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Anemia in South Africa

By Pankhuri Malayanil

As we see today, anemia rates have been on the rise and have been a major public health concern among women. Anemia is a complex issue that happens when blood can't carry enough oxygen because of fewer red blood cells or lower levels of hemoglobin. Reproductive-age women and pregnant women are particularly vulnerable to anemia because they often experience increased blood volume and require more iron to support their own health and the development of a growing fetus. In fact, in 2019, global anemia prevalence was 29.9% in women of reproductive age. This is equal to over half a billion women aged 15-49 years. Additionally, menstruation in reproductive-age women can lead to regular blood loss, further increasing their risk of developing anemia if they don't consume enough iron-rich foods.

Image: Onlymyhealth

The issue of anemia is especially prevalent in South Africa. According to an NIH study, the prevalence of anemia in the region ranges from 20 to 40%. The reason it is so concentrated in this area is for multiple reasons. First is the high rates of human immunodeficiency virus, tuberculosis, and other comorbidities within South Africa. 26% of women in South Africa are estimated to have HIV. There has been a systematic review that highlighted that these diseases are a contributing factor to rising rates of anemia. The major issue at hand is iron deficiency. As a low-income country, the iron deficiency rates are very high in South Africa.

South Africa lacks individual data on iron status. Currently, programs are dedicated to improving iron status; however, this intervention brings a problem itself. However, providing regular iron supplements as a solution has negative consequences in places where people already have enough iron or where there are a lot of infectious diseases. In a study conducted on pregnant women in South Africa, Symington and colleagues found that giving iron supplements alone might not be an effective way to reduce the number of people with anemia.

Due to the country's low socioeconomic status, South Africa has less availability and consumption of foods rich in essential nutrients, which can increase the susceptibility to infectious diseases. These influential factors encompass social and environmental determinants, such as socioeconomic status, food insecurity, educational attainment, and inadequate sanitation.

Current policies are effective. The mandatory fortification of iron and the guidelines for maternity care for daily iron supplementation in pregnancy aren't sufficient to address this major health concern. The first major step to properly address this issue is to increase data on the issue. To adequately respond to the increasing rates, it's important to see how major of a response is needed. This can be done through conducting periodic anemia surveys that include a representative sample of women across different age groups, regions, and socioeconomic backgrounds in South Africa. These surveys should use standardized diagnostic criteria and methodologies. It is also necessary to enhance the collection and reporting of anemia data through healthcare facilities, clinics, and hospitals. This includes implementing standardized anemia screening protocols, recording diagnosis, and sharing data with relevant health authorities. In order to adequately address rising rates of anemia, research needs to increase.


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