Which Country Has the Most Iron Deficiency?

December 17, 2025 •

3 min read

According to the Global Burden of Disease study, Western Sub-Saharan Africa and South Asia bear the greatest burden of anemia, a condition overwhelmingly caused by iron deficiency. Pinpointing a single country with the most iron deficiency is complex due to variations in data and the interplay of multiple factors, but statistics consistently highlight specific nations and regions disproportionately affected by this major public health issue.

Quick Summary

This article explores data from global health studies to identify the countries and regions with the highest prevalence of iron deficiency. It examines the underlying factors, such as dietary issues, infections, and socioeconomic status, that contribute to this condition in vulnerable populations like children and women.

Key Points

Prevalence is Highest in Sub-Saharan Africa and South Asia: Regions with lower socioeconomic development, like Sub-Saharan Africa and South Asia, have the highest burden of iron deficiency and related anemia.
Top Countries Include Zambia, Mali, and Yemen: Recent studies have identified specific countries, including Zambia, Mali, and Yemen, as having exceptionally high rates of anemia, which is largely caused by iron deficiency.
Low Iron Bioavailability is a Key Cause: In developing nations, a major factor is the low bioavailability of iron from staple foods like cereals, which are common in local diets.
Infectious Diseases Compound the Problem: Conditions like malaria and intestinal parasites are widespread in high-burden regions and contribute significantly to blood loss and impaired iron absorption.
Vulnerable Populations are Most Affected: Children under five and women of reproductive age are the most susceptible demographic groups globally to the effects of iron deficiency.
Interventions are Multisectoral: Combating the deficiency requires improving diet, enhancing sanitation, controlling infectious diseases, and providing targeted supplementation.
Socioeconomic Status is a Major Predictor: There is a strong negative correlation between a country's socioeconomic development and its burden of iron deficiency.

Understanding Global Iron Deficiency

Iron deficiency (ID) is the most common nutritional deficiency worldwide and the primary cause of anemia, affecting billions of people. While anemia rates have fallen globally in recent decades, significant disparities remain, with the heaviest burden concentrated in low- and middle-income countries. The prevalence of this condition varies dramatically by region, largely influenced by socioeconomic factors, infectious disease rates, and dietary habits. Data from global health research organizations, such as the Institute for Health Metrics and Evaluation (IHME) and the World Health Organization (WHO), provide critical insights into which nations are most affected.

Leading Countries and Regions for Iron Deficiency

Rather than one single country, health data consistently points to specific regions experiencing the highest burden of iron deficiency and related anemia.

Countries with the Highest Anemia Burden (Often Due to Iron Deficiency)

Based on 2019 data from a large-scale study, countries with the highest age-standardized prevalence of anemia included Zambia, Mali, and Burkina Faso. Yemen was also highlighted in a 2021 study on dietary iron deficiency in the MENA region as having a particularly high age-standardized prevalence rate. These figures align with broader regional trends, where sub-Saharan Africa and South Asia are consistently identified as major areas affected by this public health crisis.

Regional Breakdown: Sub-Saharan Africa and South Asia

Sub-Saharan Africa and South Asia face significant challenges related to iron deficiency. A study noted that in 2019, South Asia had the highest age-standardized prevalence of anemia, followed closely by Western Sub-Saharan Africa and Central Sub-Saharan Africa. This concentration is due to several factors present in these regions.

Factors Driving High Iron Deficiency Rates

Several elements contribute to the high rates of iron deficiency in developing nations:

Dietary Factors: Low iron availability from staple foods is a key driver. Diets often lack variety and sufficient sources of readily absorbable iron.
Infectious Diseases: Chronic infections, including malaria and parasitic infections, are major causes of anemia in Sub-Saharan Africa. These can lead to blood loss and interfere with iron absorption.
Socioeconomic Status: Poverty and lower socioeconomic development correlate with higher rates of iron deficiency. This impacts access to nutritious food, clean water, and healthcare.
Vulnerable Populations: Children under 5 and women of reproductive age are particularly susceptible globally, with the highest prevalence in Africa and South-East Asia. Women are vulnerable due to menstrual blood loss and increased needs during pregnancy.

Comparison of Factors: Developed vs. Developing Nations


Factor	Developing Nations (e.g., Mali, Zambia)	Developed Nations (e.g., Iceland, Norway)
Primary Cause	Inadequate dietary intake (low bioavailability) and infectious diseases like malaria.	Chronic disease (e.g., kidney disease, inflammatory bowel disease) and blood loss from sources like menstruation.
Dietary Intake	Diets are often staple-based (cereals, legumes) with low dietary diversity and limited access to iron-rich foods.	Diets are generally more diverse, but may include more processed, nutrient-poor foods that inhibit iron absorption.
Infectious Disease Burden	High prevalence of parasitic infections and malaria, which can cause blood loss and impair iron absorption.	Lower rates of infectious diseases contributing to anemia due to better sanitation and healthcare.
Public Health Interventions	Interventions like food fortification and supplementation exist but often face challenges with funding and reach, especially in rural areas.	High rates of access to fortified foods, and supplementation is readily available.
At-Risk Populations	Children under five and women of reproductive age bear the greatest burden.	Vulnerable groups include infants, pregnant women, and adolescents, but prevalence is much lower overall.

Addressing the Disparity

Addressing the global burden of iron deficiency requires a multi-faceted and targeted approach. Food fortification programs are effective, but their reach is limited in high-burden areas. Improving sanitation and access to clean water helps combat infectious diseases that interfere with iron absorption. Providing iron supplementation to high-risk groups is also crucial. Long-term solutions involve broader socioeconomic improvements, including poverty reduction, education, and enhanced dietary diversity. Organizations like the WHO and UNICEF coordinate these efforts.

Conclusion

While identifying a single country with the most iron deficiency is complex, data consistently points to countries in Sub-Saharan Africa and South Asia as having the highest burden. Nations like Zambia, Mali, and Yemen are cited for high prevalence rates of anemia, primarily caused by iron deficiency. The crisis stems from low dietary iron availability, high rates of infectious diseases, and lower socioeconomic status. Effective interventions addressing nutrition, sanitation, and healthcare access are needed to reduce the health impacts on vulnerable populations.

Frequently Asked Questions

The most common cause of iron deficiency worldwide is inadequate dietary iron intake, especially in low-income countries where access to iron-rich foods is limited and staple crops have low iron bioavailability.

According to global health data, Sub-Saharan Africa and South Asia consistently show the highest prevalence rates of iron deficiency and anemia.

Children under five and women of reproductive age have higher iron requirements due to growth and menstrual blood loss, respectively. This makes them particularly vulnerable to deficiencies, especially in resource-poor settings.

Infections like malaria, HIV/AIDS, and parasitic worms are major contributors in many developing countries. These can cause blood loss, affect nutrient absorption, and trigger inflammation that impacts iron metabolism.

Yes, while less prevalent, some high-income countries still see a burden of iron deficiency. This can be linked to factors like processed, nutrient-poor diets, certain lifestyle choices, and specific health conditions.

Interventions include food fortification programs (adding iron to staple foods), providing targeted iron and folic acid supplements, improving hygiene and sanitation to prevent infections, and promoting diverse, iron-rich diets.

No, while iron deficiency is the most common cause, anemia can also result from other nutrient deficiencies (like vitamin B12 and folate), chronic diseases, blood loss from non-nutritional causes, and inherited blood disorders.