Context

• The recent National Family Health Survey (NFHS-5) data shows anaemia rates increased from 53 per cent to 57 per cent in women and 58 per cent to 67 per cent in children in 2019-21.

Definition of anaemia

• The WHO defines anaemia as a condition where the number of red blood cells or the haemoglobin concentration within them is lower than normal. This compromises immunity and impedes cognitive development.

Why anaemia is a concern?

• Adverse effects of anaemia affect all age groups lower physical and cognitive growth and alertness among children and adolescents, and lesser capacity to learn and play, directly impacting their future potential as productive citizens.
• Anaemia among adolescent girls (59.1 per cent) advances to maternal anaemiaand is a major cause of maternal and infant mortality and general morbidity and ill health in a community.

What causes anaemia?

• Imbalanced diet: Cereal-centric diets, with relatively less consumption of iron-rich food groups like meat, fish, eggs, and dark green leafy vegetables (DGLF), can be associated with higher levels of anaemia.
• Underlying factors: High levels of anaemia are also often associated with underlying factors like poor water quality and sanitation conditions that can adversely impact iron absorption in the body.
• Iron deficiency is major cause: A diet that does not contain enough iron, folic acid, or vitamin B12 is a common cause of anaemia.
• Some other conditions: That may lead to anaemia include pregnancy, heavy periods, blood disorders or cancer, inherited disorders, and infectious diseases.

Why is anaemia so high in the country?

• Low vitamin intake: Iron-deficiency and vitamin B12-deficiency anaemia are the two common types of anaemia in India.
• High population and nutrition deprivation: Among women, iron deficiency prevalence is higher than men due to menstrual iron losses and the high iron demands of a growing foetus during pregnancies.
• Overemphasis on cereals: Lack of millets in the diet due to overdependence on rice and wheat, insufficient consumption of green and leafy vegetables could be the reasons behind the high prevalence of anaemia in India.

What is Iron fortification?

• Iron fortification of food is a methodology utilized worldwide to address iron deficiency. Iron fortification programs usually involve mandatory, centralized mass fortification of staple foods, such as wheat flour.

Why need iron fortification?

• Iron deficiency anaemia is due to insufficient iron.
• Without enough iron, the body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (haemoglobin).
• Severe anaemia during pregnancy increases risk of premature birth, having a low birth weight baby and postpartum depression. Some studies also show an increased risk of infant death immediately before or after birth.

Success story / value addition

• Nepal’s success story to improve maternal anaemia by national action plan .

Anaemia Mukt Bharat

• The scheme aims to reduce the prevalence of anaemia in India.
• It provides bi weekly iron Folic acid supplementation to all under five children through Asha workers.
• Also, it provides biannual Deworming for children and adolescents. The scheme also establishes institutional mechanisms for advanced research in anaemia.
• It also focuses on non-nutritional causes of anaemia.

We need to focus on the following interventions

• Prophylactic Iron and Folic Acid supplementation.
• Intensified year-round Behaviour Change Communication Campaign (Solid Body, Smart Mind).
• Appropriate infant and young child feeding practices.
• Increase in intake of iron-rich food through diet diversity/quantity/frequency and/or fortified foods with focus on harnessing locally available resources.
• Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
• Mandatory provision of Iron and Folic Acid fortified foods in government-funded public health programmes

Way forward

• India’s nutrition programmes must undergo a periodic review.
• The Integrated Child Development Services (ICDS), which is perceived as the guardian of the nation’s nutritional well-being must reassess itself and address critical intervention gaps, both conceptually and programmatically, and produce rapid outcomes.
• The nutritional deficit which ought to be considered an indicator of great concern is generally ignored by policymakers and experts. Unless this is addressed, rapid improvement in nutritional indicators cannot happen.

Conclusion

• When a person is anaemic, the capacity of his blood cells to carry oxygen decreases. This reduces the productivity of the person which in turn affects the economy of the country. Therefore, it is highly important to cover Anaemia under National Health Mission.

Mains question

Q. “Every second adolescent girl has anaemia. Every second woman of reproductive age is anaemic”. In this context do you think Women’s empowerment will not have any meaning without tackling anaemia? Discuss.

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