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Association between short birth intervals and childhood anemia severity in India: evidence from the fifth National Family Health Survey (NFHS-5)

Year: 2026

Type: article

Abstract: Background: Anemia affects 67.1% of Indian children aged 6-59 months. Short birth intervals (SBI) may exacerbate this burden through maternal nutritional depletion; however, empirical evidence linking SBI with specific levels of childhood anemia severity remains limited in India. Methods: We analyzed nationally representative, secondary cross-sectional data from the National Family Health Survey-5 (NFHS-5, 2019-21), comprising an unweighted analytical sample of 101,240 mother-child pairs with children aged 6-59 months. Survey-adjusted multinomial logistic regression was used to assess the association between SBI and anemia severity (mild, moderate, and severe). Adjusted odds ratios (aOR) were estimated after controlling for key child, maternal, household, and geographic characteristics. Results: Compared with non-short birth interval (NSBI), SBI was significantly associated with a higher odd of moderate anemia (aOR: 1.10; 95% CI: 1.05-1.15) and severe anemia (aOR: 1.18; 95% CI: 1.05-1.34), but not mild anemia. The highest burden of severe anemia was observed among children aged 6-23 months, those with birth weight <2,500 g, and those born to mothers with severe anemia. Children from Scheduled Caste/Scheduled Tribe (SC/ST) communities, and the West, North, Central and South regions had higher odds of severe anemia, whereas higher maternal education, greater household wealth, and residence in the Northeast were associated with a lower odd of anemia. Conclusion: SBI is associated with a higher odd of moderate and severe anemia among children in India, potentially associated with maternal nutritional depletion and intersecting structural inequities. Addressing this public health burden requires integrated strategies that promote optimal birth spacing, strengthen family planning services, and provide targeted maternal nutrition interventions for marginalized populations, thereby supporting progress toward the Sustainable Development Goals.

Source: Frontiers in Nutrition

DOI: 10.3389/fnut.2026.1945328

Authors: Soumen Barik, Arpita Show, Manoj Sonune

Institutions: International Institute for Population Sciences, Sadhu Ramchand Murmu University of Jhargram, Tata Institute of Social Sciences

Language: English

Topic: Iron Metabolism and Disorders

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Zero hunger

Open Access status: gold

Estimated APC paid: $3,801