Anemia-Related Knowledge and Practices Among Mid-adolescents in Government Schools of Nadia District, West Bengal: A Cross-Sectional Study

Background Anemia is a major public health concern globally and in India, particularly among adolescents who are vulnerable due to rapid growth and increased nutritional requirements. Despite national programs such as Weekly Iron and Folic Acid Supplementation (WIFS), knowledge and preventive practices remain suboptimal. This study assessed anemia-related knowledge and practices among mid-adolescent (predominantly 14-16 years) school students and sociodemographic predictors of these outcomes. Methods A cross-sectional study was conducted among 464 students from selected government high schools in the municipal area of Nadia district, West Bengal, using a multistage random sampling approach. Data on sociodemographic characteristics, knowledge, and practices regarding anemia were collected using a locally developed questionnaire. Records of dietary intake, hygiene, and preventive services were reviewed. Data were analyzed using Jamovi software (v 2.6.26, jamovi project, Sydney, Australia). Descriptive statistics were summarized as frequencies and percentages, while multivariable logistic regression identified predictors of good knowledge and anemia-related practices. Results The mean age of participants was 14.7 ± 1.52 years, with 56% being male. The mean knowledge score was 3.61 ± 2.04 (Q1 = 3, median = 4, Q3 = 4), and more than half of the students (55.6%) demonstrated good knowledge of anemia. In multivariate analysis, class level (Class VIII: AOR 2.37; 95% CI 1.11-5.05) and family income showed a non-linear association with knowledge (INR 70,000: AOR 4.26; 95% CI 1.20-15.08). The mean practice score was 6.20 ± 1.25 (Q1 = 5, median = 6, Q3 = 7), with 72.8% of students reporting good anemia-related practices, which were significantly associated with maternal education (≥middle school: AOR 1.65; 95% CI 1.10-2.46) and students' knowledge (AOR 1.81; 95% CI 1.16-2.83). Despite these findings, notable gaps remained in deworming coverage (11%) and adherence to weekly iron-folic acid supplementation (42.5%). Conclusions Despite moderate awareness, comprehensive knowledge and preventive practices remain suboptimal. Strengthening structured school-based health education, improving iron-folic acid supplementation and deworming program delivery, and engaging mothers are key strategies to enhance anemia prevention among adolescents.