The decision to exclude anaemia from the sixth National Family Health Survey (NFHS-6), launched in 2023, has sparked controversy following the release of NFHS fact sheets. The government stated that anaemia would be surveyed more scientifically through the Diet and Biomarkers Survey in India (DABS-I), initiated in December 2022. However, the anaemia prevalence data from DABS-I, completed in November 2025, has not yet been made public. Experts involved in DABS-I confirm that the anaemia report is ready, but the timing of its release rests with the government.
Background of the Controversy
The exclusion of anaemia from NFHS-6 drew sharp criticism after the previous NFHS (2019-21) revealed a significant rise in anaemia among children and women. The proportion of adolescent girls with anaemia increased from 54% in 2015-16 to nearly 60%. Similarly, 67% of children under five years and 52% of pregnant women were found to be anaemic. The government faced backlash over the failure of its nutrition and iron tablet distribution programs, while many questioned the unexplained increase in anaemia prevalence.
Methodological Concerns
Several experts argued that the high incidence reported by NFHS could stem from faulty methodology. The NFHS used capillary blood samples from finger pricks, which can yield results varying by almost one gram per decilitre. Published data indicate that venous blood samples (drawn from veins) provide higher haemoglobin estimates and are considered the gold standard for anaemia assessment. This methodological flaw prompted the government to transition to DABS-I, which employs venous sampling.
The New Survey: DABS-I and SAMPADA
DABS-I, now renamed the Survey for Assessment of Markers of Population Health, Activity, Diet and Anthropometry (SAMPADA), covered 2.6 lakh individuals, compared to NFHS's sample of nearly 7 lakh. By using venous samples, SAMPADA is expected to show a much lower anaemia prevalence than NFHS-5. However, direct comparison with earlier NFHS data is not possible due to differing methodologies.
Comparability with CNNS
SAMPADA's anaemia data may be comparable with the Comprehensive National Nutrition Survey (CNNS) of 2016-18, which also used venous blood samples. CNNS, conducted by the health ministry with support from UNICEF and the Population Council, covered over 1.1 lakh pre-schoolers, school-age children, and adolescents across 30 states. It found that anaemia was most prevalent (over 50%) among children under two years, declining steadily to about 15% by age 11. Among adolescents, anaemia was more common in females (about 40%) than males (about 18%), figures significantly lower than NFHS-5 estimates.
The delay in releasing SAMPADA's results has fuelled speculation and criticism. As the government holds the key to publication, the scientific community awaits data that could reshape India's anaemia narrative.
