Context
Anemia remains one of India’s most persistent public health challenges, disproportionately affecting women, children, and adolescents. Despite decades of interventions, the prevalence remains alarmingly high, demanding a multifaceted approach that encompasses nutrition, prevention, and protection.
Understanding Anemia: The Indian Context
- Definition and Causes: Anemia is characterized by a deficiency of hemoglobin in the blood, reducing its oxygen-carrying capacity. The most common cause in India is iron deficiency, but deficiencies in folate, vitamin B12, and vitamin A, as well as non-nutritional causes like malaria, hemoglobinopathies, and fluorosis, also contribute significantly.
- Prevalence and Impact: According to the National Family Health Survey-5 (NFHS-5), 67.1% of children and 59.1% of adolescent girls in India are anemic. The condition leads to fatigue, impaired cognitive and physical development in children, increased maternal and perinatal mortality, and reduced work productivity in adults.
National Initiatives: Nourish, Prevent, Protect
Anemia Mukt Bharat (AMB): The Flagship Program
Launched in 2018, Anemia Mukt Bharat (AMB) aims to accelerate the annual decline of anemia prevalence using a comprehensive 6x6x6 strategy:
- 6 Target Groups: Children (6-59 months), children (5-9 years), adolescent girls and boys (10-19 years), women of reproductive age (15-49 years), pregnant women, and lactating mothers.
- 6 Interventions:
- Iron and Folic Acid (IFA) supplementation: Age-appropriate IFA supplements for all groups.
- Deworming: Biannual deworming for children and adolescents; antenatal deworming for pregnant women.
- Behavior Change Communication: Campaigns to promote dietary diversity and health-seeking behaviors.
- Anemia Testing and Treatment: Digital screening and targeted treatment, especially for pregnant women and adolescents.
- Food Fortification: Mandatory fortification of staple foods with iron and folic acid in government programs.
- Addressing Non-Nutritional Causes: Focused interventions in endemic areas for malaria, hemoglobinopathies, and fluorosis.
- 6 Institutional Mechanisms: Multi-sectoral coordination at national, state, district, block, village, and school levels.
Other Key Initiatives
- Weekly Iron and Folic Acid Supplementation (WIFS): Supervised weekly IFA tablets for adolescents to address high anemia rates.
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): Special antenatal check-ups on the 9th of every month for early detection and treatment of anemia in pregnant women.
- Operationalization of Blood Banks: Strengthening district hospitals and sub-district facilities to manage severe anemia cases.
- Health Management Information System (HMIS) and Mother-Child Tracking System: For real-time monitoring and follow-up of anemia cases, especially among pregnant women.
Progress and Challenges
- Achievements: IFA supplementation, deworming, fortified nutrition- millions of beneficiaries reached through AMB and related programs. Awareness and early detection have improved along the school and community outreach initiatives; thereby breaking the vicious intergenerational cycle of malnutrition.
- Ongoing issues: anemia prevalence defying all expectations with improved coverage, some groups have now recorded further increases as per NFHS-5. The current emphasis tends to be too much on iron deficiency, while many other nutritional and non-nutritional aetiologies remain underdiagnosed and undertreated. Accurate diagnosis and tailor-made treatment continue to be problematic, as most patients get iron supplements irrespective of the underlying causes of their anemia.
The Way Forward: Rethinking and Reinforcing the Strategy
- Expand the scope: Screening and treatment should be broadened to address nutritional and non-nutritional causes of anemia other than iron deficiency.
- Improve Information and Diagnostics: There should be a shift to more precise surveys like the Diet and Biomarkers Survey (DABS-I) in promoting estimation and targeted interventions.
- Strengthen Behavior Change: Communication campaigns supported should be intensified to encourage dietary diversity, delayed cord clamping, and adherence to supplementation.
- Enhance Multi-sectoral coordination: Link health, nutrition, education, and sanitation to enhance integrative response.
Conclusion
India’s fight against anemia is a testament to its commitment to inclusive and preventive public health. The Anemia Mukt Bharat strategy, with its focus on nourishing the vulnerable, preventing new cases, and protecting future generations, has laid a strong foundation. However, to achieve the goal of an anemia-free India, the approach must evolve—embracing comprehensive diagnostics, addressing all causes, and fostering sustained community engagement.
Source: PIB
UPSC Mains Practice Question
Q. Critically examine the factors contributing to the persistence of anemia in India. Discuss the effectiveness of recent government initiatives in tackling the issue.
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