2) Write an Assignment on the Government program on anaemia (National

Nutritional Anaemia Prophylaxis Programme) (10 marks)

Ans:

NATIONAL NUTRITIONAL ANAEMIA PROPHYLAXIS PROGRAMME

Submitted by:

Aibianglin Thabah
Department: BSc Psychology 2nd semester
Registration number: F061200008

Submitted to:
Dr. Gracedalyne Rose Shylla Pasah
 TABLE OF CONTENT

Sl. No. Pg. No.

1. INTRODUCTION. 1

2. BODY. 1–3

3. CONCLUSION. 3

4. REFERENCES. 4

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INTRODUCTION:

Anaemia is a condition in which you lack enough healthy red blood cells to
carry adequate oxygen to your body's tissues. Having anaemia can make you feel
tired and weak.

Anaemia is a severe public health problem amongst all vulnerable age

groups in India. A programme for the prevention of anaemia was launched by
Government of India during Fourth Five Year plan. Available studies on
prevalence of nutritional anaemia in India show that 65% infant and toddlers,
60% 1-6 years of age, 88% adolescent girls (3.3% has haemoglobin <7 gm./dl;
severe anaemia) and 85% pregnant women (9.9% having severe anaemia. The
prevalence of anaemia was marginally higher in lactating women as compared to
pregnancy. The commonest is iron deficiency anaemia.

BODY:

The programme was launched in 1970 to prevent nutritional anaemia in

mothers and children. Under this programme, the expected and nursing mothers
as well as acceptors of family planning are given one tablet of iron and folic acid
containing 60 mg elementary iron which was raised to 100 mg elementary iron,
however folic acid content remained same (0.5 mg of folic acid) and children in
the age group of 1-5 years are given one tablet of iron containing 20 mg
elementary iron (60 mg of ferrous sulphate and 0.1 mg of folic acid) daily for a
period of 100 days. This programme is being taken up by Maternal and Child
Health (MCH) Division of Ministry of Health and Family Welfare. Now it is part of
RCH programme.

At present, the National nutritional Anaemia Prophylaxis Programme is

operated as part of the RCH programme. under the revised policy, the target
group has been expanded to include infants 6-12 months, school children 6-10
years and adolescents 11-18 years of age, clinically found to be anaemic. For
infants and children, liquid formulation having 20 mg elemental iron and 100 ug
folic acid per ml, will be made available. Dosage schedule for various age groups
is given below:-

• Children 6-60 months: 2o mg elemental iron + 100 ug folic acid(one tablet of

paediatric IFA or 5 ml of IFA syrup or 1 ml of IFA drops) for a total of 100 days if
the child is clinically found to be anaemic.

• School children 6-10 years: 30 mg elemental iron + 250 ug folic acid for 100
days.
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• Adolescent’s 11-18 years: 100 mg elemental iron + 500 ug folic acid for 100
days. Adolescent girls to be given greater priority in the programme.

• Pregnant women: one tablet of 100 mg elemental iron + 500 ug folic acid
prophylactically daily and if clinically anaemic, 2 such tablets to be given daily for
100 days.

• Nursing mothers and acceptors of family planning: one tablet containing 100
mg elemental iron + 500 ug folic acid daily for 100 days.

• The programme strategy also includes health and nutrition education to

improve overall dietary intakes and promote consumption of iron and folate rich
foods as well as food items that promote iron absorption.

• The Ministry of Health and Family Welfare has revised the guidelines on IFA
supplementation related to the National Nutritional anaemia Prophylaxis
programme.

This is the outcome of a long process, initiated with different consultations

on anaemia in adolescent girls, the National Consultation on Micronutrients in
end 2003 with ICMR/MHFW, work with the committee (chaired by DG ICMR)
constituted subsequently and work with NRHM and different groups on the 11
the plan. Highlights of the same include the following:-

1. The infants between 6-12 months should also be included in the programme
as there is sufficient evidence that iron deficiency affects this age also.

2. Children between 6 months to 60 months should be given 20mg elemental

iron and 100 mcg folic acid per day per child as this regimen is considered safe
and effective.

3. National IMNCI guidelines for this supplementation to be followed.

4. For children (6-60 months), ferrous sulphate and folic acid should be provided
in a liquid formulation containing 20 mg elemental iron and 100mcg folic acid per
ml of the liquid formulation. For safety reason, the liquid formulation should be
dispensed in bottles so designed that only 1 ml cab be dispensed each time.
5. Dispersible tablets have an advantage over liquid formulations in programmatic
conditions. These have been used effectively in other parts of the world and in
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large scale Indian studies. The logistics of introducing dispersible formulation of

Iron and Folic Acid should be expedited under the programme.

6. The current programme recommendations for pregnant and lactating women

should be continued.

7. School children, 6-10 year old, and adolescents, 11-18 year olds, should also be
included in the National Nutritional Anaemia Prophylaxis Programme (NNAPP).

8. Children 6-10 year old will be provided 30 mg elemental iron and 250 mcg folic
acid per child per day for 100 days in a year.

9. Adolescents, 11-18 years will be supplemented at the same doses and duration
as adults. The adolescent girls will be given priority.

10. Multiple channels and strategies are required to address the problem of iron
deficiency anaemia. The newer products such as double fortified salts / sprinkles/
ultra-rice and other micro nutrient candidates or fortified candidates should be
explored as an adjunct or alternate supplementation strategy.

CONCLUSION:

Anaemia is a severe public health problem amongst all vulnerable age

groups in India. So, efforts should be taken to reduce the prevalence of anaemia
and promote the health of an individual, community as well as the country. To
accelerate anaemia reduction health interventions should be targeted at
pregnant women together with interventions for women and children during
childhood. A holistic approach is needed. Various measures should be taken to
combat anaemia such as eating nutritious and iron-rich foods, IFA
supplementation during pregnancy and lactation, weekly iron-folic supplements
for adolescents, deworming, health education, provision of fortified foods and
screening and treatment of non nutritional causes of anaemia. Improving
women's education and empowering them is also important so they can make
better dietary choices for themselves and their families.
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References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266259/

https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-
20351360

https://www.ijmr.org.in/article.asp?issn=0971-
5916;year=2019;volume=150;issue=3;spage=239;epage=247;aulast=Kapil

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