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evidence: source inventory for anemia-women-adolescents-global (#43)
literature-scout source-inventory task. Adds 5 dated, classified evidence records (usable/limited/rejected) with measured-haemoglobin discipline, covering both prevalence and IFA supplementation coverage: - WHO/Lancet GH 2022 pooled measured-Hb estimates (usable backbone) - WHO VMNIS micronutrients database (usable source layer) - GBD 2021 anaemia burden (limited) - DHS haemoglobin + iron-supplementation recall (limited; covers IFA) - clinical pallor meta-analysis (rejection rule vs measured Hb) Refreshes access date on the pre-existing WHO GHO record (URL re-verified live). Updates datasets.md and evidence.md. Satisfies done_condition: >=4 sources classified with explicit reasons.
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‎problem-packs/public-health/anemia-women-adolescents-global/datasets.md‎

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# Dataset Inventory
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| Source | Grain | Status | Use |
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| ---------------------------- | ------------ | ------ | ------------- |
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| Primary survey data | Sub-national | Usable | Core analysis |
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| Satellite/environmental data | Variable | Usable | Risk context |
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| Population data | 100m | Usable | Denominator |
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Dated source inventory for anaemia prevalence and iron-folic-acid (IFA) supplementation coverage in women and adolescent girls in LMICs. Classification reflects fitness for a sub-national prevalence-and-coverage analysis. Inventory compiled 2026-06-18.
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## Sources
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| Source | Grain | Measure family | Status | Use |
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| ---------------------------------------- | --------------------------------- | ---------------------------------- | -------- | ---------------------------------------------- |
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| WHO Global Anaemia Estimates (GHO, 2023) | Global / national | Modeled prevalence benchmark | Usable | Global benchmark for women/children prevalence |
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| WHO/Lancet GH pooled estimates (2022) | National, by severity | Measured-Hb pooled prevalence | Usable | Cross-country prevalence backbone |
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| WHO VMNIS micronutrients database | National; survey-level entries | Measured haemoglobin distributions | Usable | Underlying measured-Hb source layer |
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| GBD 2021 anaemia burden (IHME) | National + some subnational | Modeled prevalence/YLD by cause | Limited | Burden and cause context |
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| DHS haemoglobin + iron supplementation | National + georeferenced clusters | Measured Hb (subset) + IFA recall | Limited | Sub-national prevalence and IFA coverage proxy |
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| Clinical pallor / exam-only assessment | Varies | Visual clinical assessment | Rejected | Inaccurate and unreliable (see below) |
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## Classification Reasons
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- **Usable** sources rest on measured haemoglobin and provide prevalence at national or finer grain.
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- **Limited** sources serve a narrower purpose: GBD outputs are modeled burden by cause rather than direct survey prevalence; DHS measures haemoglobin only in a subset of rounds and records IFA via recall (receipt, not confirmed consumption).
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- **Rejected**: clinical pallor / examination-only assessment has wide, inconsistent diagnostic accuracy and poor inter-observer agreement, so it cannot anchor prevalence estimates in place of measured haemoglobin.
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## Required Properties
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Source methodology, data year, geographic grain, license.
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Source methodology, data year, geographic grain, measure family (measured haemoglobin vs clinical vs recall), license, and prevalence/coverage coverage.
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## Rejection Rule
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Rejected if methodology, grain, date, or license unverifiable.
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Rejected if methodology, grain, date, or license is unverifiable, or if anaemia status is from clinical assessment rather than measured haemoglobin.

‎problem-packs/public-health/anemia-women-adolescents-global/evidence.json‎

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"url": "https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children"
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},
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"source_date": "2023-05-01",
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"access_date": "2026-06-07",
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"access_date": "2026-06-18",
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"method": "Reviewed WHO anemia database, prevalence estimates, and intervention coverage.",
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"limitations": [
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"Anemia estimates modeled from surveys of variable recency.",
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"IFA coverage data is self-reported."
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],
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"confidence": "high"
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},
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{
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"id": "who-lancet-gh-anaemia-estimates-2022",
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"problem_id": "public-health/anemia-women-adolescents-global",
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"claim": "A WHO-led pooled analysis of population-representative data estimates national, regional, and global anaemia prevalence by severity for women and children over 2000-2019, and is usable as the cross-country prevalence backbone for women of reproductive age.",
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"evidence_type": "peer-reviewed-study",
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"source": {
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"title": "National, regional, and global estimates of anaemia by severity in women and children for 2000-19: a pooled analysis of population-representative data",
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"url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9023869/"
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},
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"source_date": "2022-05-01",
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"access_date": "2026-06-18",
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"method": "Read the open-access Lancet Global Health article and methods; confirmed it pools measured-haemoglobin survey data to produce severity-disaggregated anaemia prevalence for women aged 15-49 and children, by country and year.",
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"limitations": [
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"Estimates are national, regional, and global; the analysis does not provide sub-national grain.",
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"Values are modeled where survey data are sparse, widening uncertainty for some low-income countries.",
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"Series ends in 2019 and covers women of reproductive age rather than adolescent girls specifically."
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],
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"confidence": "high"
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},
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{
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"id": "who-vmnis-micronutrients-database",
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"problem_id": "public-health/anemia-women-adolescents-global",
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"claim": "The WHO Vitamin and Mineral Nutrition Information System (VMNIS) compiles haemoglobin-distribution data from hundreds of surveys across more than 130 countries, providing the measured-haemoglobin source layer underlying global anaemia estimates.",
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"evidence_type": "dataset",
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"source": {
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"title": "WHO Vitamin and Mineral Nutrition Information System (VMNIS)",
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"url": "https://www.who.int/teams/nutrition-and-food-safety/databases/vitamin-and-mineral-nutrition-information-system"
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},
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"source_date": "2024-01-01",
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"access_date": "2026-06-18",
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"method": "Opened the VMNIS database page and confirmed it aggregates haemoglobin-distribution data from systematic literature search, collaborator network, and country consultation for women and children.",
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"limitations": [
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"It is a compilation of heterogeneous surveys; methods, recency, and representativeness vary by entry.",
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"Coverage is country-level; it is not a ready-made sub-national dataset.",
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"Source date is approximate — the database is continuously updated rather than published once."
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],
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"confidence": "medium"
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},
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{
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"id": "gbd-2021-anaemia-burden",
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"problem_id": "public-health/anemia-women-adolescents-global",
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"claim": "GBD 2021 estimates anaemia prevalence and years lived with disability by severity and cause for 204 countries over 1990-2021, reporting global all-age prevalence of 24.3 percent in 2021 and much slower progress in women and girls than in men and boys.",
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"evidence_type": "peer-reviewed-study",
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"source": {
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"title": "Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021",
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"url": "https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(23)00160-6/fulltext"
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},
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"source_date": "2023-09-01",
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"access_date": "2026-06-18",
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"method": "Reviewed the published GBD 2021 anaemia findings to confirm severity- and cause-disaggregated prevalence and YLD estimates and the women-versus-men progress gap.",
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"limitations": [
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"Outputs are modeled burden estimates with uncertainty intervals, not direct survey observations.",
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"Headline figures are all-age; women-of-reproductive-age and adolescent breakdowns require the underlying results tool.",
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"Cause attribution depends on modeling assumptions that vary across settings."
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],
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"confidence": "medium"
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},
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{
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"id": "dhs-haemoglobin-and-iron-supplementation",
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"problem_id": "public-health/anemia-women-adolescents-global",
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"claim": "DHS surveys measure haemoglobin for women and men aged 15 and over in selected rounds and record antenatal iron-supplementation receipt, providing georeferenced measured-anaemia prevalence and survey-based IFA coverage in many LMICs.",
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"evidence_type": "dataset",
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"source": {
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"title": "The DHS Program — Biomarkers",
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"url": "https://www.dhsprogram.com/What-We-Do/Biomarkers.cfm"
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},
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"source_date": "2024-01-01",
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"access_date": "2026-06-18",
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"method": "Reviewed the DHS biomarkers page and confirmed haemoglobin is collected for ages 15+ in selected surveys; cross-checked that DHS questionnaires also capture iron supplementation during pregnancy, the standard LMIC IFA-coverage measure.",
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"limitations": [
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"Haemoglobin is measured only in a subset of DHS surveys and countries, not all rounds.",
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"IFA coverage is recall-based and records receipt or number of days, not confirmed consumption.",
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"Field capillary haemoglobin measurement is less precise than venous laboratory assay.",
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"Source date is approximate — this is a continuously maintained program page, not a dated publication."
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],
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"confidence": "medium"
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},
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{
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"id": "clinical-pallor-anaemia-rejected",
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"problem_id": "public-health/anemia-women-adolescents-global",
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"claim": "A meta-analysis of clinical pallor for diagnosing anaemia finds wide and inconsistent diagnostic accuracy with poor inter-observer agreement, which is the documented basis for rejecting pallor-based or clinical-examination-only assessment as an anaemia prevalence source in place of measured haemoglobin.",
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"evidence_type": "peer-reviewed-study",
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"source": {
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"title": "Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis",
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"url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC1325025/"
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},
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"source_date": "2005-12-16",
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"access_date": "2026-06-18",
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"method": "Read the open-access meta-analysis to confirm the reported sensitivity and specificity ranges and inter-observer reliability for pallor, then applied it as the rejection rule for clinical-assessment-only anaemia data.",
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"limitations": [
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"The meta-analysis is in children, so the precise accuracy figures may differ for adolescent girls and adult women.",
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"It establishes the rejection rationale; it is not itself a usable prevalence data source.",
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"It does not address iron-supplementation coverage measurement."
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],
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"confidence": "high"
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}
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]

‎problem-packs/public-health/anemia-women-adolescents-global/evidence.md‎

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WHO estimates 30 percent of women aged 15-49 have anemia, with prevalence exceeding 50 percent in several Sub-Saharan African and South Asian countries.
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### who-lancet-gh-anaemia-estimates-2022
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WHO-led pooled analysis of measured-haemoglobin surveys gives national/regional/global anaemia prevalence by severity for women and children, 2000-2019. Usable backbone; national grain only and ends in 2019.
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### who-vmnis-micronutrients-database
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VMNIS compiles haemoglobin-distribution data from hundreds of surveys across 130+ countries — the measured-Hb source layer beneath global estimates. Usable; heterogeneous entries, country-level.
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### gbd-2021-anaemia-burden
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GBD 2021 (IHME) supplies modeled anaemia prevalence and YLDs by severity and cause for 204 countries, 1990-2021 (24.3% global all-age in 2021). Limited: modeled burden, all-age headline figures.
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### dhs-haemoglobin-and-iron-supplementation
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DHS measures haemoglobin for ages 15+ in selected rounds and records antenatal iron-supplementation receipt, with georeferenced clusters. Limited: Hb in a subset of surveys; IFA is recall-based.
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### clinical-pallor-anaemia-rejected
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A meta-analysis finds clinical pallor has wide, inconsistent accuracy and poor inter-observer agreement. Basis for rejecting clinical-assessment-only anaemia data in place of measured haemoglobin.
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## Evidence Quality Rule
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Evidence accepted only when source, method, limitations, and confidence are explicit enough for a reviewer to attack.

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