Corporate social responsibility inequality and persistent anemia burden: insights from KBK region of Odisha, India

Background: Anemia remains a major public health concern in India, with NFHS-4 and NFHS-5 documenting increasing prevalence among women and children. Despite growing corporate social responsibility (CSR) investment, regional inequities persist, particularly in Odisha’s vulnerable KBK region. This study examines anemia trends across India, selected states, and KBK districts and assesses their alignment with CSR spending on health and nutrition. Methods: A secondary-data analysis used NFHS-4 and NFHS-5 factsheets, official government datasets and portals, and CSR disclosures. Descriptive, comparative, and trend analyses assessed anemia prevalence and the distribution of corporate investment in health, nutrition, water, and sanitation. Results: Anemia among pregnant women increased nationally, while KBK districts consistently exceeded state and national averages. Odisha’s CSR expenditure on health, hunger and malnutrition, drinking water, and sanitation rose from ₹130.58 crore in 2019 to ₹416.27 crore in 2024; however, anemia among women of reproductive age increased by 13.3% between NFHS-4 and NFHS-5. Improvements in health- and water-related SDGs contrasted with weaker poverty outcomes, suggesting that higher expenditure alone has not resolved underlying nutritional and socio-economic barriers. Conclusions: Anemia reduction in the KBK region requires better-targeted CSR investment aligned with local governance and public programmes. Priorities include stronger ICDS implementation, community-based nutrition education, reliable iron and folic acid supplementation, and improved healthcare access in vulnerable areas.