What is Anemia?
Anemia is a global public health problem that has not shown any significant improvement over the last decade.
Anemia is a condition in which the number and size of red blood cells, or the haemoglobin concentration, falls below an established cut-off value, consequently impairing the capacity of the blood to transport oxygen around the body. Anemia is an indicator of both poor nutrition and poor health.
Anemia and iron deficiency reduce individuals’ well-being, cause fatigue and lethargy, and impair physical capacity and work performance. Failure to reduce anemia worldwide consigns millions of women to impaired health and quality of life, generations of children to impaired development and learning, and communities and nations to impaired economic productivity and development. Maternal anemia is associated with mortality and morbidity in the mother and baby, including risk of miscarriages, stillbirths, prematurity and low birth weight.
Burden of anemia in Jharkhand
According to WHO, if the prevalence of anemia in a population is 40 per cent or higher it is categorized as a severe public health problem.
In Jharkhand, 70 per cent of children 6-59 months, 62.6 per cent of pregnant women and 65.2 per cent of women in the reproductive age are anemic. According to NFHS 4 report, anemia is more prevalent in rural areas of Jharkhand and among tribal women and women with no schooling.
Dr Madhulika Jonathan, Chief of UNICEF Jharkhand says, “Iron deficiency is the most common cause of anemia globally. But it is also caused by malaria, hookworm, nutritional deficiencies and chronic infections. Improved dietary habits can prevent anemia to a large extent, however NFHS 4 found that in Jharkhand only 16 percent of children (9-23 months) ate iron-rich foods before the survey and 17 percent of children age 6-59 months were given iron supplements in the week before the survey.”
Anemia Mukt Bharat
In 2012, all the member states of the World Health Assembly including India endorsed the six global nutrition targets to be achieved by 2025. The second global nutrition target calls for a 50 per cent reduction in anemia among women of reproductive age.
Last year, 8 March 2018, Prime Minister Narendra Modi launched the POSHAN Abhiyan with an aim to reduce stunting and anemia by 2 per cent and 3 per cent annually. This isa reflection of India’s strong commitment towards improving the nutritional status of children and women.
The Ministry of Health & Family Welfare (MoHFW), Government of India has launched the “Anemia Mukt Bharat” programme to address anemia across the life cycle. It will follow a 6x6x6 strategy which focus on six target beneficiary groups, through six interventions and six institutional mechanisms in order to achieve the envisaged target under the POSHAN Abhiyan.
The six beneficiaries covered under the Anemia Mukh Bharat programme are children (6-59 months), children (5-10 years), adolescent boys & girls (15-19 years), women of reproductive age, pregnant women and lactating women.
The Anemia Mukt Bharat strategy will focus on the following six interventions
1. Prophylactic Iron Folic Acid supplementation for children, adolescents, women of reproductive age, pregnant women and lactating women
2. Deworming: To intensify efforts towards Soil Transmitted Helminths (STH) control
3. Intensified year-round Behaviour Change Communication (BCC) campaign including ensuring delayed cord clamping in newborns. Delayed clamping of the umbilical cord for 3 minutes (or until cord pulsations cease) for newborns across improves the infant’s iron reserves up to 6 months after birth.
4. Testing and treatment of anemia, with focus on pregnant women and school-going adolescents
5. Mandatory provision of iron and folic acid fortified foods in government-funded health programmes
6. Intensifying awareness, screening and treatment of non-nutritional causes of anemia in endemic pockets, with special focus on malaria
The Government has identified and established institutional mechanism at the national and state level to ensure accountability and effective implementation of the Anemia Mukt
Bharat strategy. These six institutional mechanisms are
1. Intra-ministerial coordination: The existing national steering committee platform of the Rastriya Kishore Swasthya Karyakram(RKSK) will be used to strengthen inter departmental convergence within MoHFW.
2. Inter-departmental convergence: The Anemia Mukt Bharat has given an opportunity to various department such as MoHFW, Women & Child Development, School education and Tribal Welfare to work convergently to achieve the reduction in anemia prevalence by 2022.
3. National Anemia Mukt Bharat Unit at MoHF will monitor and anchor programme implementation across India.
4. National Centre of Excellence for Anemia at AIIMS Delhi will provide technical inputs to MoHFW & different state to address research needs and support supply chain monitoring.
5. Strengthening supply chain management for uninterrupted supplies and ensuring programme stability
6. Online dashboard and digital portal to strengthen monitoring and review mechanism.
The Government must ensure optimal programme coverage, continuity, intensity and quality (C2IQ) for achieving the desired result. Ensuring evidence based equitable approach and prioritizing the most vulnerable groups under this intensified programme would help reaching the goal faster.