Prevalence of Anemia in Reproductive-age Females (15-49 Years) from Indian Indigenous Population: A Systematic Review...

Anemia remains a critical public health challenge in India, disproportionately affecting indigenous populations. This systematic review and meta-analysis estimated the prevalence of anemia among reproductive-age females (15-49 years) from indigenous communities in India and identified associated risk factors. Four databases (PubMed/MEDLINE, Embase, Scopus, Web of Science) were systematically searched from 2000 to 2024 following PRISMA guidelines. Two independent reviewers conducted study selection, data extraction, and quality assessment using the Joanna Briggs Institute checklist. Random-effects meta-analysis with Freeman-Tukey double arcsine transformation was used to calculate pooled prevalence estimates, with comprehensive subgroup and meta-regression analyses. Publication bias was evaluated using Egger's regression test. Analysis of 41 studies (131,267 participants) revealed a pooled anemia prevalence of 73% (95% CI: 64-81%). Notable regional variations emerged, with the Eastern region showing the highest prevalence (84%, 95% CI: 68-93%) and the Northeastern region the lowest (53%, 95% CI: 33-72%). Areas with IFA supplementation coverage greater than 50% paradoxically showed higher observed prevalence (91%), likely reflecting targeting of interventions toward high-burden areas. At the ecological level, tropical monsoon climate zones showed the highest pooled prevalence (87%), while hot semi-arid regions had the lowest (44%). Key risk factors included labor-intensive occupations (OR = 3.18, 95% CI: 1.52-6.64), low monthly income (OR = 2.38, 95% CI: 1.42-3.98), and lower educational attainment (OR = 1.77, 95% CI: 1.15-2.72). Köppen Climate Classification explained the greatest proportion of between-study variance in meta-regression (R² = 18.5%), though substantial heterogeneity remained unexplained (residual I² = 99.3%). The pooled anemia prevalence of 73% among reproductive-age women from Indian indigenous communities substantially exceeds the national average. Regional disparities, climatic variation, and socioeconomic factors-particularly occupation, income, and education-emerged as key determinants. These findings highlight the need for targeted, culturally appropriate interventions and region-specific programmatic strategies for anemia control in indigenous communities.