NATIONAL ANAEMIA

PROPHYLAXIS
PROGRAMME

ANKIT TALUJA
M.B.A (HCM) 2009-11
Roll no. - 1504
 Anaemia: A Global Challenge
 Anemia is one of the world's most widespread
health problems. It affects more than 2 billion
people worldwide, women and children being more
affected.

 In India, about 52% of the women of reproductive

age & 74% of children are anemic.

 Reducing the number of women dying in childbirth

by 3/4ths by 2015 is one of the key goals of the
Millennium Declaration of the World Health
Organization.

http://www.bsog.in/Anemia%20Monograph.pdf
 CAUSES OF MATERNAL MORTALITY
SRS-1998
Others Hemorrhage
Toxemia 8% 30%
8%

Obst. Lab
10%

Abortion Anemia
Sepsis
9% 19%
16%

Anaemia directly causes 20% of maternal deaths and indirectly

accounts for another 20% of maternal deaths. These figures have
remained unchanged in the last five decades .
 90 A N A E M IA IN P R E G N A N C
80
A S IA N C O U N T R IE S
70

60

50

40

30

20

10

0
Bangladesh China India Indonesia Malay sia My anm ar Nepal Pakistan Philippines Singapore Srilanka Thailand

Prevalence of anaemia is high in South Asia. Even

among South Asian countries prevalence of
anaemia in pregnancy is highest in India.
 Prevalence of Anemia in NHFS-III
India

India Rural Urban

Anemia 69.5 71.5 63.0
among
children

Anemia 56.2 57.4 50.9

among
women
(15-49)

Source: NFHS-III
 Major causes of anemia

 Inadequate iron, folate intake due to low

vegetable consumption and perhaps low B12
intake

 Poor bioavailability of dietary iron from the

fibre, phytate rich Indian diets

 Chronic blood loss

 Increased requirement of iron during pregnancy
MICRONUTRIENTS
VIT-A

72% of the children in 103 countries

received 2 doses of Vit-A in 2007 as
compared to 16% in 1999

IODINE
Countries with IDD as a major public health
concern, reduced from 110 to 47 between
1993 and 2007 with the use of fortified salt

IRON should also make such progress

National Policies
 NationalNutrition Policy, 1993 advocates a
comprehensive inter-sectoral strategy for alleviating all
the multi-faceted problems of under/malnutrition and its
related deficiencies and diseases

 NationalPopulation Policy, 2000 advocates convergence

of services at village levels

 National
Health Policy, 2002 emphaises health needs of
women and children

 NRHM, 2005 - Universal access to public health services

such as Women’s health, child health, water, sanitation
& hygiene, immunization, and Nutrition.
 National Programme
 Program started in 1970

 Aims at significantly decreasing the prevalence and

incidence of anemia in women in reproductive age group,
especially pregnant and lactating women, and pre-school
children.

 DIET DIVERSIFICATION: Promotion of regular consumption

of foods rich in iron.

 SUPPLEMENTATION: Provisions of iron and folate

supplements in the form of tablets (folifer tablets) to the
"high risk" groups: Pregnant women and young children.

 TREAT INFECTION

 TREAT SEVERE ANEMIA: Identification and treatment of

severely anemic cases.
Strategy for the program

 Distribution of iron folic acid (adult and paediatric doses)

to pregnant and lactating women, and children aged 1 to 5
years.

 Provision in ICDS

 Department of Food is responsible for promoting

consumption of iron rich food.

 Promoting cultivation of iron rich food

 Promoting consumption or iron rich diet.

Revised Guidelines, April 2007
Infants between 6-12 months included

For children 6-60 months, ferrous sulphate

and folic acid should be provided in a liquid
formulation containing 20mg elemental iron
and 100 mcg folic acid per ml of the liquid
formulation

National IMNCI guidelines to be followed

Revised Guidelines, April 2007
 Children 6-10 years will be provided 30 mg
elemental iron and 250 mcg folic acid per child per
day for 100 days in a year
 Adolescents 11- 18 years will be supplemented at
the same doses and same duration as adults.
Adolescent girls will be given priority
 Multiple channels and strategies are required to
address the problem of iron deficiency anemia.
 Double fortified salts/sprinklers /ultra rice and
other micronutrient candidates or fortified
candidates should be explored as an adjunct or
alternate supplementation strategy
Groups to be targeted for Iron supplementation to prevent
IDA
Population group Dosage Schedule Duration of
Supplementaion

Low Birth Weight Infants 2 2 mg / kg / day 2 months to 23 months

to 23 months of age of age

Normal Infants 6 to 23 2 mg / kg / day 6 months 23 months of age

months of age *

Children 24 to 59 months of 2 mg / kg / day up to 30 mg 3 months

age *

School Aged children * Iron: 30 mg / day 3 months

(above 60 months age) Folic Acid: 250 :g / day

All women of child Iron: 60 mg / day 3 months

bearing age * Folic Acid: 400 :g / day

Pregnant and Lactating As above Throughout pregnancy

Women
Way Forward

A National task force on Anaemia should be

constituted by the Department of Health
Research

Develop Integrated training module on

micronutrients for capacity building of
multisectoral service providers – NIHFW