Anemia among WRA

Anemia exerts a severe toll on global health, especially among women and children in the world’s poorest nations. In 2019, anemia accounted for 50 million years of healthy life lost due to disability (YLDs), making it the second-leading cause of YLDs worldwide.1

Quick facts

Anemia is a potentially debilitating condition that can affect physical and neurocognitive capacity. Women of reproductive age and children are particularly at risk. It is associated with reduced productivity, economic losses, and preventable negative health outcomes.

US $66-110B

The estimated economic returns from productivity gains from investing US$8 billion in target interventions to reduce global anemia burden among women by 50 percent is US$66–110 billion. 2


The pooled benefit-to-cost ratio from investment in anemia prevention is modeled as x8.2 to 12.1. 2


Boosted productivity earnings from treating anemia is estimated as +4 percent to +17 percent. 2

Anemia is a health condition characterized by a reduced number of red blood cells (RBCs) or a lower-than-normal concentration of hemoglobin (Hb) within the RBCs.

Hb is a protein structure responsible for carrying oxygen in high concentrations in RBCs. Deficits in either RBC count or Hb concentration decrease the blood’s capacity to carry oxygen to the body’s tissues, potentially leading to both physical and neurocognitive impairment over time.

Explore this diagram to understand the factors that lead to anemia.

Although anemia can be a very dangerous condition, it is also both preventable and treatable. However, if anemia is so damaging, why haven’t we been able to do a better job of addressing it? The answers are varied across complex diagnosis, control, and policy challenges.

Challenges of Addressing Anemia


  • Anemia can emerge from any of several causes that are difficult to distinguish from each other.
  • Global standards for anemia diagnosis have several limitations.
  • At an individual level, diagnosing anemia presents some unique field-level difficulties.
  • At a population level, estimating anemia burden is difficult in the field.


  • A major lever for addressing high-anemia-burdened populations is iron plus folic acid supplementation, but several bottlenecks exist in coverage and uptake.
  • Guidance varies as to what supplementation and fortification should be provided and when.


  • Anemia is a highly intersectoral issue requiring governance, collaboration across sectors, political commitment, and fundamental improvements in socioeconomic environment.

Under SDG 2: Reduce anemia among Women of Reproductive Age (WRA) by 50 percent by 2030.

Sustainable Development Goal 2 includes a goal to reduce anemia among WRA by 50 percent by 2030.3 However, there has been little global progress in reducing the prevalence of anemia among WRA over the last decade, with global prevalence stagnated at approximately 30 percent. This lack of progress is particularly stark in South Asia and sub-Saharan Africa, where prevalence has increased over this time in some countries.1

The second Global Nutrition Target 2025 called for a 50 percent reduction of anemia in WRA. Based on the 2012 WRA anemia prevalence of approximately 30 percent, achieving the original target (anemia prevalence of approximately 15 percent by 2025) would have required an annual average rate of reduction of 5.2 percent. However, no country is on track to achieve this goal.4

What can we do to accelerate progress?

ask an expert

Find out how to apply Exemplars lessons to your work.
Ask an Expert

Anemia among WRA Exemplars

  1. 1
    Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease (GBD). Institute for Health Metrics and Evaluation. 2019. Accessed September 21, 2021.
  2. 2
    Shekar M, Kakietek J, Eberwein JD, Walters D. An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting. World Bank Group; 2016. Accessed September 21, 2021.
  3. 3
    Korenromp E, Wüstefeld M. Targets and indicators for the Post-2015 Sustainable Development Goals: Accountability for the Measurement of Results in Nutrition. Standing Committee on Nutrition, United Nations; 2014. Accessed September 21, 2021. 
  4. 4
    Keats EC, Neufeld LM, Garrett GS, Mbuya MNN, Bhutta ZA. Improved micronutrient status and health outcomes in low‐ and middle‐income countries following large‐scale fortification: evidence from a systematic review and meta‐analysis. Am J Clin Nutr. 2019;109(6):1696‐1708.