Global Evidence on Knowledge, Attitudes, and Practices Related to Anemia Among Women of Reproductive Age: A Systematic Review and Meta-Analysis

Background: Anemia remains a major public health problem among women of reproductive age (WRA) worldwide, particularly in low- and middle-income countries. Knowledge, attitudes, and practices (KAP) related to anemia play a crucial role in its prevention and control; however, evidence on KAP levels among WRA is fragmented and region-specific.

Objective: To systematically review and meta-analyze global evidence on knowledge, attitudes, and practices related to anemia among women of reproductive age.

Methods: A systematic search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was conducted from inception to December 2025. Observational studies reporting quantitative data on anemia-related KAP among women aged 15–49 years were included. Study selection, data extraction, and quality assessment using the Joanna Briggs Institute checklist were performed independently by two reviewers. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test.

Results: Thirty-eight studies involving 42,378 women from 26 countries were included. The pooled prevalence of adequate knowledge regarding anemia was 56.3% (95% CI: 49.8–62.7), positive attitudes were reported by 61.8% (95% CI: 55.1–68.2), and appropriate preventive practices by 41.2% (95% CI: 35.0–47.6). Substantial heterogeneity was observed across all outcomes (I² > 94%). Lower KAP levels were consistently identified among women residing in rural areas, those from low-income countries, and women with lower educational attainment.

Conclusion: Globally, women of reproductive age demonstrate moderate awareness and attitudes toward anemia, but preventive practices remain inadequate. Addressing the gap between knowledge and practice requires multifaceted, context-specific interventions that integrate behavior change communication, nutrition education, and strengthened primary healthcare systems.