India faces a tough battle ahead in protecting its female population from anaemia

At the recent International Conference on Maternal & Child Health and Nutrition, countries like India, Nepal, Bangladesh, Malaysia, the USA, and the Netherlands witness the power of collective determination united by a shared vision – to combat anemia and malnutrition that continue to cast a shadow over the lives of countless mothers and children all across the world.

Situation in India:

• Stunting- While there was some reduction in stunting rates (35.5% from 38.4% in NFHS­4) 13 States or Union Territories have seen an increase in stunted children since National Family Health Survey (NFHS­4).
• This includes Gujarat, Maharashtra, West Bengal and Kerala.
• Malnutrition- Malnutrition trends across NFHS surveys show that wasting, the most visible and life threatening form of malnutrition has either risen or has remained stagnant over the years.
• Anaemia-India also has the highest prevalence of anaemia in the world. The NFHS­5 survey indicates that more than 57% of women (15­49 years) and over 67% children (six­59 months) suffer from anaemia.

About Anaemia

• Anemia is defined as a low number of red blood cells. In a routine blood test, anemia is reported as a low hemoglobin or hematocrit.
• Hemoglobin is the main protein in your red blood cells. It carries oxygen, and delivers it throughout your body.

• Symptoms of anemia: Fatigue or shortness of breath.

Why anaemia is a concern?

• Anaemia affect all age groups which causes 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 anaemia and 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.

Reasons for high Anaemia numbers in India:

• 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.

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.

Other Initiatives:

• Surakshit Matritva Aashwasan (SUMAN) provides assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting public health facilities to end all preventable maternal and newborn deaths.
• Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme for promoting institutional delivery.
• Under Janani Shishu Suraksha Karyakram (JSSK), every pregnant woman is entitled to free delivery, including caesarean section, in public health institutions along with the provision of free transport, diagnostics, medicines, other consumables & diet.
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality antenatal check up by a Specialist/Medical Officer on the 9th day of every month.
• LaQshya improves the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful and quality care during delivery and immediate post-partum.
• Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the ICDS.
• Delivery Points- Over 25,000 ‘Delivery Points’ across the country have been strengthened in terms of infrastructure, equipment, and trained manpower for provision of comprehensive RMNCAH+N services.
• MCP Card and Safe Motherhood Booklet are distributed to the pregnant women for educating them on diet, rest, danger signs of pregnancy, benefit schemes and institutional deliveries.
• Reproductive and child health (RCH) portal is a name-based web-enabled tracking system for pregnant women and new born so as to ensure seamless provision of regular and complete services to them including antenatal care, institutional delivery and post-natal care.

Suggestive measures:

• There’s a critical need for the government to create stronger partnerships with non-profits, especially the ones working ground not just for broader iron-folic acid supplementation programmes but also compliance, targeting all wealth quartiles and more effective social and behavior change campaigns that drive positive action.
• To address the issue, we need to allocate sufficient resources to programs like the Integrated Child Development Scheme, mid-day meals, and public distribution schemes, with a focus on pregnant women and the first 1000 days of a child's life.
• Promoting healthy eating habits requires considering cultural, social, and economic factors, and we should also combat the impact of advertising unhealthy foods while investing in nutrition-focused interventions and strengthening healthcare resources.
• Iron fortification can be used: 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.

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.