Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the World Health Organization.

Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations

World Health Organization

Publication Date: Mar 5, 2024

Page Last Updated: May 5, 2026

Document Overview

Document Title: Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations

Authoring Society: World Health Organization

Document Publication Date: Mar 5, 2024

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: Global

Full Text Freely Available: Yes

Full Text Guideline: www.who.int/publications/i/item/9789240088542

Source Citation: Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO.

Document Scope, Criteria, and Use Cases

Document Objectives: This guideline aims to help Member States and their partners in their efforts to make informed decisions on the appropriate tools to support assessing and reducing the global burden of anaemia as an important public health priority.

Scope: Assessment and Screening, Diagnosis, Management

Diseases/Conditions (MeSH)

D000740 - Anemia

D006454 - Hemoglobins

D000740 - Anemia

D006454 - Hemoglobins

Keywords: Haemoglobin, Hemoglobin, anemia

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Infant, Older Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 102

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Population	Haemoglobin concentration (g/L)*
Children, 6–23 months	<105
Children, 24–59 months	<110
Children, 5–11 years	<115
Children, 12–14 years, nonpregnant girls	<120
Children, 12–14 years, boys	<120
Adults, 15–65 years, nonpregnant women	<120
Adults, 15–65 years, men	<130
Pregnancy - 1st trimester	<110
Pregnancy - 2nd trimester	<105
Pregnancy - 3rd trimester	<110

Population	No anaemia	Mild anaemia	Moderate anaemia	Severe anaemia
Children, 6–23 months	≥105	95–104	70–94	<70
Children, 24–59 months	≥110	100–109	70–99	<70
Children, 5–11 years	≥115	110–114	80–109	<80
Children, 12–14 years, nonpregnant girls	≥120	110–119	80–109	<80
Children, 12–14 years, boys	≥120	110–119	80–109	<80
Adults, 15–65 years, nonpregnant women	≥120	110–119	80–109	<80
Adults, 15–65 years, men	≥130	110–129	80–109	<80
Pregnancy - 1st trimester	≥110	100–109	80–109	<70
Pregnancy - 2nd trimester	≥105	95–104	70–99	<70
Pregnancy - 3rd trimester	≥110	100–109	70–99	<70

Elevation range (metres above sea level)	Adjustments in haemoglobin concentration (g/L)
1–499	0
500–999	4
1000–1499	8
1500–1999	11
2000–2499	14
2500–2999	18
3000–3499	21
3500–3999	25
4000–4499	29
4500–4999	33

Cigarettes per day	Haemoglobin adjustment (g/L)
Smoker, quantity unknown	3
<10	3
10–19	5
>20	6

Category of public health significance	Prevalence of anaemia (%)
Severe	40 or higher
Moderate	20.0–39.9
Mild	5.0–19.9
Normal	4.9 or lower

Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations

Summary of Recommendations

Haemoglobin cutoffs to define anaemia in individuals and populations

Haemoglobin cutoffs to define anaemia severity in individuals

Adjustments to haemoglobin concentration (g/L) in 500 m increments in elevation

Adjustments to haemoglobin for smoking status and cigarettes per day

Classification of public health significance of anaemia in populations based on prevalence estimated from blood levels of haemoglobin

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology