ANAEMIC SURVEY – SCI & TECH

News: Warning on Haemoglobin estimation method

 

What is in the news?

       Recently, Health experts have questioned the efficacy of the method being used to estimate haemoglobin levels.

 

Key takeaways from the news:

1. New method of assessment:

       India is being shifted to the new Diet and Biomarkers Survey in India (DABS-I), launched last year to map diet, nutrition and health status and provide the correct estimate of anaemia among the rural and urban population.

2. Overdiagnosis assessment of anaemia:

       Researchers had cautioned that there is a danger of anaemia being over-diagnosed in India as it follows WHO cut-offs for haemoglobin which may not be suited to India, because the cut-off point depends on the age, gender, physiological status, altitude and other factors.

3. WHO's concentration limit:

       The WHO defines anaemia in children aged under five years and pregnant women as a haemoglobin concentration <110 g/L at sea level, and anaemia in non-pregnant women as a haemoglobin concentration <120 g/L.

4. Poor method in drawing samples:

       The study by the Indian team also pointed to differences in the way blood is drawn for sampling in NFHS. The NFHS survey measured haemoglobin in a drop of capillary blood that oozes from a finger prick.

       This, as per the report, can dilute the blood and give a falsely lower value. The recommended method of venous blood sampling, as per the report, gives a more accurate value.

5. Anaemic burden in India:

       India’s anaemia burden has grown alarmingly with NFHS-5 (2019-21) finding that 57% of women in the age group 15-49 and 67% children between six months and 59 months are anaemic.

 

DABS-I Survey system:

       DABS-I is a comprehensive national-level dietary survey, which will define food and nutrient adequacy by collecting individual dietary intake data of different age-groups of people from all States and UTs across the country.

       The study will also provide nutrient composition data on cooked and uncooked foods from various regions of the country for the first time.

 

What is Anaemia?

       According to the World Health Organization (WHO), anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal.

 

Impacts of anaemia:

       Haemoglobin is needed to carry oxygen and if there are too few red blood cells, or not enough haemoglobin, there will be a decreased capacity of the blood to carry oxygen to the body’s tissues, resulting in symptoms such as fatigue, weakness, dizziness and shortness of breath among others.

       The most common nutritional cause of anaemia is iron deficiency although deficiencies in folate, vitamins B12 and A are also important causes.

 

Issues of anaemia:

1. Affect work capacity:

       Iron-deficiency anaemia reduces the work capacity of individuals and entire populations, with serious consequences for the economy and national development.

2. Maternal and Child health:

       Anaemia is related to morbidity and mortality in the population groups usually considered to be the most vulnerable pregnant women and children under five.

3. Issues in education:

       Anaemia will reduce the cognitive capacity of the children and affect their educational outcomes severely.

4. Affect reproductive health:

       Anaemia also has negative consequences on the reproductive health of the Children and pregnant women and newborn.

5. Other Health implications:

       Anaemia can have significant health consequences, leading to fatigue, weakness, shortness of breath, dizziness, and reduced physical and cognitive performance.

 

Measures taken by the government to tackle the issue of anaemia:

1. Project as public health challenge:

       The Health Ministry has noted that anaemia is a public health challenge and accurate estimates are needed to tackle the crisis.

       This will speed up the government's efforts to address the anaemic problem.

2. Iron fortified rice:

       In 2021, the government decided to distribute rice fortified with iron via government schemes.

3. Anaemia Mukht Bharat:

       In 2018, the Government of India launched the Anaemia Mukt Bharat (AMB) strategy with the target to reduce anaemia in women, children and adolescents in life cycle approach.

       The target groups for AMB are Children 6-59 months, 5-9 years, Adolescent Girls & Boys of 10-19 years, Women of Reproductive Age (15-49 years), Pregnant Women and Lactating Mothers.

4. Weekly Iron and Folic Acid Supplementation (WIFS):

       This Programme is being implemented to meet the challenge of high prevalence and incidence of anaemia amongst adolescent girls and boys.

       The intervention under WIFS includes supervised weekly ingestion of Iron Folic Acid (IFA) tablets.

5. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA):

       It has been launched to focus on conducting a special ANC check up on 9th of every month with the help of medical officers/ OBGYN to detect and treat cases of anaemia.

 

WAY FORWARD:

1. Area specific addressal:

       The data from NFHS reveals the need for new programmes with an area specific focus.

2. Universal screening:

       District wise universal anaemia screening among the school, college, and workplaces can be initiated for early detection.

3. Targeted approach:

       Government can tie up with the NGOs to identify the regions with high anaemia cases for early detection and treatment.

4. Awareness promotion:

       Field-level awareness by ASHAs through community mobilisation activities and primary health sectors should focus on anaemia in pregnant women and children.

5. Minerals fortification:

       Encourage fortification of staple foods, such as flour, rice, and salt, with essential nutrients like iron, folate, and vitamin B12.

       This approach reaches a large population and helps address nutritional deficiencies.