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Indian Journal of Community Medicine

Letters to Editor

Author(s): Editorial Staff

Vol. 30, No. 4 (2005-10 - 2005-12)

How Anemic are ICDS Anganwadi Workers?

The Integrated Child Development Services (ICDS) workers were administered a structured questionnaire, which included basic demographic information. Each AWW after she completed proforma, was directed for the measurement of height and weight, which were measured by the Public Health Nurse. There after venous blood was collected by two investigators using a sterile glass syringe and needle (size 22G) into the pre-coded EDTA bulbs. The blood samples so collected were then brought to the central laboratory of Pathology Department Medical College, Vadodara, where the hemoglobin was estimated using cyanmethemoglobin method.

A total of 280 AWWs were studied with age ranging from 19 to 56 years. Of the 280 samples obtained 13 samples clotted. Thus a total of 267 samples were available for final analysis. Anemia prevalence was 72.3% (95% Confidence interval of 66.5% - 77.6%) in the AWWs. Anemia was defined as per WHO guidelines of haemoglobin levels less than 120 g/L1. The mean haemoglobin among these workers was 111 g/L with standard deviation of ±13.5 gm/L.

Prevalence of severe, moderate and mild anemia among AWWs was 0.7%, 15.7% and 55.8% respectively. Hemoglobin value less than 70 gm/L was found in 0.7% of AWWs, 38.2% had less than 110 gm/L and 52.4% had less than 115 gm/L.

World health organization (WHO) has suggested the use of reference value for body mass index (BMI) for different age group by age and sex as given by Must et al2. Under nutrition as defined by BMI less than 5th percentile was present in 23.7% of workers, 70.6% had normal BMI, and 5.7% had BMI above normal.

Anemia was equally widespread among all levels of nutritional status among the AWWs studied. The prevalence of anemia remained high and did not differ significantly between different levels of nutritional status as defined by BMI.

Three fourth AWW were anemic. Further, high level of anemia reflected their poor dietary practice and probable lack of knowledge in light of the fact that they are the custodians of women and child health in the population served by ICDS. These findings raise the fundamental question of the capabilities of ICDS AWWs to provide for all the services and their capacity to imbibe from the training provided to them for NHED.


  1. WHO (World Health Organization). (1968). Nutritional anemia: report of a WHO Scientific Group. Technical Report Series No. 405. Geneva WHO.
  2. Must A, Dallal GE, Diet WH. Reference data for obesity: 85th and 95th percentiles of body mass index (Wt/Ht2)-a correction. American Journal of Clinical Nutrition 1991; 54:773.

P.V. Kotecha, P.D. Karkar
Deptt. of Preventive & Social Medicine,
Government Medical College,
Vadodara-390 001, Gujarat, India.
E-mail: [email protected]

Socio-Demographic Factors Affecting Anemia in Rural Area

This was a cross sectional study conducted between 1st August, 2001 to 15th August, 2001 in Shepwadi village, selected randomly among the villages within a radius of 10 kms from Ambajogai.

Complete data from each household was collected in a predesigned, pre-tested proforma with estimation of Hemoglobin percentage of each member by Sahili's acid Hematine method. In all 1131 individuals were interviewed and examined for Hemoglobin percentage.

Out of 1131 respondents, 494 (43.64%) were anemic and 637 (56.36%) were non-anemic. Most number of anemic patients i.e. about 50%, were seen in both the sexes between 0 to 19 years age group and between 20 to 29 years age group in females.

The same trend was observed in 60+ years age group in both sexes. Percentage of anemia was significantly (x2 = 16.04, df = 1, p < 0.001) higher in non-agricultural group because of the presence of housewives, students and others that included, elderly respondents, physically handicapped and children not registered for school and individuals doing nothing.

There were no respondents from class I in the present study. It was found that, as socio economic class increased, the incidence of anemia also increased significantly (x2 = 22.27, df = 2, p < 0.001). It was found that there was no significant (P > 0.5) difference in the occurrence of anemia in relation of the family type.

S.B. Tak, R.N. Lakade, G.H. Thite
Deptt. of Preventive & Social Medicine,
Swami Ramanand Tirth
Rural Medical College,
Ambajogai, Distt. Beed, Maharashtra.

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