New findings from a HarvestPlus-commissioned systematic review challenge a key prevailing assumption about the proportion of anemia attributable to iron deficiency, and reinforce the need for interventions that are tightly tailored to the specific needs of the country or context of delivery.

While the causes of anemia are complex, a widespread assumption in the nutrition and public health community attributes half of all anemia cases to deficiencies in iron, with inherited blood disorders and chronic infections, such as malaria and hookworm, thought to constitute the next major causes. Globally, many interventions aimed at reducing anemia and redressing iron deficiency are largely informed by this estimation.

In contrast to the prevailing assumption, the systematic review of 23 countries found that iron deficiency accounts for 25 percent of anemia in young children and 37 percent of anemia in women of reproductive age. Moreover, significant variations exist between countries, which may render generalized assumptions misleading. The review found, for instance, that iron deficiency anemia was less than 1 percent among young children in Georgia and as high as 75 percent among women in Oman.

The systematic review underscores the need for anemia-reduction programs to closely fit country- or context-specific realities. While that imperative requires the availability of such specific data and more research remains necessary, the review findings make a compelling case for the consideration of these new estimates when developing and evaluating future interventions. These findings should be useful for international public health organizations to revise the current one-fits-all guideline.