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Anemia among Students of Rural China's Elementary Schools: Prevalence and Correlates in Ningxia and Qinghai's Poor Counties

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Journal of Health, Population and Nutrition, Vol. 29, page(s): 471–485

October 2011

journal of hpn

Although the past few decades have seen incomes rise and increased government commitment to helping the poor, there is concern that a large fraction of children in rural China still lack regular access to micronutrient-rich regular diets. Insufficient diets and poor knowledge of nutrition among low income populations can result in nutritional problems, including iron deficiency anemia, which adversely affect attention and learning in school. Surprisingly, there has been little research in China trying to document the prevalence of nutritional problems among certain vulnerable populations, such as school-aged children in rural areas. The absence of programs to combat iron deficiency anemia among students might be interpreted as a sign that the government does not recognize the severity of this problem. The goal of this paper is to increase our understanding of the extent of anemia among school-aged children in poor regions of Qinghai and Ningxia, and to identify structural correlates of anemia in this region. We report on the results of a cross-sectional survey involving over 4000 fourth grade students, from 76 randomly selected elementary schools in 10 poor counties in Qinghai Province and Ningxia Hui Autonomous Region, in China’s poor northwest region. Data were collected through structured questionnaires and standardized tests. Trained professional nurses administered hemoglobin (Hb) tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment. Our baseline data shows that the overall anemia rate is 34.5% (23.0%) using the World Health Organization’s blood Hb cutoff of 120g/L (115g/L). We find that students who live and eat at school have higher rates of anemia. Children with less-educated parents are more likely to be anemic. Higher anemia rates are associated with students with parents working on farms and away from home. Anemia rates are correlated with adverse physical (lower body mass index (BMI) z-scores and higher incidences of stunting), cognitive and psychological impacts among students. Such findings are consistent with recent findings of other studies in other poor areas in China’s Northwest.

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