A persistent public health burden
The National Family Health Survey-5 put anemia prevalence among pregnant women ages 15-49 at 52.2%. NITI Aayog says the share of pregnant women affected in India has stayed around 50% for more than four decades.
Diet is part of the problem: according to the Ministry of Health and Family Welfare, three in four Indian women consume too little dietary iron. But menstrual blood loss, pregnancy and unequal access to nutrition and health care also contribute to a challenge that cannot be explained by individual food choices alone.
The effects extend beyond health. NITI Aayog estimates that physical and cognitive losses associated with iron deficiency anemia cost developing countries up to 4.5% of GDP annually, with the loss in India equivalent to about 1.18% of GDP.
When fatigue signals more than a busy day
Exhaustion after household work, difficulty concentrating in class or unusual breathlessness during farm labor may be dismissed as routine demands of daily life. Persistent weakness during pregnancy can likewise be treated as an ordinary part of motherhood. Such assumptions can leave symptoms of anemia unquestioned.
Anemia means the blood lacks enough hemoglobin to deliver oxygen effectively to tissues. Hemoglobin is the oxygen-carrying protein in red blood cells, and the body needs iron to make it. If iron intake or absorption falls short of the body's needs, iron reserves can decline and hemoglobin production may suffer.
Possible symptoms include weakness, dizziness, headaches, shortness of breath and trouble concentrating. Iron deficiency is a major cause, but not the only one: other nutrient deficiencies, blood loss, infections and inherited blood disorders can also cause anemia.
Supplements, fortified rice and the national program
India launched Anaemia Mukt Bharat in September 2018 under the National Health Mission. Its "6x6x6" framework combines six interventions, six beneficiary groups and six institutional mechanisms.
The program targets children ages 6-59 months, children ages 5-9 years, adolescents ages 10-19, pregnant women, lactating women and women of reproductive age, defined as ages 15-49. The Ministry of Health and Family Welfare says 154 million children and adolescents received iron and folic acid supplements through the program in the second quarter of fiscal year 2024-25.
Food fortification is another part of the government's effort. It said that, by March 2024, fortified rice had replaced all custom-milled rice in every scheme. Rice enriched with iron, folic acid and vitamin B12 is distributed through the Targeted Public Distribution System, PM POSHAN, ICDS and other welfare schemes.
For fiscal year 2024-25, the National Health Mission allocated Rs 805.91 crore to states and union territories for Anaemia Mukt Bharat activities.
What one district study found
A 2026 mixed-methods implementation study in Palwal district, Haryana, examined how the national anemia program reached pregnant women. It found that 67% had received at least one dose of iron and folic acid, while 48.6% had undergone hemoglobin testing.
Among women with records for both hemoglobin and iron and folic acid, only 5% received supplement dosages matched to the severity of their anemia. The authors attributed the delivery gaps to cultural misconceptions, limited counseling, weak follow-up and fragmented supply chains. These findings describe one district, not national coverage.
A wider challenge and an unmet goal
The World Health Organization puts the global burden at around 500 million women ages 15-49 and 269 million children under 5. Its 2019 figures show anemia affected about 30% of nonpregnant women, or 539 million, and about 37% of pregnant women, or 32 million.
The World Health Assembly's global nutrition targets included a 50% reduction in anemia among women of reproductive age by 2025. FOGSI has noted that progress has been limited and warned that the target may not be reached even by 2030.
