Why in news?

 According to the National Family Health Survey-5 (NFHS 2020-21), 65.5 per cent of children aged 6-59 months in Karnataka are anaemic.

Highlights:

What is Anaemia?

• Anaemia is a condition in which the blood doesn’t have enough healthy red blood cells.
• It results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body’s organs.

What is the main cause of anaemia?

• People may be born with certain types of anaemia or develop anaemia because they have certain chronic diseases.
• Poor diet causes iron-deficiency anaemia, which is the most common form of anaemia

What are the types of Anaemia?

• Iron deficiency anaemia: Iron deficiency anaemia involves the body producing too few RBCs due to a lack of iron in the body.
• Vitamin B12 deficiency anaemia(Cobalamin) : If a person does not consume or absorb enough B12, their RBC count may be low.
• Aplastic anaemia: This rare blood condition happens when the bone marrow cannot produce enough new RBCs.
• Hemolytic anemia: This type of anemia happens when RBCs are destroyed faster than the body can produce new ones

Anaemia results in:  

• Anaemia among women can result in maternal mortality, weakness, diminished physical and mental capacity, increased morbidity from infectious diseases, perinatal mortality, premature delivery, low birth weight and in children it can cause impaired cognitive performance, motor development and scholastic achievement,

The  treatment:

• Iron-deficiency anemia: Iron supplements and dietary changes can help this regard.
• Vitamin deficiency anemia: Treatments can include dietary supplements and vitamin B12 injections.
• Thalassemia: Treatments include Trusted Source folic acid supplements, iron chelation, and, for some people, blood transfusions and bone marrow transplants.
• Anemia due to chronic disease: The doctor will focus on managing the underlying condition.
• Aplastic anemia: Treatment for aplastic anemia involves blood transfusions or bone marrow transplants involves blood transfusions or bone marrow transplants.
• Sickle cell anemia: It is treated with oxygen therapy, pain relief medication, and intravenous fluids. They may also prescribe antibiotics, folic acid supplements and  blood transfusions.

Important Data and facts regarding anaemia 

According to the National Family Health Survey-5 (NFHS 2020-21),

• 5 per cent of children aged 6-59 months in Karnataka are anaemic.
• In the 15-49 year age group, around 48 per cent women are anaemic compared to 19 per cent men.
• Adolescent girls (in the 15-19 age group) are also severely affected 49 per cent, compared to 26.5 per cent of adolescent boys with anaemia. Globally, iron deficiency is estimated to be responsible for half of all anaemia cases
• Across all categories, the numbers in NFHS-5 had increased by 1-5 per cent compared to the NFHS-4 survey of 2015-16.

Situation in Karnataka : Girls more affected than boys

• The comprehensive national nutrition survey of 2016-18 reports found out that

1. those aged 1-5 years were the most affected by anaemia in Karnataka – around 35 per cent, compared to around 40 per cent at the national level.
2. Of them, a majority (around 40 per cent) had iron deficiency anaemia.
3. Across children of all age groups in Karnataka, girls had worse deficiency compared to boys.
4. The survey found that among children aged 1-9 years, anaemia was more prevalent among those with no diet diversity and those not consuming green, leafy vegetables, eggs and animal source foods.
5. It was also more prevalent among poor, rural households and SC/ST groups.

What are reason for high anaemia prevalence ?

• Most common causes : Nutritional deficiencies, particularly iron deficiency, though deficiencies in folate, vitamins B12 and A
• Prevalence of Disesase : Haemoglobinopathies and infectious diseases, such as malaria, tuberculosis, HIV and parasitic infections also one of the root cause of anaemia.
• The lack of proper food security and iron-fortified foods creates a widespread issue of iron deficiency.
• Supplementing nutrition means that the main nutrition source is inadequate, so one needs to assess the dietary habit
• Geographical barriers: The tribal population is vulnerable population, in terms of social development, isolating dwelling places in difficult terrain, rigid customs and beliefs, illiteracy, and separation from non-tribal population exposes them to many health and social issues.
• Nutritional anaemia is the biggest cause of postpartum haemorrhage (excessive bleeding occurring within 24 hours of delivery of a baby) and postpartum haemorrhage is the biggest cause of maternal deaths.
• Cultural factors : women eating last in the household and hence, getting lesser nutrients,should also be recognised.

What are the government intervention to prevent anaemia?

• Anaemia Mukt Bharat (AMB) strategy : Was launched under National Health Mission in 2018 with the target to reduce anaemia prevalence among women and children by 3 per cent annually . It included

1. Prophylactic Iron and Folic Acid Supplementation including Adolescents girls (10-19 years)
2. Intensified year-round Behaviour   Change  Communication (BCC)

• Campaign includes ensuring

1. Testing of anaemia using digital methods and point of care treatment
2. Addressing non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
3. Management of severe anaemia in pregnant women undertaken by administration of IV Iron Sucrose/Blood transfusion
4. Providing incentives to the ANM for identification and follow-up of pregnant women with severe anaemia in high priority districts (HPDs)
5. Training and orientation of Medical Officers and front line-workers on newer Maternal Health and Anaemia Mukt Bharat guidelines
6. Field level awareness by ASHAs through community mobilization activities and IEC and BCC activities focused on anaemia in pregnant women

Way forward

• There is a need for holistic approach but not to follow a single iron deficiency approach and look at nutrition, infection, sanitation, education, hygiene and poverty

• Nutritional counsellors are needed at the Anganwadi level, that understand local dietary habits , nutrition gaps and cheap diet and local alternatives like gourds and drumsticks are available to bridge the gap.