Anemia remains a critical global public health concern and practical approaches to assessing anemia and its key determinants are required in both clinical and public health settings. To achieve global goals for anemia reduction, greater reliability, precision, and consistency of anemia assessment approaches are needed.

Anemia is characterized by low hemoglobin or hematocrit concentrations which are both relevant for the selection of assessment strategies. Limitations for the definition of anemia, including establishment of hemoglobin thresholds, exist. The choice of strategies to prevent and treat anemia should consider key causes of anemia in different settings, and these strategies should be prioritized based on the contribution of the different causes to the anemia burden.

Causes of anemia can generally be classified as non-nutritional causes (e.g., genetic disorders, infection, inflammation, and blood loss), and nutrition-related (e.g., deficiencies of iron and other key micronutrients including vitamin A, folate, vitamin B₁₂, and others). A more systematic approach to anemia assessment, including an improved understanding of anemia etiologies, can better inform anemia control efforts.

USAID Advancing Nutrition’s Anemia Task Force has developed a diagnostic algorithm that uses a systematic approach to determine the prevalence and causes of anemia in a country or in subnational areas. The algorithm considers the proportion of anemia due to different causes in a population and suggests a sequence of biomarker tests that will help to determine the main causes of anemia. These causes can then be addressed with public health interventions. The algorithm also considers various population groups that may need targeted interventions, such as women of reproductive age or young children.