Context:
India is reconsidering its anaemia policy and shifting the estimation of anaemia prevalence from the National Family Health Survey (NFHS) to the Diet and Biomarkers Survey (DABS-I).
Relevance:
GS II: Health
Dimensions of the Article:
- About Anaemia
- How to tackle anaemia?
- Government initiatives related to addressing anaemia in India
About Anaemia:
- Anaemia is a condition characterized by a deficiency in the number of red blood cells or their oxygen-carrying capacity.
- The most common cause of anaemia is iron deficiency, but it can also be caused by deficiencies in folate, vitamin B12, and vitamin A, chronic inflammation, parasitic infections, and inherited disorders.
Symptoms:
- Severe anaemia can lead to symptoms such as fatigue, weakness, dizziness, and drowsiness. Pregnant women and children are particularly vulnerable to the effects of anaemia.
Anaemia Burden in India:
- According to the NFHS-5 (2019-21) survey, there has been a significant increase in the prevalence of anaemia in India.
- It reported that 57% of women (aged 15-49) and 67% of children (aged 6-59 months) in India are anaemic.
Challenges in Diagnosis:
- Over-diagnosis of anaemia in India has been cautioned against, as the World Health Organization (WHO) cut-offs for haemoglobin may not be suitable for the population.
- The cut-off points for haemoglobin depend on various factors such as age, gender, physiological status, and altitude.
- Differences in blood sampling methods used in surveys like NFHS and recommended venous blood sampling can also lead to inaccuracies in values.
Diet and Biomarkers Survey (DABS-I):
- DABS-I is a comprehensive national-level dietary survey conducted to determine food and nutrient adequacy across different age groups and regions in India.
- It collects individual dietary intake data and provides nutrient composition information on cooked and uncooked foods.
- DABS-I is expected to improve estimates of anaemia prevalence and support the development of targeted interventions.
Importance of Anaemia Data:
- Anaemia data is a crucial indicator of public health, especially for vulnerable populations like pregnant women and children under five.
- Prevalence studies on anaemia help monitor progress in reproductive health, understand the impact on work capacity, and contribute to national development efforts.
- These key points highlight the prevalence, causes, challenges, and efforts to address anaemia in India.
How to tackle anaemia?
Tackling anaemia involves a comprehensive approach that addresses the underlying causes and promotes preventive measures. Here are some strategies to tackle anaemia:
Nutritional Intervention:
- Promote a balanced and diverse diet rich in iron, folate, vitamin B12, and other essential nutrients.
- Encourage consumption of iron-rich foods such as leafy green vegetables, legumes, nuts, seeds, meat, poultry, and fortified cereals.
- Advocate for nutrition education and awareness programs to improve dietary practices.
Iron Supplementation:
- Provide iron supplements, particularly to high-risk groups such as pregnant women, children, and adolescents.
- Promote adherence to iron supplementation guidelines and ensure availability and accessibility of iron supplements.
Food Fortification:
- Implement fortification programs to enhance the iron and other micronutrient content of commonly consumed foods such as flour, rice, salt, and cooking oils.
- Monitor and enforce food fortification standards to ensure the quality and effectiveness of fortified products.
Deworming Programs:
- Conduct regular deworming programs to control parasitic infections, which can contribute to anaemia.
- Provide anthelmintic medication, such as Albendazole, to at-risk populations, especially children and pregnant women.
Health Education and Awareness:
- Raise awareness about anaemia, its causes, symptoms, and preventive measures through community-based programs, schools, healthcare facilities, and media campaigns.
- Educate individuals and communities about the importance of proper nutrition, hygiene, and seeking timely healthcare.
Antenatal Care and Maternal Health:
- Ensure universal screening of pregnant women for anaemia and provide iron and folic acid supplements during pregnancy.
- Enhance antenatal care services to include regular monitoring of haemoglobin levels and early detection and management of anaemia.
Healthcare System Strengthening:
- Improve access to quality healthcare services, including regular health check-ups, diagnostic facilities, and treatment for anaemia.
- Train healthcare professionals to effectively diagnose and manage anaemia and provide appropriate counseling and support to patients.
Monitoring and Evaluation:
- Establish robust systems for monitoring anaemia prevalence, nutritional status, and program effectiveness.
- Regularly assess the impact of interventions and adjust strategies based on the findings.
Government initiatives related to addressing anaemia in India:
Anaemia Mukt Bharat (AMB):
- Launched in 2018 as part of the Intensified National Iron Plus Initiative (NIPI) Program, AMB aims to accelerate the decline of anaemia prevalence by one to three percentage points annually.
- The target groups for AMB include children aged 6-59 months, 5-9 years, adolescent girls and boys aged 10-19 years, women of reproductive age (15-49 years), pregnant women, and lactating mothers.
Weekly Iron and Folic Acid Supplementation (WIFS):
- Implemented to tackle high anaemia prevalence among adolescent girls and boys, WIFS involves supervised weekly ingestion of Iron Folic Acid (IFA) tablets.
Operationalization of Blood Bank:
- Blood banks have been set up in district hospitals and blood storage units in sub-district facilities such as sub-divisional hospitals and community health centers.
- This initiative aims to address complications arising from severe anaemia.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA):
PMSMA focuses on conducting special antenatal care (ANC) check-ups on the 9th of every month, led by medical officers and obstetricians, to detect and treat cases of anaemia among pregnant women.
Deworming Program:
- Biannual deworming with Albendazole is provided to control worm infestation, which can contribute to anaemia.
Health Management Information System and Mother Child Tracking System:
- These systems are implemented for reporting and tracking cases of anaemia, particularly among pregnant women.
Universal Screening and Provision of Iron and Folic Acid:
- Pregnant women are universally screened for anaemia as part of antenatal care, and iron and folic acid tablets are provided to them during their visits to sub-centers, primary health centers, and other health facilities.
- Outreach activities are also conducted through Village Health & Nutrition Days (VHNDs).
-Source: The Hindu
