Knowledge, Attitude, and Practice on Iron-deficiency Anemia and Anthropometric Assessment among Females in Ernakulam, Kerala, India

Introduction: The health and nutrition of females are pivotal for their own well-being as well as the health of future generations. However, many experience barriers that increase the risk of malnutrition and anemia, particularly in developing countries like India. Aims: This cross-sectional study aimed to assess the anthropometry, knowledge, attitude, and practice (KAP) regarding iron-deficiency anemia among female residents of Mulavukad Panchayat in Ernakulam, Kerala, India. Material and Methods: The research included 317 randomly selected females across three age groups namely adolescents (12–19 years), adults (20–40 years), pre- and postmenopausal women (41–55 years) using a pretested interview schedule and anthropometric measurements during January–June 2025. Socioeconomic status was evaluated through the Kuppuswamy scale, anthropometric assessments were performed using Body Mass Index (BMI) and Waist-to- Hip Ratio (WHR). Knowledge, Atitude and Practice (KAP) of iron deficiency anemia were assessed using the standardized questionnaire developed according to the Food Agriculture Organization (FAO) guidelines. Results: The findings revealed a dual burden of malnutrition among adolescents, with both undernutrition and overweight/obesity present. A significant majority of adult (77%), pre- and postmenopausal women (84%) in the study belonged to the BMI categories of overweight/obesity. A considerable proportion of participants exhibited a high Waist-Hip Ratio (WHR), with 16% of adolescents, 52% of adult women, 77% of pre- and postmenopausal women showing elevated central adiposity, indicating an increasing trend of abdominal obesity with age. Adults demonstrated the highest levels of knowledge, whereas adolescents, pre- and postmenopausal women showed similarly low levels of understanding. Attitude scores improved with age, with both adults, pre- and post menopausal women displaying more positive attitudes compared to adolescents. Practice scores, however, remained consistently low across all groups, irrespective of age or knowledge. Conclusions: The study underscores the importance of targeted health education and interventions to improve knowledge and promote better nutritional practices among females in Ernakulam. Awareness and behavior change initiatives are mandate to effectively improve the nutritional status of this population.