For a country that has immense human capital and one of the youngest populations in an ageing world, this disease burden can be a liability that can even hamper India’s aim of being a leading global economy.
India carries the highest burden of anemia in the world. This burden is cyclically passed down to the next generation — National Family Health Survey (NFHS-4) states that 58 percent of children below five years of age suffer from this deficiency. This is despite having an anemia control program for over 50 years.
The most common type of anemia is nutritional in nature — it occurs when the body does not get enough iron or a few other nutrients from the diet. Anemic people lack healthy red blood cells, leading to symptoms of fatigue, shortness of breath, light-headedness, dizziness or a fast heartbeat. Anemia is an especially serious concern for children because it can impair cognitive development, stunt growth and increase morbidity from infectious diseases.
Magnitude of anemia in India
For a country that has immense human capital and one of the youngest populations in an ageing world, this disease burden can be a liability that can even hamper India’s aim of being a leading global economy. Currently, India ranks 116 out of 157 countries on the human capital index in the World Bank’s latest annual report that indicates human development. The historical lack of adequate investment in health and education can be a cause for slower economic growth.
Therefore, the scale and magnitude of the problem, combined with the functional impact such deficiencies have on the quality of life, both physiologically and socio-economically, demand the urgent adoption of known and effective measures.
Key Indian strategies to tackle anemia
Since 2018, there is a renewed focus on tackling this disease. Efforts are ramped under Anemia Mukt Bharat Abhiyaan to improve coverage by the Union Ministry of Health and Family Welfare under the POSHAN Abhiyaan. The program aims at lowering the nation’s maternal and child anemia burden. While it aggressively targets coverage for iron and folic acid supplements for women, adolescent girls and young children, it also provides mineral and vitamin-fortified foods through mid-day meals.
However, these approaches are dependent on various external stakeholders, which may lead to a problem during unforeseen situations such as COVID-19 , that saw the disruption in the provision of mid-day meals to millions of needy children. To truly ensure an anemia-free and malnutrition-free India by 2022, long-term and sustainable solutions need to be put in place.
Locally sourced nutrition to eliminate anemia
One of the strategies that have had considerable success on-ground, across all states, is the locally sourced nutrition-based strategy. Various international food-based dietary guidelines (FBDGs) recognise the fact that people consume food which lacks nutrients required for health and development. Thus, the focus should be on giving simple, practical advice and counselling support on readily available, appropriate foods that meet nutrient requirements and avoiding jargon that focuses on how each specific nutrient should be provided in an adequate amount.
To ensure constant food security in marginalised families with meagre incomes, we need to train mothers, adolescents and anganwadi workers to grow nutrition gardens along with providing knowledge, seeds and organic fertilisers to make it into a sustainable solution. This solution also helps mothers, often from impoverished backgrounds, have the financial freedom that enables them to take independent decisions for their child’s health and nutrition requirements.
A mother’s role in preventing anemia
Another strategy is to identify and train mothers of infant and young children with leadership qualities into mentors who address childhood malnutrition issues at the community level by identifying, propagating and practising what is going right in the community in order to amplify it. Locally-available foods play an important role here too as the mentor would hold cooking classes and myth-busting sessions with other mothers and caregivers in their community to create awareness of the goodness of certain local foods along with useful practices for beating malnutrition.
Of late, the Indian National Nutrition Strategy has recognised the need to include community-based nutrition interventions that identify and adopt affordable and locally available foods that exist within the community, thus enabling the community to seek existing local solutions to address malnutrition.
Beating anemia is not hard if we adapt three key understandings:
- Community involvement is necessary to create a more honest, trusting and effective environment,
- For scale and penetration, the support of local, state and the central government is imperative
- Solutions that are easily achievable and locally-sourced, last longer.
This article was written by Pratibha Pandey, Health Specialist, ChildFund India.
For more information, read our article on Anemia.
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