1 ─　　─ 2022；72：1～8 Original Anemia and the Factors in Women of Reproductive Age: A Community-Based Study in West Papua, Indonesia Nova Sumihartini 1,2 , Chiho Yamazaki 1 , Sekar Ayu Paramita 1 , Eka Widrian Suradji 2 , Hiroshi Koyama 1 and Kei Hamazaki 1 1 Department of Public Health, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan 2 Teluk Bintuni Regional Public Hospital, KM. 7 Wesiri, Teluk Bintuni Regency, West Papua 98364, Indonesia Abstract Background & Aims: Anemia in women of reproductive age impairs health and well-being of generations. This study was undertaken to determine the prevalence, severity, and correlates of anemia in women of reproductive age at West Papua Province of Indonesia, also to discuss the burden of anemia in Papuan women. Methods: A community-based cross-sectional study was conducted on 221 women aged 15-49 years using structured questionnaires and body sample analysis. Results: An extremely high prevalence of 72.9％ anemia was found among women of reproductive age, asso- ciated with early-20s age, living area, low educational level, and Papua ethnic group. Conclusion: The ethnicity-particu- larly Papua with certain traditions and cultural beliefs related to lifestyle practices and sexual behaviors-might be a noteworthy risk factor of anemia, which needs to be considered for a future multifaceted approach to overcome the burden of anemia and improving the sexual and reproductive health and rights of women in Indonesia and worldwide. Introduction Anemia is a worldwide public health problem that impairs health and well-being of women. The World Health Organization (WHO) noted that half a billion women of reproductive age are affected by anemia. 1 Largely owing to population growth, the Anemia Collab- orators in the Global Burden of Diseases Study counted an increased number of cases worldwide, to a total of 1.93 billion people with anemia in 2013 compared with 1.83 billion in 1990, and developing countries account for more than 89％ of the burden. 2 Anemia increases the risk of maternal and neonatal adverse outcome. 3 The propensity score analysis showed that severe anemia was associated with maternal death (adjusted odds ratio＝1.86 [95％ confidence interval＝ 1.39-2.49]). 4 The global maternal mortality ratio (MMR) in 2015 was 216╱100,000 live births. 5 Indonesia was one of the highest ratio in South-East Asia with the number of estimation was 126╱100,000 live births in 2015, while MMR of the Southeast Asian region in the same year was 110╱100, 000 live births. 6,7 These conditions are aggravated by another fact, that the WHO 8 also indicated Indonesia as a country with moderate category of public health problem of anemia in pregnant women, non-preg- nant women of reproductive age, and children. Overall, Indonesiaʼ s prevalence of anemia among women of reproductive age in 2015 was 27.9％. 9 Indonesia, ethnically and culturally diverse, is facing a high ratio of maternal mortality with wide dis- parity and inequity among regions. Eastern Indone- sia-where Papua as its part-contributes the much higher rates than other regions. 10 Institutional maternal mortal- ity ratio of the Teluk Bintuni Regency, West Papua Prov- ince of Indonesia, was recorded an exceptionally high ratio of 448╱100,000 live births by 2015. 11 Since anemia Article Information Key words: anemia, women, reproductive health, ethnicity, Papua Publication history: Received: August 16, 2021 Revised: December 1, 2021 Accepted: December 9, 2021 Corresponding author: Kei Hamazaki Department of Public Health, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan Tel: ʴ81272208010 E-mail: kei.hamazaki@gunma-u.ac.jp