Anemia Among Women of Reproductive Age in Indonesia: Prevalence and Associated Factors in Two Districts

Abstract

Background: Anemia remains a major public health issue, particularly among women of reproductive age (WRA) in developing countries. In Indonesia, anemia prevalence among women remains high, Riskesdas 2018 reporting a rate of 48.9%. Multiple factors including nutritional deficiencies, reproductive status, and sociodemographic determinants contribute to this burden. Objectives: This study aimed to determine the prevalence and factors associated with anemia among women of reproductive age in 2 districts in Indonesia. Methods: A cross-sectional study was conducted from December to April 2025 among 231 women aged 15–49 years. Data were collected using questionnaires and complete blood examinations. Variables assessed included sociodemographic, menstrual history, body mass index (BMI), and dietary patterns. Results: The prevalence of anemia among respondents was 16%, with 59% of those with anemia classified as microcytic hypochromic anemia and 41% as normocytic normochromic anemia. Although 84% of participants had normal hemoglobin levels, several non-anemic individuals showed early iron deficiency based on erythrocyte indices. Education level was significantly associated with anemia (p = 0.022), with women with lower education having a 2.16-fold higher risk of anemia compared to those with higher education (Exp(B) = 2.163; p = 0.046). No significant association was observed between BMI and anemia (p = 0.310). Conclusion: The study found that Low educational attainment is a key determinant of anemia, emphasizing the importance of health promotion programs that enhance nutritional knowledge and awareness, particularly among socioeconomically disadvantaged groups. Although BMI and dietary factors did not show significant associations, they remain biologically relevant and warrant further longitudinal investigation. Keywords: anemia; women of reproductive age; education level; hemoglobin; Indonesia