Spatial Heterogeneity and Socioeconomic Inequalities in Anaemia Among Indian Women

Background Anaemia is one of the most concerning public health issues in India, primarily affecting women of reproductive age. Despite the interventions dedicated to this, the prevalence of anaemia remains rather high. This study aims to analyse the socioeconomic inequalities, factors contributing to these inequalities, and spatial variations in the prevalence of anaemia among pregnant and nonpregnant women at the national level in India. Method We use National Family Health Survey (NFHS‐5), 2019–21 data, covering a sample of 724,115 women aged 15–49 years. Differences in women’s socioeconomic status were assessed through the decomposition of concentration indices, while spatial inequalities were investigated using district‐level heat maps and Moran’s I statistics. Results Anaemia prevalence was 52.4% (95% CI: 51.3–53.0) and 57.2% (95% CI: 57.0–57.5) among pregnant and nonpregnant women, respectively. We find that differences in socioeconomic status are quite significant, with members of poorer households being disproportionately affected. The wealth quintile was the major contributing factor, explaining 38.6% of the overall inequality. The Erreygers′ concentration index (ECI) was −0.170 (95% CI: −0.190, −0.151) for pregnant women and −0.099 (95% CI: −0.104, −0.094) for nonpregnant women, respectively, indicating a pro‐poor inequality. The spatial differences proved substantial, with the cases clustering in the country’s (i) north and eastern states such as Uttar Pradesh, Bihar, Jharkhand and West Bengal (Indo‐Gangetic Belt), (ii) central regions such as Madhya Pradesh and Chhattisgarh and (iii) parts of northern Himalayas like Uttarakhand and Himachal Pradesh and north‐eastern states such as Assam and Tripura. Conclusion Healthcare interventions are necessary to address socioeconomic and regional disparities by enhancing nutritional access and accounting for regional variations in dietary behaviours, healthcare services and education among marginalized populations. The findings can serve as a valuable baseline for policy interventions addressing anaemia among Indian women.