National nutritional anaemia control programme in India.

Ministry of Health & Family Welfare, Government of India, New Delhi.
Indian journal of public health 43(1):3-5, 16.
Source: PubMed
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    ABSTRACT: Anemia during pregnancy remains an important public health problem in developing countries like India. Anemia is the direct cause of 12-15% of maternal deaths. Iron deficiency is the commonest cause for anemia in the Indian subcontinent. Several preventive and therapeutic approaches are in practice. The available routes of iron supplementation are oral and intravenous. In spite of oral iron being least invasive, cheap and safe, the ineffectiveness of oral iron due to dietary inhibitors and poor compliance are well known. Intravenous iron sucrose can be a promising therapy for moderate to severely anemic pregnant women and has been in practice for quite some time in private and public health practices. In this article, we report the current evidence on the safety and efficacy of intravenous iron sucrose in anemic pregnant women on hematological and clinical outcomes. Though the evidence on its efficacy in improving hemoglobin and serum ferritin is convincing, its effect on maternal and fetal outcomes are unclear. This is primarily due to lack of well-designed and larger studies powered to detect difference in clinical outcomes. Hence, there is a need to gather evidence from a well-designed large randomized clinical trial conducted in a developing country. The results of such a study would feed into the national policy and would form the basis to frame guidelines for management of anemia in developing countries.
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    ABSTRACT: The average rural Indian women enter her reproductive life, particularly in pregnancy, suffer from nutritional anemia due to iron deficiency. National program of India had implemented a strategy for supplementation of iron folic acid by means of iron folic acid (IFA) tablets at least 3 months during antenatal period. The study had been conducted to assess the proportion of pregnant mothers consumes the IFA tablets and the factors determine compliance. A cross-sectional, community-based study was conducted in rural area of India on 50 antenatal mothers by multistage sampling technique. The data were analyzed by using SPSS 16 (Statistical Package for the Social Sciences, ver. 16), Chicago, considering the level of significance at 95%. The IFA tablet was adequately consumed by 62% mother among the study population. The consumption is more among the mother who were explained properly than those who were not explained by the health worker (χ(2)= 4.529, P < 0.05). The compliance of iron folic acid tablets was still far behind to reach the National Goal though the service component are quite strong by the front line workers and health providers. An effort should be given at the level of front line health workers by training and re-training them to improve the compliance of IFA consumption.
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    ABSTRACT: Anemia is an important health concern worldwide, particularly in poor populations such as in India. The objective of this study was to determine the prevalence and predictors of anemia and iron status. One thousand children ages 6 to 30 mo were included in a study undertaken in low- to middle-income neighborhoods in New Delhi, India. Children of Tigri and Dakshinpuri were identified through a community survey. Plasma concentrations of hemoglobin (Hb), soluble transferrin receptor (sTfR), folate, vitamin B12, and total homocysteine (tHcy) were measured. Predictors for plasma Hb concentration were identified in multiple linear regression models and considered significant if P-value <0.05. The prevalence of anemia (Hb concentration <11 g/dL) was 69.6% (n = 696) whereas the prevalence of iron deficiency (elevated sTfR i.e., >4.7 nmol/L) was 31% (n = 309). The main predictors for Hb concentration were plasma concentrations of sTfR (standardized beta coefficient [β], -0.49; P < 0.001), folate (β, 0.15; P < 0.001), vitamin B12 (β, 0.10; P < 0.001), tHcy (β, -0.11; P < 0.001) among the biomarkers. Length-for-age Z score (β, 0.08; P = 0.002) and family income (β, 0.06; P = 0.027) also predicted Hb concentration. Anemia was common in this population. Iron, folate, and vitamin B12 status were important predictors for plasma Hb concentration. Improving the status of these nutrients might reduce the burden of childhood anemia in India.
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