Context: 57% of women in their reproductive age in India have undiagnosed and untreated Anaemia. This increases the risk of pre-term birth, low birth weight, and life-threatening maternal complications which contribute to maternal and perinatal morbidity and mortality.
Relevance of the Topic:Prelims: Key facts about Anaemia.
About Anaemia
- Anaemia is a condition in which the number of red blood cells (RBCs), and consequently their oxygen-carrying capacity, is insufficient to meet the body’s physiological needs.
- Anaemia impairs the body’s ability for gas exchange by decreasing the number of RBCs transporting oxygen and carbon dioxide.
- The function of the RBCs is to deliver oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs.
- This is accomplished by using haemoglobin (Hb), a protein composed of haem and globin.
- Symptoms: Fatigue, weakness, dizziness and shortness of breath etc.
- Treatment: Anaemia is preventable and treatable. Treatments include folic acid supplements, iron chelation, and blood transfusions and bone marrow transplants (in advanced cases).
Factors causing Anaemia
Anaemia results from one or more of the following process:
- Iron deficiency is the most common cause of anaemia globally (around 50% cases).
- Iron is necessary for synthesis of haemoglobin (Hb).
- Other nutritional deficiencies (including folate, vitamin B12 and vitamin A)
- Defective red cell production, increased red cell destruction or blood loss.
- Inherited or acquired disorders that affect Hb synthesis, red blood cell production or red blood cell survival can all cause anaemia.
- Acute and chronic inflammation, helminths infestation (hookworm, flukes), parasitic infections (like Malaria).
Impacts
- Iron deficiency anaemia results in impaired cognitive and motor development in children and decreased work capacity in adults.
- In pregnancy iron deficiency anaemia can lead to perinatal loss (miscarriage, still birth), prematurity and low birth weight babies.
- Iron deficiency anaemia adversely affects the body’s immune response.
Burden of Anaemia in India
- India’s anaemia burden has grown alarmingly with NFHS-5 (2019-21) finding that:
- 57% of women in the age group (15-49)
- 67% of children between 6-59 months
- 59% in adolescent girls (15-19 yrs)
- 31% in adolescent boys (15-19 yrs)
- This is a rise from the data in NFHS-4 (2015-16).
Government Initiatives to tackle Anaemia burden
1. Anaemia Mukt Bharat strategy (2018):
6X6X6 strategy to reduce prevalence of anaemia in children, adolescents, and women.
- Reduce Anaemia among six beneficiary age groups:
- children 6-59 months
- children 5-9 years
- adolescents 10-19 years
- women of reproductive age (15-49 years)
- pregnant women
- lactating women
- Implementation of six interventions:
- Prophylactic Iron Folic Acid Supplementation
- Periodic deworming (Albendazole tablet)
- Intensified year-round Behaviour Change Communication Campaign
- Testing of anemia using digital invasive haemoglobinometer
- Point of care treatment
- Mandatory provision of Iron Folic Acid fortified foods in public health programmes
- Addressing non-nutritional causes of anemia in endemic pockets, via six institutional mechanisms.
2. Mission Poshan 2.0:
- Supplementary nutrition is provided to children (6 months to 6 years), pregnant women, lactating mothers and Adolescent Girls (14 to 18 years in Aspirational districts and North-East States).
- Poshan Maahs and Poshan Pakhwadas: Celebrated in September and March-April, dedicated activities for awareness on anaemia are conducted.
3. Rice Fortification Initiative:
- Government is supplying fortified rice enriched with iron, folic acid and vitamin B12 under the Targeted Public Distribution System (TPDS), Pradhan Mantri Poshan Shakti Nirman (PM-POSHAN) Scheme, Integrated Child Development Services (ICDS) Scheme in all States and Union Territories.
4. Diet and Biomarkers Survey in India (DABS-I) survey (2022):
- New survey launched to map diet, nutrition and health status pan India. It will collect individual dietary intake data of different age groups for correct estimates of anaemia among urban and rural populations.
5. AnemiaPhone:
- It is a latest technology to accurately, quickly, and cheaply assess iron deficiency, recently transferred to the Indian Council of Medical Research.
- It requires a small finger prick, a drop of blood is placed on a test strip, and the device can determine iron deficiency in a few minutes. It would enable access to rapid screening, and diagnosis of iron deficiency at the point of need.