{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T20:54:40Z","timestamp":1774990480637,"version":"3.50.1"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980023002379_as1\"><jats:title>Objective:<\/jats:title><jats:p>Adolescent girls are at risk of anaemia due to increased nutrient demands because of growth, menstrual blood loss and possible pregnancies. Sociocultural and household conditions influence their anaemia risk. We aimed to identify the sociocultural and economic factors associated with anaemia among adolescent girls in Nepal.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023002379_as2\"><jats:title>Design:<\/jats:title><jats:p>The Nepal Demographic and Health Surveys (NDHS) conducted in 2006, 2011 and 2016 were pooled for secondary analysis. We used data on haemoglobin measurements for anaemia and conducted bivariate and multivariable logistic regression analyses to identify factors associated with anaemia.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023002379_as3\"><jats:title>Setting:<\/jats:title><jats:p>Nationally representative NDHS households with adolescent girls 15\u201319 years of age.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023002379_as4\"><jats:title>Participants:<\/jats:title><jats:p>Non-pregnant adolescent girls 15\u201319 years, with a haemoglobin measurement (<jats:italic>n =<\/jats:italic> 3731).<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023002379_as5\"><jats:title>Results:<\/jats:title><jats:p>The overall prevalence of anaemia among adolescent girls was 39\u00b76 %. Adolescents from socially disadvantaged caste\/ethnicity groups were 1\u00b742 times (95 % CI: 1\u00b713, 1\u00b778) more likely to have anaemia compared with those from <jats:italic>Brahmin\/Chhetri<\/jats:italic> households. We found a counter-intuitive association between socio-economic status and anaemia where adolescents from the middle (adjusted OR (aOR) 1\u00b737, 95 % CI: 1\u00b701, 1\u00b785) and highest (aOR 1\u00b774, 95 % CI: 1\u00b718, 2\u00b756) quintiles were at increased odds of anaemia. Relative geographical inequality was observed where adolescents from the Terai region had 3\u00b75 times (95 % CI: 2\u00b732, 5\u00b733) higher odds of anaemia.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023002379_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>The disparities in the distribution of anaemia among adolescents by caste\/ethnicity groups, wealth quintiles and geographical regions are evident. Reducing the anaemia burden will require addressing the social determinants of anaemia by allocating resources and expanding anaemia prevention programmes to target adolescents at higher risk.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980023002379","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T10:08:50Z","timestamp":1698746930000},"page":"2973-2981","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Social and ecological disparities in anaemia among adolescent girls 15\u201319 years old in Nepal"],"prefix":"10.1017","volume":"26","author":[{"given":"Anjana","family":"Rai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei Ting","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smita","family":"Nambiar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"S1368980023002379_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1301300211"},{"key":"S1368980023002379_ref33","doi-asserted-by":"publisher","DOI":"10.1177\/156482650903000302"},{"key":"S1368980023002379_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s12878-017-0084-x"},{"key":"S1368980023002379_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmv016"},{"key":"S1368980023002379_ref35","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13044"},{"key":"S1368980023002379_ref37","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13366"},{"key":"S1368980023002379_ref38","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980022000350"},{"key":"S1368980023002379_ref12","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.115.107896"},{"key":"S1368980023002379_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzz013"},{"key":"S1368980023002379_ref26","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.10.020434"},{"key":"S1368980023002379_ref41","unstructured":"41. World Health Organization (2017) Safely Managed Drinking Water - Thematic Report on Drinking Water 2017. LCB-N-S IGO. Geneva, Switzerland: WHO. https:\/\/www.who.int\/publications\/i\/item\/9789241565424"},{"key":"S1368980023002379_ref13","volume-title":"Nepal Demographic and Health Survey 2016","year":"2017"},{"key":"S1368980023002379_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.gfs.2020.100467"},{"key":"S1368980023002379_ref22","volume-title":"Accelerating Anaemia Reduction: A Comprehensive Framework for Action","year":"2023"},{"key":"S1368980023002379_ref31","doi-asserted-by":"publisher","DOI":"10.3126\/ajms.v8i5.17546"},{"key":"S1368980023002379_ref16","doi-asserted-by":"publisher","DOI":"10.3390\/nu10121978"},{"key":"S1368980023002379_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13013"},{"key":"S1368980023002379_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01687-1"},{"key":"S1368980023002379_ref44","volume-title":"Gender Equality and Social Inclusion Diagnostic of Selected Sectors in Nepal","year":"2020"},{"key":"S1368980023002379_ref48","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/137.9.2147"},{"key":"S1368980023002379_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1309"},{"key":"S1368980023002379_ref40","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/130.10.2527"},{"key":"S1368980023002379_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60149-4"},{"key":"S1368980023002379_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqac028"},{"key":"S1368980023002379_ref28","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497"},{"key":"S1368980023002379_ref6","volume-title":"Global Nutrition Targets 2025: Anaemia Policy Brief","year":"2014"},{"key":"S1368980023002379_ref23","volume-title":"Nepal Demographic and Health Survey 2006","year":"2007"},{"key":"S1368980023002379_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13670"},{"key":"S1368980023002379_ref20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208878"},{"key":"S1368980023002379_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2013.04.006"},{"key":"S1368980023002379_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13332"},{"key":"S1368980023002379_ref42","unstructured":"42. Ghimire, U (2019) Inequalities in Health Outcomes and Access to Services by Caste\/Ethnicity, Province, and Wealth Quintile in Nepal. DHS Further Analysis Report No. 117. 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Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}