia by oral questionnaire method supplemented by physical examination and haemoglobin estimation. Due to feasibility and cost effectiveness, haemoglobin estimation was done by Sahli's haemoglobinometer.

Results:

Table:1: Distribution of anaemia in adolescent girls according to severity of anaemia.

Severity of anaemia Haemoglobin (gm%) Adolescent girls Prevalence (%)
Mild 10-<cut off* 96 19.0
Moderate 7-<10 71 14.1
Severe <7 07 1.4
No Anaemia cut off+ 330 65.5

*cut off = 12gm% for non-pregnant and 11 gm% for pregnant adolescent girls.

Among the 504 adolescent girls covered in the study 174(34.5%) girls were found to be anaemic. The prevalence of mild, moderate and severe anaemia among adolescent girls was 19%, 14.1% and 1.4% respectively as shown in Table I. The proportion of mild, moderate and severe anaemia was 55.2%, 40.8% and 4.0% respectively.

Table II: Socio-demographic correlates and prevalence of anaemia in adolescent girls.

Socio-demographic
correlates
No. of
adolescent girls
Anaemic Cases Anaemic Cases X2, df, p
Number Prevalence (%)
Type of Family
Nuclear 318 90 28.3 14.7, 1, <0.001
Joint 186 84 45.2  
Socio-economic Class
I 66 18 27.3 13.3, 4, <0.01
II 162 48 29.6  
III 114 38 33.3  
IV 150 64 42.7  
V 12 06 50.0  
Father's Occupation
Service 56 18 32.1 12.07, 3, <0.01
Business 36 12 33.3  
Agriculture 221 60 27.1  
Labour 191 84 44.0  
Mother's Education
Illiterate 166 70 42.2 19.2, 5, <0.01
Just literate 52 27 51.9  
Primary 102 28 27.5  
Middle (JHS) 108 30 27.8  
High School 48 12 25.0  
Intermediate & above 28 07 25.0  
Family Size
< or =3 162 44 27.2 5.7, 1, <0.02
>3 342 130 38.0  
Total 504 174 34.5  

*Source5,6.

Various socio-demographic factors which were found to be significantly associated with anaemia in adolescent girls have been tabulated in Table II.

Prevalence of anaemia was significantly higher (p<0.001) among adolescent girls belonging to joint family (45.2%) than those belonging to nuclear family (28.3%) (odds ratio 2.1). Prevalence of anaemia was also found to be significantly associated with socio-economic status (p<0.01) as anaemia was higher in socio-economic class V (50%) and significantly reduced with rise in socio-economic status being minimum (27.3%) in class I (p<0.01). Prevalence of anaemia was found to be significantly higher (44%) in those adolescent girls whose fathers were working as labourers than those of agriculturers (27.1%)(p<0.01). Prevalence of anaemia was also found to be significantly higher (p<0.01) in those adolescent girls having illiterate (42.2%) and just literate mother (51.9%) as compared to better literate mothers. A significantly high (p<0.02) prevalence of anaemia was found in adolescent girls belonging to families having family size >3(38%) than 27.2% in those girls from families of family size <3 (odds ratio 1.6).

Age, religion, caste, father's education and mother's working status of adolescent girls did't show any significant relationship with the prevalence of anaemia in these adolescent girls (p>0.05).

Discussion:

The study revealed the overall prevalence of anaemia as 34.5% in adolescent girls which is higher than 27% among rural girls reported by Vasanthi et al (1981)7 but is reported to be low as compared to multicentric study8 recently completed in 3 regions of India (Mumbai, Gujarat and Delhi) which showed anaemia as 62-65%, 57-65% and 48-50% respectively in adolescent girls. This is probably because Meerut is one of the prosperous region of North India having fertile soil and good agricultural yield. In the study, majority of anaemic girls were having mild anaemia (55.2%) and in only 4% anaemia was severe in nature. In the present study, the prevalence of anaemia was significantly higher (45.2%) among the adolescent girls belonging to joint families as compared to (28.3%) those from nuclear families (p<0.001), which may be due to availability of quantitatively and qualitatively adequate food in nuclear families.

An inverse association between socio-economic status (SES) and prevalence of anaemia was observed (p<0.01) which may be because of better availability of high quality food with better SES. A significantly higher (p<0.01) prevalence of anaemia in adolescent girls having illiterate and just literate mothers showed better awareness among literate mothers. Prevalence of anaemia in relation to father's occupation was found to be significant (p<0.01), which may be because of availability of better quality foods to the girls of agricultural family. A higher prevalence of anaemia (p<0.02) in adolescent girls belonging to families having family size >3 than those girls from families of family size <3 may be due to availability of adequate diet to all the family members in small families.

Conclusion and Recommendations:

The prevalence of anaemia among adolescent girls was found to be 34.5%. The significant association of anaemia with socio-economic status, type of family, father's occupation, mother's education and family size stressed the need to develop strategies for intensive adult education, nutrition education and dietary supplementation including anaemia prophylaxis.

References:

  1. World Health Organization. Pregnancy and abortion in adolescence. WHO Techn Rep Ser No. 1975; 583.
  2. Tanner JM. Growth of adolescents 2nd Ed. Oxford Blackwell Scientific Publication. 1962; 326-41.
  3. Brabin L, Brabin BJ. The cost of successful adolescent growth and development in girls in relation to iron and vitamin A status. Am J Clin Nutr 1992; 55: 955-8.
  4. De-Meyer EM. Preventing and controlling iron deficiency anaemia through primary health care. WHO: Geneva, 1989; 8-26.
  5. Kumar P. Social classification - need for constant updating. Ind J Comm Med 1993; 18(2): 60-1.
  6. Nalwa AS. Social health and fertility profile of a village in Delhi. Ind J Prev Soc Med 1978; 3(1): 19-28.
  7. Vasanthi G, Pawashe AB, Susie H, Sujatha T, Ramesh L. Iron nutritional status of adolescent girls from rural area and urban slum. Ind Peaed 1994; 31(2): 127-32.
  8. Ministry of Health and Family Welfare. National consultation on control of nutritional anaemia in India. Nirman Bhawan, New Delhi. 16-17 October 1997; 2-4.
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