title: Association of household environment and prevalence of anemia among children under-5 in India.
abstract: OBJECTIVE
  The study explores the association between the household environment and the prevalence of anemia among children under the age of 5 years in India. Data and methodology: The study is based on 52,868 children under the age of 5 years, included in India's National Family Health Survey-3. The outcome variable was the prevalence of anemia. To understand the role of environment in determining child anemia, step wise logistic regression models consisting of environmental, child, socio-economic, and media exposure variables were applied.
  
  
  RESULTS
  The occurrence of childhood anemia was higher in the North Eastern and Eastern regions compared to all other regions of India. Unclean fuel use, poor toilet facilities, staying in non-concrete house, exposure to smoking were important variables determining the prevalence of anemia. Smoking, when it was controlled with only socio economic factors, showed lesser impact on anemia, but when it got adjusted with socio-economic, child, and media variables together it showed an important impact as it increased the risk of anemia.
  
  
  CONCLUSIONS
  Children under 5 years of age generally stay inside their house and are more exposed to the household environment. Thus, among these children there are multiple risk factors causing anemia along with the nutritional deficiencies. Better resources are needed to educate the public and to increase awareness for improved hygiene, sanitation and housing facilities, health and nutrition, etc. Along with a wider program to manage nutritional deficiency, anemia in children <5 years, there should be a holistic approach toward anemia control inculcating household environmental conditions and socio economic determinants.
authors.affiliation: Environmental Health Resource Hub, School of Habitat Studies, Tata Institute of Social Sciences , Mumbai , India.
authors.forename: Annu
authors.initials: A
authors.lastname: Baranwal
authors.affiliation: International Institute for Population Sciences , Mumbai , India.
authors.forename: Anshu
authors.initials: A
authors.lastname: Baranwal
authors.affiliation: Environmental Health Resource Hub, School of Habitat Studies, Tata Institute of Social Sciences , Mumbai , India ; Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Nobhojit
authors.initials: N
authors.lastname: Roy
keywords: India; anemia; children; environment; health