India’s great anaemia mystery

Source– The post is based on the article “India’s great anaemia mystery” published in The Indian Express on 14th September 2022.

Syllabus: GS2- Development and management of health

News- The article explains the increase in prevalence of anaemia among women and children despite improvement in other health indicators.

The prevalence of anaemia among women has increased from 53% in 2015 to 57% in 2019-20. Similarly, the percentage of anaemic children has increased from 58% in 2015 to 67% in 2019-20.

How WHO defines anaemia?

Anemia is a condition where the number of red blood cells or the hemoglobin concentration within them is lower than normal.

What could be the probable reason behind it?

Cereal-centric diets, with relatively less consumption of iron-rich food groups. However, there is increase in children and women consuming iron dense food from NFHS-4 to NFHS-5. The children consuming an adequate diet has increased from 9.6 percent to 11.3 percent from NFHS-4 to NFHS-5.

Poor water quality and sanitation conditions. Sanitation coverage of households has increased from 48.5 percent to 70.2 percent. Households with access to improved drinking water sources improved from 94.4 percent to 95.9 per cent.

Delivery of health and nutritional interventions. Women’s consumption of folic acid during pregnancy and access to ante-natal check-ups has improved over the last five years

Women’s empowerment is another factor. But women empowerment has increased during this period

Why does the data on anaemia seem anomalous?

Several factors that are responsible for anaemia have improved since NFHS-4.

All other major undernutrition outcomes like stunting, wasting and underweight have improved over the past four to five years.

How to properly understand the reason behind the increase in anaemia?

There is a need to go beyond haemoglobin and look for some other iron-specific biomarkers, like serum ferritin and marker of inflammation. It will identify the role of iron deficiency as a driver of anaemia.

Measurement of anaemia should account for non-iron nutritional deficiencies like that of vitamin B12. There is a need for screening for genetic blood disorders, like thalassemia and sickle-cell anaemia.

The NFHS data must be expanded on food consumption to estimate the intake of various micronutrients. We need to compare it against recommended intake.