Structure:

Introduction: (up to 30 words) Mention the effects – Anaemia and why it is important to tackle this problem

Body: (up to 100 words) Reasons for prevailing conditions. Outline the some of the efforts already taken and then more measures that could be taken.

Conclusion: (up to 30 words) Conclude by saying that with concerted effort, effective implementation, increased awareness and perseverance, India can be made Anaemia free.

Supporting Points:

Anaemia is a condition in which a person has a lower-than-normal number of red blood cells or quantity of haemoglobin, which reduces the capacity of their blood to carry oxygen and can lead to a number of health problems, and even death. It is considered a severe public health problem if more than 40% of the population is diagnosed with anaemia. By that measure, anaemia in women and children has been a major problem in India for half a century.

Low haemoglobin levels lower productivity and cause illness and death, and thus impose an economic cost. The loss of gross domestic product to anaemia was estimated to be more than $20 billion, more than the health budget of India.

Anaemia prevalence:

Men with haemoglobin levels of less than 13.0 grams (g) per decilitre (dL) are considered anaemic, as per World Health Organization norms. Women with levels lower than 12.0 g/dL are considered anaemic if they are not pregnant. Among pregnant women, levels lower than 11.0 g/dL signal anaemia. By this measure around half of Indian women of reproductive age (15 to 49 years) are anaemic. Anaemia causes 20% of maternal deaths in India and was the associate cause in 50% of maternal deaths. Among men, 20% or one in five are anaemic, less alarming than the prevalence rate among women, but of no less concern.

Efforts so far:

1. Nutritional deficiency is by far the most common cause of anaemia worldwide. Nearly half the cases of nutritional deficiency-related anaemia in India are caused by consuming too little iron. Inadequate intake of the vitamins B9 (folate) and B12 is also a frequent cause.
2. The flagship initiative to combat anaemia that started in 1970, the National Anaemia Prophylaxis Programme, concentrated on distributing iron and folic acid tablets among two vulnerable population segments–pregnant women, and children aged 1 to 5 years.
3. In 1991, the flagship programme was renamed National Nutritional Anaemia Control Programme and made part of the National Child Survival and Safe Motherhood Programme, which attempts to cater to the overall needs of mothers and children pertaining to health and disease. Dosages of iron-folic acid supplements were also increased.
4. Iron-folic acid supplements are meant to be distributed under the National Nutritional Anaemia Control Programme and the Weekly Iron and Folic Acid Supplementation (WIFAS) programme, an initiative introduced in 2013 to reduce adolescent anaemia, estimated to affect more than half of all adolescent girls and just under one in three adolescent boys.

Why does anaemia persist?

1. Low political commitment is one of the top reason and the other is non-effective implementation of intervention programs.
2. Supplements failed to reach all the intended beneficiaries in adequate amounts, and not all beneficiaries who received the supplements actually ingested them.
3. Poor coverage, gaps in availability of the supplement and health workers’ inability to identify potential beneficiaries. The health functionaries were not properly oriented towards the programme, as many of them were not aware of all the beneficiaries under the programme.

Way forward:

1. To better target anaemia prevention and treatment, the governent is surveying children and adolescents to check for vitamin B12 deficiency and worm infestation. A parasitic infestation can cause malabsorption of essential nutrients, which, in turn, can cause anaemia, which is why de-worming tablets are also distributed under the existing iron and folic acid supplementation programmes.
2. To improve the coverage of the WIFAS programme for adolescents, the Government plans to use the Mid-Day Meal programme software that requires schools to update the number of beneficiaries every week.

• Efforts to improve supply to women have been on since the launch of the National Iron Plus programme in 2013, under which the government provides supplements to all women of reproductive age irrespective of their haemoglobin levels and pregnancy status, unlike earlier initiatives.

1. Emphasis on improved consumption; not all beneficiaries who receive these supplements consume them–often, they are unaware of the need to. At other times, they are put off by the side-effects such as nausea and dark stools.
2. Creating awareness is particularly vital because anaemia can go undetected until it becomes severe. High-profile awareness campaign, along the lines of the Pulse Polio programme which has the actor Amitabh Bachchan as its brand ambassador, could be deployed.
3. The need to change family food traditions is one more message to disseminate in mass anaemia-eradication awareness campaigns.