Anaemia Continues To Rise Among Women Of Childbearing Age And Children In The Country, Shows Fifth National Family Health Survey

New Delhi: Findings of the phase-1 of the fifth round of Nation Family Health Survey (NFHS-5) recently released by the Ministry of Health and Family Welfare (MoHFW) show that anaemia continues to be a worrying condition among women and children in almost all states and Union Territories in the country. Anaemia is a medical condition in which a person has a lower number of red blood cells, thereby reducing the ability of their blood to carry oxygen to the body’s organs. People suffering from this condition experience fatigues, shortness of breath, light-headedness, dizziness, and fast heartbeats among other symptoms. Experts say that anaemia can lead to serious problems including heart and lung complications and can also cause a lack of attention, delayed development of motor skills and problems with learning among children.

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According to NFHS-5, out of the 17 states and five Union Territories (UTs) surveyed, the prevalence of anaemia among children under five years of age has increased in 16 states and two UTs. These are: Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Mizoram, Nagaland, Sikkim, Telengana, Tripura, West Bengal, Jammu & Kashmir, and Ladakh.

Anaemia Prevalence Among Children (Under 5 Years)

The highest increase in anaemia, among children surveyed, over the last five years was recorded in Assam (by 32.7 per cent), followed by Mizoram (by 27.1 per cent), Manipur (by 18.9 per cent), Jammu and Kashmir (by 18.9 per cent) and Gujarat (by 17.1 per cent) the survey data has revealed.

The improvement in the status of anaemia was recorded in only one state and three UTs. The state of Meghalaya and the UTs of Andaman & Nicobar Islands, Dadra & Nagar Haveli and Daman & Diu and Lakshadweep were able to reduce anaemia by 2.9 per cent, 9 per cent, 6.2 per cent, and 10.5 per cent respectively.

NFHS-5 also highlights that most women in the country continue to suffer from anaemia. The data shows the prevalence of anaemia among women in the age group 15-49 has increased in 14 states including Assam, Bihar, Goa, Gujarat, Karnataka, Kerala, Maharashtra, Manipur, Mizoram, Nagaland, Sikkim, Telangana, Tripura, and West Bengal and two UTs- Jammu and Kashmir and Ladakh.

Anaemia Prevalence Among Women(Age 15-49 Years)

With 71.4 per cent of the total women surveyed suffering from the condition, West Bengal has the highest prevalence of anaemia among women (15-49 years) in the country. Tripura has the second-highest share of anaemic women, 67.2 per cent, followed by Assam with 65.9 per cent. Among UTs, 92.8 per cent of women (15-49 years) surveyed in Ladakh have anaemia followed by Jammu and Kashmir with 65.9 per cent women suffering from the condition.

A decrease in anaemia among women was recorded in the states of Himachal Pradesh, Andhra Pradesh and Meghalaya by 0.5 per cent, 1.2 per cent and 2.4 per cent respectively. In the UTs of Andaman & Nicobar Islands, Dadra & Nagar Haveli and Daman & Diu, and Lakshadweep by 8.2 per cent, 10.4 per cent, and 20.2 per cent respectively.

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The survey findings also show that in all the states, anaemia is much higher among women compared to men.

Almost 10 states and two UTs have recorded an increase in anaemia among men in the age group 15-49 years. These are: Assam, Goa, Gujarat, Karnataka, Kerala, Maharashtra, Mizoram, Tripura, West Bengal, Sikkim, Jammu and Kashmir, and Ladakh. The highest prevalence of anaemia among men has been recorded in Ladakh (75.6 per cent).

Anaemia Prevalence Among Men (Age 15-49 Years)

Assam Goa, Gujarat, Kerala, Maharashtra, Mizoram, Tripura, West Bengal, Sikkim and Jammu and Kashmir are the states/UT where anaemia has worsened in all children, women and men surveyed under NFHS-5.

According to Dr Shweta Khandelwal is Head, Nutrition Research and Additional Professor, Public Health Foundation of India,

NFHS-5 has shown that anaemia is worsening across most states and in the majority of our population. This is a serious issue which requires attention and discussion. Anaemia has several consequences like poor cognition, decreased productivity, sub-optimal health among others. Also, there is a need to understand that anaemia is not an iron deficiency issue alone. Several nutrients are important here while the authorities are only focusing on iron-fortified foods. Our sole obsession (in programs and policy) with feeding or enhancing elemental iron to tackle anaemia in a country as disperse and diverse as India, is short-sightedness. Research shows that improving Vitamin C, B12 and folate intake among other key nutrients may be promising in improving nutritional anaemia. Of course, other nutrition-sensitive interventions like better WASH (water, sanitation and hygiene), mother’s education among others also influence both prevalence and incidence of anaemia.

Commenting on the impact of programmes like Anaemia Mukt Bharat, a programme under POSHAN (Prime Minister’s Overarching Scheme for Holistic Nutrition) aiming to make the country free from anaemia, Dr. Khandelwal said,

Policy efforts are well-intentioned but not optimally positioned to make India Anaemia Mukt in the near future. Fortification is not a panacea and studies have shown the differential effect of the same amount of supplemental iron being given to people across different geographies.

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She recommends that strategies to tackle anaemia should take into account the conditions in each state – the facilitators and barriers to reducing anaemia prevalence in each region. Empower people with the right information and ability to access better healthier foods grown locally, she added. Dr. Khandelwal said,

Industry must not be allowed to promote and sell ultra-processed foods and powders in the name of fortified products or enhanced nutrition. Please realize processing millets and making chocolate-coated candies of millet will not curb anaemia or for that matter any health issue. Traditional recipes with minimally processed locally grown ingredients will be definitely better than packaged HFSS (High Fat, Sugar and salt) products.

Commenting on the findings of the survey, Basanta Kumar Kar, International Development Professional in Nutrition said,

In order to address anaemia, POSHAN sets a target to reduce anaemia among young children, women and adolescent girls by 3 per cent per annum. In order to bring down key malnutrition indicators like anaemia to single digits by 2040, India needs to Double or even quadruple the current rate of reduction levels by giving it the required push. Increase in anaemia, as reported by NFHS-5 needs deeper introspection because some states are facing a reverse in the gains made towards the efforts to tackle anaemia. A state like Sikkim that improved the situation between NFSH 3 and 4 seem to be performing poorly in NFHS 5. Similarly,a persistent increase of anaemia in an advanced state like Kerala is a cause of concern.

He further noted that the condition has worsened among women in childbearing age, in spite of better reach of ANMs (Auxiliary Nursing Midwifery), more antenatal checks, more distribution of iron-folic acid and institutional deliveries.

Mr. Kar further said that the condition is highly prevalent even among the frontline warriors fighting anaemia. He said,

It is a paradox, indeed. A large number of our nutrition warriors like the grassroots functionaries, smallholder farmers, workforce engaged in industries that are pivotal to anaemia reduction are themselves anaemic. We need to invest in workforce nutrition and specifically the reduction of anaemia among the workers and their children.

The experts suggest enhancing efforts and investments during the first 1,000 days of a child along with addressing anaemia among adolescent girls, early marriages, school drop-outs and poor sanitation including menstrual hygiene practices.

Also Read: Most Anaemic Women Are Not Aware That They Are Dealing With Anaemia: Lovneet Batra, Clinical Nutritionist

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.