Does Adolescence Anemia Persist Over a Woman’s Life Cycle? Evidence from the Indonesian Family Life Survey

DOESADOLESCENCEANEMIAPERSISTOVERAWOMAN’SLIFECYCLE? EVIDENCEFROMTHEINDONESIANFAMILYLIFESURVEY ElanSatriawan,RanjanShrestha,FirmanWitoelar,andTakashiYamano NO.690 July2023 ADBECONOMICSWORKINGPAPERSERIES ASIANDEVELOPMENTBANK ADBEconomicsWorkingPaperSeries DoesAdolescenceAnemiaPersistoveraWoman’s LifeCycle?EvidencefromtheIndonesianFamilyLifeSurvey ElanSatriawan,RanjanShrestha,FirmanWitoelar,andTakashiYamano TheADBEconomicsWorkingPaperSeriespresentsresearchinprogresstoelicitcommentsandencouragedebateondevelopmentissuesinAsiaandthePacific.TheviewsexpressedarethoseoftheauthorsanddonotnecessarilyreflecttheviewsandpoliciesofADBor itsBoardofGovernorsorthegovernmentstheyrepresent. No.690|July2023 ElanSatriawan(esatriawan@ugm.ac.id;elan.satriawan@tnp2k.go.id)isanassociateprofessoratUniversitasGadjahMadaandthechiefofthePolicyGroupofNationalTeamforAccelerationofPovertyReduction(TNP2K),OfficeoftheVicePresident,RepublicofIndonesia.RanjanShrestha(rshrestha@wm.edu)isalectureratWilliam&Mary.FirmanWitoelar(firmanwitoelar.kartaadipoetra@anu.edu.au)isafellowattheCrawfordSchoolofPublicPolicy,AustralianNationalUniversity.TakashiYamano(tyamano@adb.org)isaprincipaleconomistattheEconomicResearchandDevelopmentImpactDepartment,AsianDevelopmentBank. ASIANDEVELOPMENTBANK CreativeCommonsAttribution3.0IGOlicense(CCBY3.0IGO) ©2023AsianDevelopmentBank 6ADBAvenue,MandaluyongCity,1550MetroManila,PhilippinesTel+63286324444;Fax+63286362444 www.adb.org Somerightsreserved.Publishedin2023. ISSN2313-6537(print),2313-6545(electronic)PublicationStockNo.WPS230253-2 DOI:http://dx.doi.org/10.22617/WPS230253-2 TheviewsexpressedinthispublicationarethoseoftheauthorsanddonotnecessarilyreflecttheviewsandpoliciesoftheAsianDevelopmentBank(ADB)oritsBoardofGovernorsorthegovernmentstheyrepresent. ADBdoesnotguaranteetheaccuracyofthedataincludedinthispublicationandacceptsnoresponsibilityforanyconsequenceoftheiruse.ThementionofspecificcompaniesorproductsofmanufacturersdoesnotimplythattheyareendorsedorrecommendedbyADBinpreferencetoothersofasimilarnaturethatarenotmentioned. Bymakinganydesignationoforreferencetoaparticularterritoryorgeographicarea,orbyusingtheterm“country”inthispublication,ADBdoesnotintendtomakeanyjudgmentsastothelegalorotherstatusofanyterritoryorarea. ThispublicationisavailableundertheCreativeCommonsAttribution3.0IGOlicense(CCBY3.0IGO)https://creativecommons.org/licenses/by/3.0/igo/.Byusingthecontentofthispublication,youagreetobeboundbythetermsofthislicense.Forattribution,translations,adaptations,andpermissions,pleasereadtheprovisionsandtermsofuseathttps://www.adb.org/terms-use#openaccess. ThisCClicensedoesnotapplytonon-ADBcopyrightmaterialsinthispublication.Ifthematerialisattributedtoanothersource,pleasecontactthecopyrightownerorpublisherofthatsourceforpermissiontoreproduceit.ADBcannotbeheldliableforanyclaimsthatariseasaresultofyouruseofthematerial. Pleasecontactpubsmarketing@adb.orgifyouhavequestionsorcommentswithrespecttocontent,orifyouwishtoobtaincopyrightpermissionforyourintendedusethatdoesnotfallwithintheseterms,orforpermissiontousetheADBlogo. CorrigendatoADBpublicationsmaybefoundathttp://www.adb.org/publications/corrigenda. ABSTRACT Westudythedeterminantsofhemoglobinconcentrationinwomenthroughouttheirlifecycleandaskwhetheranemiaduringadolescencepersistsintoadulthood.UsingapanelofindividualsfromtheIndonesianFamilyLifeSurvey(IFLS),wefindthatalthoughabout30%ofoursamplewasanemicduringagivensurveywave,63%experiencedanemiaatleastonceoverthefoursurveywaves,suggestingahighburdenofanemiaamongIndonesianwomen.Furthermore,thehighprevalenceofanemiaisnotlimitedtopoorwomenbutisalsoobservedinthewealthiersegmentsofthepopulation.Usingadynamicpanelframework,wefindasignificantrelationshipbetweencurrenthemoglobinconcentrationanditsmeasurementintheprecedingsurveywave,suggestingsomepersistenceofanemiastatusacrosssurveywaves.However,asmallautoregressivecoefficientsuggeststhathemoglobinconcentrationandthelikelihoodofanemiaconvergeacrosswomenovertime.Wefindafewvariablesthataresignificantdeterminantsofhemoglobinconcentration.Amongthem,householdsocioeconomicstatusandwagesofwomencomparedwithmeninthecommunityarepositivelyassociatedwithhemoglobinconcentration. Keywords:anemia,hemoglobinconcentration,IndonesianFamilyLifeSurvey,femaleadolescenthealth JELcodes:I15,I18 _ ThegrantfundforthisstudywasreceivedfromtheJapanFundforProsperousandResilientAsiaandthePacificfinancedbytheGovernmentofJapanthroughtheAsianDevelopmentBank. I.Introduction Anemiaischaracterizedbylowhemoglobinconcentrationorthenumberandsizeoferythrocytes(redbloodcells),resultinginadecreasedcapacityofthebloodtotransportoxygenthroughoutthebody,andislargelyassociatedwithnutrition,infectiousdiseases,andgenetics(Balarajanetal.2011).1Symptomsofanemiaincludefatigue,lethargy,andshortnessofbreath.Asinmanylow-andmiddle-incomecountries,thereisahighprevalenceofanemiainIndonesia—aboutaquarterofthepopulationisanemicatanygiventime,withhigherprevalenceinwomenandchildren.2Thishighprevalenceofanemiaamongwomencouldhaveanimpac