Background Childhood Anemia affects an estimated 40% of children aged 6-59 months globally and arises from heterogeneous nutritional, infectious, and socioeconomic factors that vary substantially across settings. This variability challenges the generalizability of predictive machine learning models, which often degrade under cross-population or temporal shifts. We investigated the utility a modern transformer-based tabular foundation model (TabPFN) as a complementatry framework with respect to supervised classical machine learning methods across diverse country contexts, with particular attention to data-scarce settings where surveillance capacity is most limited. Methods We conducted a multi-country prediction study using Demographic and Health Surveys (DHS) children's recode data from 16 countries spanning Africa, Asia, Latin America, the Caucasus, and the Middle East. The harmonized analytic cohort comprised of (n = 68,856)children aged 6-59 months with valid hemoglobin measurements. Anemia was defined using WHO age and altitude-adjusted thresholds and treated as a binary outcome. We trained Logistic Regression, XGBoost, and LightGBM models using standard supervised learning, and evaluated TabPFN v2.6 in an in-context learning setting. Performance was assessed using Area Under the Receiver Operating Characteristic Curve (AUC-ROC) and other standard classification metrics, with calibration evaluated via Brier score and expected calibration error (ECE). Uncertainty in performance estimates was quantified using bootstrap resampling to derive 95% confidence intervals. Robustness was assessed in a few-shot learning setting. Cross-population generalization was examined using leave-one-country-out (LOCO) validation and reverse-LOCO experiments to assess directional transferability. Subgroup analyses were conducted across five demographic strata: child age group, sex, maternal education, residence type, and household wealth quintile. Feature importance was assessed using standard linear and tree-based explainer SHAP values for the three supervised models and an adapted version of SHAP for TabPFN, aggregated across countries and examined at the country level. TabPFN also yielded the best probabilistic calibration across all 16 countries, achieving the lowest mean Brier score (0.203) and Expected Calibration Error (ECE = 0.042) of all models evaluated; LightGBM and Logistic Regression exhibited the greatest miscalibration, particularly at higher predicted probabilities. Under full-data conditions, within-country discrimination was moderate across all models (AUC-ROC 0.59-0.76) Under LOCO validation, performance declined modestly (AUC-ROC 0.58-0.69) Reverse-LOCO analyses revealed asymmetric and directional transferability, with epidemiologically diverse populations serving as more informative training sources and certain target populations remaining persistently difficult to predict regardless of model or training data.