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HEMATOLOGY / CLINICAL RESEARCH
A silent crisis: two decades of anaemia trends among women in the Eastern Mediterranean Region (2000–2019)
1
Department of Medical Laboratory Science, College of Applied Medical Science, University of Ha’il, Saudi Arabia
2
Medical and Diagnostic Research Center, University of Ha’il, Hail, Saudi Arabia
3
Department of Mathematics, College of Science, University of Ha’il, Ha’il, Saudi Arabia
Submission date: 2025-02-10
Final revision date: 2025-03-14
Acceptance date: 2025-04-13
Online publication date: 2025-04-20
Corresponding author
Reem Eltayeb
Department of Medical Laboratory Science College of Applied Medical Science University of Ha’il Ha’il 55476, Saudi Arabia
Department of Medical Laboratory Science College of Applied Medical Science University of Ha’il Ha’il 55476, Saudi Arabia
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Anaemia remains a major public health issue. This condition adversely impacts women of reproductive age, especially in low-income countries. Although there is an ongoing global effort to reduce anaemia prevalence, progress is slow and uneven. Anaemia exhibits unique patterns in the Eastern Mediterranean Region (EMR) due to this region’s economic disparities and variations in access to health services. This study examined trends in anaemia prevalence among pregnant and nonpregnant women in the EMR by national income.
Material and methods:
This retrospective cross-sectional study examined anaemia prevalence among pregnant and nonpregnant women in 21 EMR countries in the period 2000–2019 at 5-year intervals. The data on anaemia prevalence were compiled by the World Health Organization (WHO), while the World Bank provided the income classifications. Descriptive statistics were used to examine trends in prevalence and their associations with each country’s income.
Results:
Although a general decrease in anaemia prevalence was observed among both pregnant and nonpregnant women, this improvement varied by income group. Pregnant women exhibited a greater reduction than nonpregnant women (–12% vs. –10%). Low-income countries reported higher prevalence rates. The study revealed significant negative associations between national income and anaemia prevalence (p < 0.001). While some countries demonstrated improvements, others exhibited unique or unexpected behaviours or stagnant rates.
Conclusions:
Economic differences significantly impact trends in anaemia prevalence among women of reproductive age in the EMR. Urgent, country-targeted interventions, particularly in low-income countries, are necessary to meet the WHO’s goal of reducing anaemia among women of reproductive age by 50% before 2030.
Anaemia remains a major public health issue. This condition adversely impacts women of reproductive age, especially in low-income countries. Although there is an ongoing global effort to reduce anaemia prevalence, progress is slow and uneven. Anaemia exhibits unique patterns in the Eastern Mediterranean Region (EMR) due to this region’s economic disparities and variations in access to health services. This study examined trends in anaemia prevalence among pregnant and nonpregnant women in the EMR by national income.
Material and methods:
This retrospective cross-sectional study examined anaemia prevalence among pregnant and nonpregnant women in 21 EMR countries in the period 2000–2019 at 5-year intervals. The data on anaemia prevalence were compiled by the World Health Organization (WHO), while the World Bank provided the income classifications. Descriptive statistics were used to examine trends in prevalence and their associations with each country’s income.
Results:
Although a general decrease in anaemia prevalence was observed among both pregnant and nonpregnant women, this improvement varied by income group. Pregnant women exhibited a greater reduction than nonpregnant women (–12% vs. –10%). Low-income countries reported higher prevalence rates. The study revealed significant negative associations between national income and anaemia prevalence (p < 0.001). While some countries demonstrated improvements, others exhibited unique or unexpected behaviours or stagnant rates.
Conclusions:
Economic differences significantly impact trends in anaemia prevalence among women of reproductive age in the EMR. Urgent, country-targeted interventions, particularly in low-income countries, are necessary to meet the WHO’s goal of reducing anaemia among women of reproductive age by 50% before 2030.
REFERENCES (72)
1.
Alem AZ, Efendi F, McKenna L, et al. Prevalence and factors associated with anemia in women of reproductive age across low- and middle-income countries based on national data. Sci Rep 2023; 13: 20335.
2.
Michalak SS, Rupa-Matysek J, Hus I, Gil L. Unexplained anemia in the elderly – a real life analysis of 981 patients. Arch Med Sci 2020; 16: 834-41.
3.
WHO. Prevalence of anaemia in non-pregnant women (aged 15-49) (%) [Internet]. [cited 2025 Feb 5]. Available from: https://www.who.int/data/gho/d...-(-).
4.
WHO. Anaemia in women and children [Internet]. [cited 2025 Mar 4]. Available from: https://www.who.int/data/gho/d....
5.
Safiri S, Kolahi AA, Noori M, et al. Burden of anemia and its underlying causes in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019. J Hematol Oncol 2021; 14: 185.
6.
Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci 2019; 1450: 15-31.
7.
Elmore C, Ellis J. Screening, treatment, and monitoring of iron deficiency anemia in pregnancy and postpartum. J Midwifery Womens Health 2022; 67: 321-31.
8.
Gunes S, Aldemir R, Gunes A, Ekinci O. Parent-reported sleep problems in children and adolescents with sickle cell disease: relationship to health-related quality of life. Arch med sci 2021; 18: 659-65.
9.
Brown B, Wright C. Safety and efficacy of supplements in pregnancy. Nutr Rev 2020; 78: 813-26.
10.
Jouanne M, Oddoux S, Noël A, Voisin-Chiret AS. Nutrient requirements during pregnancy and lactation. Nutrients 2021; 13: 692.
11.
Rogerson SJ. Management of malaria in pregnancy. Indian J Med Res 2017; 146: 328-33.
12.
Arndt MB, Abate YH, Abbasi-Kangevari M, et al. Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 404: 2543-83.
13.
Al-Jermmy ASM, Idris SM, Coulibaly-Zerbo F, Nasreddine L, Al-Jawaldeh A. Prevalence and correlates of anemia among adolescents living in Hodeida, Yemen. Children 2022; 9: 977.
14.
Anwary Z, Stanikzai MH, Wyar WM, Wasiq AW, Farooqi K. Anemia among women who visit bost hospital for delivery in Helmand Province, Afghanistan. Anemia 2021; 2021: 9358464.
15.
Kadhim EJ. Iron-deficiency anemia in relation to body mass index among Iraqi primigravida women. J Med Life 2023; 16: 868-72.
16.
Swareldhab ESE, Al-Jawaldeh A, Qureshi AB, et al. Assessment of micronutrient situation among reproductive-age women (15-49) and under-five children in Sudan. Nutrients 2021; 13: 2784.
17.
Alsaeed M, Ahmed SS, Seyadi K, Ahmed AJ, Alawi AS, Abulsaad K. The prevalence and impact of anemia in hospitalized older adults: a single center experience from Bahrain. J Taibah Univ Med Sci 2022; 17: 587-95.
18.
Mikki N, Abdul-Rahim HF, Stigum H, Holmboe-Ottesen G. Anaemia prevalence and associated sociodemographic and dietary factors among Palestinian adolescents in the West Bank. East Mediterr Health J Rev Sante Mediterr Orient Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit 2011; 17: 208-17.
19.
Arabyat R, Arabyat G, Al-Taani G. Prevalence and risk factors of anaemia among ever-married women in Jordan. East Mediterr Health J Rev Sante Mediterr Orient Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit 2019; 25: 543-52.
20.
Al Kaabi SZ, Al-Saad DS, Al-Rubaye AK, Alkinani AAA. The association between the severity of anemia and socio-demographic factors among children under five years of age in Kut City. J Public Health Afr 2023; 14: 2676.
21.
Al-Jawaldeh A, Taktouk M, Doggui R, et al. Are countries of the eastern mediterranean region on track towards meeting the world health assembly target for anemia? A review of evidence. Int J Environ Res Public Health 2021; 18: 2449.
22.
Eltayeb R, Binsaleh N, Barnawi H, Ali RM, Kanwal R, Alyahyawi AR. A persistent burden: global prevalence of and changes in anaemia by country income in children aged 6–59 months (2000–2019). Arch Med Sci DOI: https://doi.org/10.5114/aoms/1....
23.
Loechl CU, Datta-Mitra A, Fenlason L, et al. Approaches to address the anemia challenge. J Nutr 2023; 153: S42-59.
24.
de Romaña DL, Mildon A, Golan J, Jefferds MED, Rogers LM, Arabi M. Review of intervention products for use in the prevention and control of anemia. Ann N Y Acad Sci 2023; 1529: 42-60.
25.
Sappani M, Mani T, Asirvatham ES, Joy M, Babu M, Jeyaseelan L. Trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age during the last 15 years in India. PLoS One 2023; 18: e0286464.
26.
Wu Y, Ye H, Liu J, et al. Prevalence of anemia and sociodemographic characteristics among pregnant and non-pregnant women in southwest China: a longitudinal observational study. BMC Pregnancy Childbirth 2020; 20: 535.
27.
Kinyoki D, Osgood-Zimmerman AE, Bhattacharjee NV, Kassebaum NJ, Hay SI. Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018. Nat Med 2021; 27: 1761-82.
28.
Araujo Costa E, de Paula Ayres-Silva J. Global profile of anemia during pregnancy versus country income overview: 19 years estimative (2000-2019). Ann Hematol 2023; 102: 2025-31.
29.
Hasan MM, Soares Magalhaes RJ, Garnett SP, et al. Anaemia in women of reproductive age in low- and middle-income countries: progress towards the 2025 global nutrition target. Bull World Health Organ 2022; 100: 196-204.
30.
GBD 2021 Anaemia Collaborators. Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021. Lancet Haematol 2023; 10: e713-34.
31.
Liu Y, Ren W, Wang S, Xiang M, Zhang S, Zhang F. Global burden of anemia and cause among children under five years 1990–2019: findings from the global burden of disease study 2019. Front Nutr 2024; 11: 1474664.
32.
Leppäniemi H, Ibrahim ET, Abbass MMS, et al. Nutrition profile for countries of the eastern mediterranean region with different income levels: an analytical review. Children 2023; 10: 236.
33.
Ciapponi A, Lewin S, Herrera CA, et al. Delivery arrangements for health systems in low-income countries: an overview of systematic reviews. Cochrane Database Syst Rev 2017; 2017: CD011083.
34.
Liu X, Huang X, Yang Y, et al. Maternal anaemia prevention and control in China: a policy review. Matern Child Nutr 2024; 20: e13653.
35.
da Silva Lopes K, Yamaji N, Rahman MO, et al. Nutrition-specific interventions for preventing and controlling anaemia throughout the life cycle: an overview of systematic reviews. Cochrane Database Syst Rev 2021; 2021: CD013092.
36.
Benfo A, Zumesew F, Akoto EB, et al. Exploring the perspective of young adults about anaemia prevention; the contributions of knowledge about at-risk groups and consequences of anaemia. BMC Public Health 2023; 23: 2081.
37.
Mokdad AH, Forouzanfar MH, Daoud F, et al. Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Glob Health 2016; 4: e704-13.
38.
Leppäniemi H, Ibrahim E, Abbass MMS, et al. Nutrition profile for countries of the eastern Mediterranean region with different income levels: an analytical review. Child Basel Switz 2023; 10: 236.
39.
Mokhtar G, Youssef A, Abdel Baky A, et al. Evidence-based Egyptian clinical practice guidelines: for the prevention and management of iron deficiency and iron deficiency anemia in infants, children and adolescents. Bull Natl Res Cent 2023; 47: 162.
40.
Khader Y, Al Nsour M, Abu Khudair S, Saad R, Tarawneh MR, Lami F. Strengthening primary healthcare in Jordan for achieving universal health coverage: a need for family health team approach. Healthcare 2023; 11: 2993.
41.
Erzse A, Desmond C, Hofman K, Barker M, Christofides NJ. Identifying pregnant and postpartum women’s priorities for enhancing nutrition support through social needs programmes in a resource-constrained urban community in South Africa. BMC Public Health 2024; 24: 2231.
42.
WHO. Prioritizing quality of care in maternal health [Internet]. [cited 2025 Feb 5]. Available from: https://www.who.int/activities....
43.
Ramavhoya TI, Maputle MS, Lebese TR. Developing and prioritising strategies to improve the implementation of maternal healthcare guidelines in South Africa: the nominal group technique. Afr J Prim Health Care Fam Med 2022; 14: 3184.
44.
http://bitwize.com.lb B. Times of Oman. [cited 2025 Feb 5]. Oman nutrition strategy to ensure healthy, sustainable diet for all. Available from: https://timesofoman.com/articl....
45.
Al Hinai H, Al Mufarji K, Al Siyabi H, Al Anqoudi Z, Al Saadi R, Al Awaidy S. Health promotion strategy as part of Vision 2050 in Oman: the way forward. Glob Health Promot 2020; 27: 145-9.
46.
Gosadi IM. National screening programs in Saudi Arabia: overview, outcomes, and effectiveness. J Infect Public Health 2019; 12: 608-14.
47.
AlQurashi WS, Abdulgader RA, Gari RA, Badawi MA. Screening for iron deficiency among pregnant women. Npj Womens Health 2024; 2: 1-6.
48.
Bin Sunaid FF, Al-Jawaldeh A, Almutairi MW, et al. Saudi Arabia’s healthy food strategy: progress & hurdles in the 2030 road. Nutrients 2021; 13: 2130.
49.
Alnasser A. The palm or the plate? An assessment of dietary guideline promotion, awareness, and preferences among Saudis: cross-sectional survey. BMC Public Health 2023; 23: 1984.
50.
Al-Kharabsheh AM, Alahmad IF, Al-Tamimi MM, Abufraijeh SM, Alnawaiseh N. Prevalence of maternal anemia in Southern Jordan: findings from a cross-sectional study and 5-year review. Healthcare 2024; 12: 2495.
51.
Karami M, Chaleshgar M, Salari N, Akbari H, Mohammadi M. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis. Matern Child Health J 2022; 26: 1473-87.
52.
Abu-Baker NN, Eyadat AM, Khamaiseh AM. The impact of nutrition education on knowledge, attitude, and practice regarding iron deficiency anemia among female adolescent students in Jordan. Heliyon 2021; 7: e06348.
53.
The Jordan National Micronutrient Survey (JNMNS) 2019 | UNICEF Jordan [Internet]. [cited 2025 Feb 26]. Available from: https://www.unicef.org/jordan/....
54.
Opoku MP, Moustafa A, Anwahi N, et al. Nutritional needs of children with disabilities in the UAE: understanding predictors and mediators of nutritional knowledge and practices. BMC Nutr 2022; 8: 109.
55.
AlBlooshi S, Khalid A, Hijazi R. The barriers to sustainable nutrition for sustainable health among Zayed University students in the UAE. Nutrients 2022; 14: 4175.
56.
Faris ME, Al Gharaibeh F, Islam MR, et al. Caffeinated energy drink consumption among Emirati adolescents is associated with a cluster of poor physical and mental health, and unhealthy dietary and lifestyle behaviors: a cross-sectional study. Front Public Health 2023; 11: 1259109.
57.
Almansour FD, Allafi AR, Al-Haifi AR. Impact of nutritional knowledge on dietary behaviors of students in Kuwait University. Acta Bio-Medica Atenei Parm 2020; 91: e2020183.
58.
Alkhulaifi F, Al-Hooti S, Al-Zenki S, AlOmirah H, Darkoh C. Dietary habits, meal timing, and meal frequency in Kuwaiti adults: analysis of the Kuwait National Nutrition Surveillance Data. Nutrients 2023; 15: 4537.
59.
Hajat C, Harrison O, Shather Z. A profile and approach to chronic disease in Abu Dhabi. Glob Health 2012; 8: 18.
60.
Al Sabbah H, Assaf EA, Al-Jawaldeh A, et al. Nutrition situation analysis in the UAE: a review study. Nutrients 2023; 15: 363.
61.
Al-Dabbagh B, Shawqi S, Yasin J, Al Essa A, Nagelkerke N, Denic S. Half of the emirati population has abnormal red cell parameters: challenges for standards and screening guidelines. Hemoglobin 2014; 38: 56-9.
62.
Mahar B, Shah T, Shaikh K, et al. Uncovering the hidden health burden: a systematic review and meta-analysis of iron deficiency anemia among adolescents, and pregnant women in Pakistan. J Health Popul Nutr 2024; 43: 149.
63.
Ali SA, Abbasi Z, Shahid B, et al. Prevalence and determinants of anemia among women of reproductive age in Thatta Pakistan: findings from a cross-sectional study. PLoS One 2020; 15: e0239320.
64.
Qadir MA, Rashid N, Mengal MA, et al. Iron-deficiency anemia in women of reproductive age in urban areas of Quetta District, Pakistan. BioMed Res Int 2022; 2022: 6677249.
65.
Afghanistan: Acute Food Insecurity Situation for March – April 2024 and Projection for May - October 2024 | IPC – Integrated Food Security Phase Classification [Internet]. [cited 2025 Feb 26]. Available from: https://www.ipcinfo.org/ipc-co....
66.
Flores-Martinez A, Zanello G, Shankar B, Poole N. Reducing anemia prevalence in afghanistan: socioeconomic correlates and the particular role of agricultural assets. PLoS One 2016; 11: e0156878.
67.
Keats EC, Neufeld LM, Garrett GS, Mbuya MNN, Bhutta ZA. Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis. Am J Clin Nutr 2019; 109: 1696-708.
68.
Ndiaye M, Siekmans K, Haddad S, Receveur O. Impact of a positive deviance approach to improve the effectiveness of an iron-supplementation program to control nutritional anemia among rural Senegalese pregnant women. Food Nutr Bull 2009; 30: 128-36.
69.
Mason JB, Saldanha LS, Ramakrishnan U, et al. Opportunities for improving maternal nutrition and birth outcomes: synthesis of country experiences. Food Nutr Bull 2012; 33 (2 Suppl): S104-137.
70.
Girum T, Wasie A. The effect of deworming school children on anemia prevalence: a systematic review and meta-analysis. Open Nurs J 2018; 12: 155-61.
71.
Risonar MGD, Tengco LW, Rayco-Solon P, Solon FS. The effect of a school-based weekly iron supplementation delivery system among anemic schoolchildren in the Philippines. Eur J Clin Nutr 2008; 62: 991-6.
72.
Abd Rahman R, Idris IB, Md Isa Z, Abd Rahman R. The effectiveness of a theory-based intervention program for pregnant women with anemia: a randomized control trial. PLoS One 2022; 17: e0278192.
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