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 Table of Contents 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 1  |  Page : 145-147  

Prevalence of anemia among tribal women


1 Community Health Nursing, College of Nursing, AIIMS, Raipur, Chhattisgarh, India
2 Department of Psychiatric Nursing, Manipal College of Nursing, Manipal, Karnataka, India
3 Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal, Karnataka, India

Date of Web Publication31-Jan-2019

Correspondence Address:
I K Rohisha
IK House, Padannakkad, Nileshwar, Kasaragod, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_249_16

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  Abstract 


Background: A healthy citizen contributes to the development of a country. Tribes are considered as the primitive groups who are backward and have a shyness to contact with the community for their health services. Hence, there is a need to look into their health status. The study aimed to assess the prevalence of anemia among tribal women of Kasaragod district, Kerala. Methods: The tribal settlements of Karadukka block panchayath of Kasaragod district were selected randomly as the setting, and the design adopted was a descriptive survey design. A descriptive survey was undertaken among 445 tribal women in the reproductive age group from the selected tribal settlements, and hemoglobin level was assessed using hemoglobin strip apparatus and classified as nonanemia, mild, moderate, and severe anemia based on World Health Organization classification. Analysis was done using SPSS Version 16. Frequency and percentage distribution was done for identifying the prevalence of anemia. Results: The study found that the majority (89%) of the tribal women had anemia in which 62% and 11% of tribal women had moderate and severe anemia, respectively. Conclusion: Among tribal women, the majority have anemia which is an indicator of health status. To provide them with good health status, government and health professionals have to identify the causes and interfere in that through various promotive and therapeutic activities.

Keywords: Anemia, prevalence, tribal women


How to cite this article:
Rohisha I K, Jose TT, Chakrabarty J. Prevalence of anemia among tribal women. J Family Med Prim Care 2019;8:145-7

How to cite this URL:
Rohisha I K, Jose TT, Chakrabarty J. Prevalence of anemia among tribal women. J Family Med Prim Care [serial online] 2019 [cited 2019 Oct 17];8:145-7. Available from: http://www.jfmpc.com/text.asp?2019/8/1/145/251146




  Background Top


“Healthy citizens are the greatest asset any country can have” – Winston Churchill

A healthy citizen contributes to the development of a country. Tribes are considered as the primitive groups who are backward and have a shyness to contact with the community for their rights and services. Healthcare system should take efforts to reduce health problems among tribes and reduce their vulnerability to become a backward group. The statistics shows that tribal population contributes to an important portion of the population both in India and Kerala.[1],[2] According to 2011 census report, there are 104,281,034 scheduled tribes (ST) in India, and in Kerala there are 484,839 ST which includes 246,636 females. Among 1,302,600 population in Kasaragod district, there are 29,283 ST (Census of India, 2011).[3] Reviews show that studies had been conducted in many parts of India to identify health problems among tribal women. Balarajan and Fawzi [4] had done a cross-sectional study to identify the changing patterns in anemia among women in India. The samples were selected from National Family Health Survey (NFHS) 1998/99 and 2005/2006. The sample size was 80,851 from NFHS 2 and 112,714 women from NFHS 3. The study found that there was 10% increase in the relative risk of anemia over time in Kerala.[5],[6] Toteja et al.[7] have done a similar study to identify the prevalence of anemia among pregnant women and adolescent girls in 16 districts of 11 states of India. The sample included 6923 pregnant women and 4337 adolescent girls. The overall prevalence of anemia was found to be 84.9% in pregnant women and 90.1% in adolescent girls. Agarwal (2013) conducted a cross-sectional survey to identify the poor condition of tribal women in Orissa, India. The sample was selected from NFHS 3 registers. The study found that 74% were anemic. Balgir [8] studied the prevalence of anemia in the coastal regions of Odisha. The samples were 180 pregnant women who attended two major hospitals of coastal Odisha. It was found that 71.15% of women were anemic. Sreelakshmi [9] conducted a study among tribal women of age 15–45 years in Palakkad district, Kerala, to determine the prevalence of anemia among 348 tribal women. The results showed that 78.32% was found to be anemic. All these reviews show that anemia is a common problem among women in reproductive age group. Hence, the researcher was interested to study the prevalence of anemia among tribal women.

The aim of the study was to determine hemoglobin level among tribal women which would provide an insight to their health status and make the policy makers for devoting to reduce the mortality and morbidity issues. The objective of the study was to identify the prevalence of anemia among tribal women of Kasaragod district.


  Methods Top


The study has adopted a quantitative survey approach and descriptive survey design to identify the prevalence of anemia among tribal women. Cluster sampling was used for selecting the settings and samples. The minimum sample size needed for the study was calculated using the formula:



Z1−α= 1.96

P = 0.6 (proportion of samples who are assumed to have anemia; taken from pilot study)

d = 0.05

The estimated sample size was 367; however, by considering 20% attrition, it was decided to take 440 samples. The samples included in the study were 445. The tribal settlements of Karadukka block panchayath of Kasaragod district were selected randomly as the setting. The tribal women of age group 18–45 years residing in the tribal settlements of Kasaragod district was the population under study and the sample included 445 tribal women residing in the tribal settlements of Karadukka block panchayath of Kasaragod district. The data collection tools used were background information and hemoglobin strip apparatus. Tool 1 background information included two sections: section A – demographic proforma consisting of items such as age, marital status, age of marriage,[10] years of marital life, number of pregnancies, age of first pregnancy, number of deliveries, number of children, type of family, educational status, occupation, category of tribe, yearly family income, and personal habits; and section B – physiological parameter which included hemoglobin in gram percentage. Tool 2 was hemoglobin strip apparatus to measure hemoglobin level.[10] Content validity and language validity of tool 1 were established. The reliability of tool 2 was done using interrater reliability and was found to be 1. Administrative permission was taken from Dean Manipal College of Nursing, Manipal, Institutional Ethics Committee, Kasturba Hospital, Manipal, and from the tribal department of Kasaragod and Trivandrum. Informed consent was taken from the participants, and confidentiality of the information was assured. Data collection was done for the willing participants who met the eligibility criteria and were asked to assemble in the community hall in their respective colony. The participants were interviewed to obtain the demographic data. Hemoglobin level of the samples was estimated using hemoglobin strip apparatus and was recorded. Data were analyzed using descriptive statistics using SPSS Inc., acquired by International Business Machines Corp. New Orchard Road Armonk, New York, US. Descriptive statistics and frequency and percentage distribution were used to describe sample characteristics and anemia.


  Results Top


Among the 445 tribal women who participated in the study, most (41.6%) of the participants were in the age group of 36–45 years, and considering occupation most (51.5%) are unemployed. The majority (80.7%) of the participants were married and most (59.6%) of them were married at the age of 18–25 years. Most (35.5) of them become pregnant one to two times, and the majority (87.2%) become pregnant at the age of 18–25 years. Most (38.4%) of them had undergone one to two deliveries and 40.2% of them have one to two children. Most (77.3%) of them had a yearly family income less than 6000 INR and 38.9% had high school education. Tribal women were included in mavilan (53.7%) and malavettuvan (46.3%) subcaste of ST group. Most (45.4%) of them were having bad habit of pan chewing.

Prevalence of anemia

According to World Health Organization, the hemoglobin level was categorized into nonanemia, mild anemia, moderate anemia, and severe anemia.[11] The study found that the majority (62%) of participants had moderate anemia and 11% had severe anemia. Only 11% of participants were nonanemic [Figure 1].
Figure 1: Percentage distribution of hemoglobin level among tribal women. Hemoglobin level of tribal women n = 445

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  Discussion Top


This study showed that most (62%) of the participants had moderate anemia and 11% had severe anemia The findings of the above study support a descriptive study conducted to assess the prevalence of anemia among the reproductive age group women in Sampla block of Haryana which found that 48.9% of women in the reproductive group were anemic, and among those 27.6% were moderately anemic (Verma et al., 2014). A cross-sectional survey was done in Wayanad district of Kerala to identify the prevalence of anemia among tribal women in reproductive age group (15–45 years). The study found that majority of the samples were anemic (96.5%) and among those 55.9% were moderately anemic.[12]


  Conclusion Top


The study was conducted using cluster random sampling and covered all the willing participants in selected settings which is a strength of the study, and the limitations of the study were study samples were restricted to selected panchayaths of Kasaragod district, hence the generalization is limited. The hemoglobin level was assessed using hemoglobin strip apparatus by considering the convenient use in community settings and the reliability of hemoglobin strip apparatus was assessed only by interrater reliability method. Future research can be undertaken in a larger population to increase the generalizability of the findings and a follow-up study can be conducted on the same population by providing interventions to improve the hemoglobin level.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
IIPS District Level Household Survey, RCH Survey-2. Available from: http://www.rchiips.org/pdf/rch2/National_Report_RCH-II.pdf. [Last accesed on 2015 Nov 22].  Back to cited text no. 1
    
2.
Indian Ministry of Tribal Affairs. New Delhi: The National Tribal Policy. Available from: http://www.tibal.nic.in/final/content.pdf. [Last updated on 2013 May 03].  Back to cited text no. 2
    
3.
4.
Balarajan YS, Fawzi WW, Subramanian SV. Changing patterns of social inequalities in anaemia among women in India: Cross-sectional study using nationally representative data. BMJ Open 2013;3. pii: e002233.  Back to cited text no. 4
    
5.
India's Report. Available from: http://www.siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/IndiaUndernourishedChildrenFinal.pdf. [Last updated on 2008 Dec; Last accesed on 2015 Nov 22].  Back to cited text no. 5
    
6.
National Family Health Survey. Available from: http://www.rchiips.org/nfhs/nfhs3.shtml. [Last accessed on 2015 Nov 22].  Back to cited text no. 6
    
7.
Toteja GS, Singh P, Dhillon BS, Saxena BN, Ahmed FU, Singh RP, et al. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull 2006;27:311-5.  Back to cited text no. 7
    
8.
Balgir RS. A cross sectional study of anaemia in pregnant women of eastern coast of Odisha. Tribal Health Bull 2011;17:1-7.  Back to cited text no. 8
    
9.
Sreelakshmi PR. Anaemia and body mass index of non pregnant tribal women of reproductive age group in Palakkad district of Kerala, India. Indian J Prev Soc Med 2012;43:35-41.  Back to cited text no. 9
    
10.
Panigrahi A, Sahoo PB. Nutritional anemia and its epidemiological correlates among women of reproductive age in an urban slum of Bhubaneswar, Orissa. Indian J Public Health 2011;55:317-20.  Back to cited text no. 10
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11.
Available from: http://www.who.int/topics/anaemia/en/. [Last accesed on 2015 Apr 30].  Back to cited text no. 11
    
12.
Sreenivasa BM. Prevalence of anaemia among tribal women of reproductive age-group in Wayanad district of Kerala. Int J Health Allied Sci 2014;3:120-4.  Back to cited text no. 12
    


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