Friday, June 4, 2010

Combating Anemia: Killing two birds with one shot

September 6, 2000 – the United Nations Headquarters, New York! Nobody can forget the UN Millennium Declaration ‘to combat global hunger and poverty’ in 2000, signed by 191 nations around the world. The world leaders from 191 nations charted a set of eight goals to be achieved by world nations, christened as ‘Millennium Development Goals’.
Among the eight goals, Goal 4 states to ‘reduce child mortality’, with the target to reduce by two thirds the mortality rate among children under five. Similarly, Goal 5 states to ‘improve maternal health’, with the target to reduce by three quarters the maternal mortality rate.
What if, there is a way to achieve Goal 4 and 5 with one weapon, sort of killing two birds with one shot. Fighting anemia can help world nations to achieve both Goal 4 and 5. How? Before that let us know about anemia.
Anemia is a global public health problem, as compelling and harmful as the epidemics of infectious diseases. With a global population of 6,700 million, at least 3,600 million people have iron deficiency and 2000 million out of these suffer from anemia, particularly iron deficiency anemia (IDA). Children and women in reproductive age group are more vulnerable.
World Health Organization (WHO) estimates that over one third of the world's population suffer from anemia. India continues to be one of the countries with the highest prevalence of anemia. National Family Health Survey (NFHS) estimates reveal the prevalence of anemia to be 70-80% in children, and 70% in pregnant women, while 56 per cent of adolescent girls are anemic. This is more pronounced in rural areas. A 1997 survey of 12-18 year old girls in rural India (by Survival for Women and Children (SWACH) Foundation) found an anemia prevalence rate of 82.9% among girls in school and 92.7% among girls not in school. These are our potential mothers.
As a consequence, anemia has well known adverse effects on physical and cognitive performance of individuals. But the true toll of anemia lies in the ill-effects on maternal and fetal health. Poor nutritional status and anemia in pregnancy have consequences that extend over generations. Anemia is also related to perinatal and maternal mortality. The rates of low birth weight, prematurity, neonatal and infant mortality among children born to undernourished adolescent girls is high. In India, one in five i.e. 20% of all the maternal deaths are attributed to anemia during pregnancy and in another 40% anemia is a contributory factor. And this where the beauty lies. If one were to address anemia, we can achieve the twin goal of reducing child mortality as well ensuring maternal health.
The major cause for prevalence of such high-level of anemia in India is because of low dietary intake, poor availability of iron and chronic blood loss due to hook worm infestation and malaria. Besides, an increase in demand for iron during adolescence, the low iron status is further complicated by low dietary intake and poor bioavailability of iron in the Indian diet.
In order to prevent high maternal mortality and high incidence of low birth weight babies in India, there is a need to combat anemia during adolescence, and pregnancy. There is complete lack of awareness about the importance of having an optimal hemoglobin level.
The solution lies in ‘Nutrition awareness’ programs that inform the people on ways that can improve hemoglobin like taking iron and folic acid (IFA) tablets, eating iron-rich food, etc.

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