The latest National Family Health Survey (NFHS) data reasserts anaemia as a major concern in India – especially among its women and children.
According to the fifth set of NFHS data, India’s prevalence of the disease is the highest in the world. The Union Ministry of Health and Family Welfare posits a rate of 39.86 percent. In thirteen out of 22 states and union territories, more than half of women and children are affected by anaemia. Women in the age demographic of fifteen to 49 years are considered to be especially vulnerable to anaemia. In 2017, research indicated that 51 percent of women in this bracket are affected by the condition.
Anaemia is a serious medical condition, making its high prevalence in India a disturbing phenomenon. As outlined by my colleague Nicholas Parry in a disease profile for Health Issues India, “iron-deficiency anaemia places an increased strain on the heart, placing a great deal of stress on the organ and resulting in reduced cardiac function. Heart disease is the most common cause of death in India.
“Anaemia, due to its high prevalence, may be playing a role in this. Anaemia can cause cardiac stress through issues such as tachycardia and increased stroke volume. It can also cause reduced renal blood flow and fluid retention, adding further stress to the heart.”
In response to this severe public health problem, the Union Government has launched Anemia Mukt Bharat (AMB) in tandem with UNICEF. It aims to effect a reduction in the prevalence of anaemia in India by promoting a 6x6x6 strategy incorporating targeted interventions and fortifying the existing institutional mechanisms. With such strategies, including the provision of iron and folic acid supplementation, testing, deworming, communication campaigns and addressing causes of anaemia unrelated to nutrition, the strategy seeks to bring down the prevalence of anaemia by three percent yearly between 2018 and 2022.
Testing is of particular importance. “First, screening, prevention and then treatment,” said Dr J. L. Meena, joint director within the National Health Authority (NHA). “Screening should be qualitative because it ensures the actual status. For this, the role of point of care…is very important. Screening for anaemia needs serious consideration as per protocols in the public and private sector. Quality control is also very important in this direction.”
Meanwhile, there is some success in the Government’s efforts to tackle anaemia. “Although NFHS-5 data show [that] anaemia continues to be a major concern among women, children…[the AMB campaign, with an ambitious target of reducing anaemia by three percentage points per annum till 2022, are not really captured in the NFHS-5 data because they really got going only recently,” argues Dr Kapil Yadav, additional professor and nodal person at the National Centre of Excellence and Advanced Research on Anemia Control at the All India Institute of Medical Sciences’s Centre for Community Medicine.
“And we have made remarkable progress in 2.5 years as there has been a paradigm shift in anaemia point of care diagnostic tests,” he added. “Digital haemoglobin meters have lots of scopes and are widely used for testing with increased demand. Three things – point of care [diagnostics], food fortification, and the parenteral (non-oral means of administration) iron for moderate to severe anaemia are the key to achieve AMB targets.”