Nationally representative anaemia levels among women and children were recently determined in conjunction with the Demographic and Health Surveys in Kazakstan (1995), Uzbekistan (1996), and the Kyrgyz Republic (1997). Anaemia was assessed by measuring the haemoglobin level in capillary blood of women aged 15 to 49 and their children under the age of 3 using the photometric Hemocue technique. The numbers of women tested were 3,658, 4,333, and 3,760 in Kazakstan, Uzbekistan, and the Kyrgyz Republic, respectively. All three Central Asian republics had a high prevalence of anaemia. The highest overall rates were in the regions of Kazakstan and Uzbekistan near the Aral Sea, which are characterized by severe agrochemical pollution and other environmental and socio-economic problems. Approximately half (49%) of the women in Kazakstan, 60% of the women in Uzbekistan, and 40% of the women in the Kyrgyz Republic suffered from some degree of anaemia. Mild anaemia (haemoglobin level, 10.0-11.9 g/dl; 10.0-10.9 g/dl for pregnant women) was diagnosed in 37%, 45%, and 28% of the women in Kazakstan, Uzbekistan, and the Kyrgyz Republic, respectively. Eleven percent of the women in Kazakstan, 14% in Uzbekistan, and 9% in the Kyrgyz Republic had moderate anaemia (haemoglobin level 7.0-9.9 g/dl). Severe anaemia (haemoglobin level less than 7.0 g/dl) was found among 1% of the women in all three Central Asian republics.

In Kazakstan, 69% of the children under the age of three suffered from some degree of anaemia. About the same number of children had mild (30%) and moderate (34%) anaemia. A smaller, but substantial, proportion of children (5%) were severely anaemic. In Uzbekistan and the Kyrgyz Republic, 61% and 50% of children, respectively, suffered from anaemia. The percentages of children with mild, moderate, and severe anaemia were 34%, 26%, and 1%, respectively, for Uzbekistan, and 24%, 24%, and 1%, respectively, for the Kyrgyz Republic.

There is sufficient evidence to suggest that negative iron balance is probably a major cause of anaemia among both women and children in Central Asia. Our findings provide important information for the development of health intervention programmes to prevent iron-deficiency anaemia among women of certain ethnic, educational, and residential groups in this region. Based on the results of the Demographic and Health Survey as well as other geographically focused studies, the UNICEF Area Office for the Central Asian Republics and Kazakstan proposed an integrated strategy of education, supplementation, fortification, and research to address the problem and called for donors’ support. It is expected that this approach can considerably improve maternal and child health in Central Asia.