Times of India
09 February 2011
By Bushra Baseerat
Hyderabad, India

Over the last five decades, the government has been pumping in crores to address anaemia, one of the biggest public health problems, women in Andhra Pradesh are grappling with. Annually, several doses of iron and folic acid tablets are being distributed for free to adolescent girls and pregnant women to address it. And if one thought that women would be in the pink of their health after this massive ‘anaemia riddance’ exercise, the statistics paint a grim picture at least in Andhra Pradesh.

According to the National Nutrition Monitoring Bureau, 73 per cent of the adolescent girls in AP are anaemic, 74 per cent of the pregnant women are anaemic and the percentage touches 76 among lactating women. Further, the bureau study shows that 68 per cent of the non–pregnant/nonlactating women are anaemic.

"AP has the dubious distinction of marrying girls before the marriageable age (18 years). The girls also end up conceiving before they complete 18 years. As many as 25 per cent of the deaths that occur during delivery are because of anaemia," said Dr P Balamba, senior member of the Federation of Obstetrics and Gynaecology Societies of India (FOGSI). She adds that anaemia deficiency can lead to poor cognitive development among children and that an alarming 90 per cent of the pregnant women visiting government hospitals are anaemic.

This, despite several staterun and national programmes, wherein iron and folic acid supplements are distributed for free in schools as well as health units. A scientist from National Institute of Nutrition (NIN) says that policy makers should relook the implementation of this supplementation programme. "Data shows that hardly 50 per cent of the women are getting these tablets and among them, only 30 per cent get 100 tablets as stipulated under the programme," he said.

Experts say that children of mothers who have anaemia are also much more likely to be anaemic. In fact, FOGSI representatives suggested that intravenous injections for anaemia should be administered to anaemic mothers mandatorily.

But the Commissioner of Family Welfare, Y S Srilakshmi says that any changes in the programme will have to come from Government of India. "We recommend dietary changes, inclusion of milk and milk products in the diet, meat, green leafy vegetables but these days, women are not eating a balanced and healthy diet," she said. In 2009–10, the Commissioner of Family Welfare had distributed 3.76 crore iron and folic acid tablets and in the current financial year, 4.35 crore tablets were distributed.

As the debate goes on, Dr G N V Brahmam, scientist with NIN, talking from the nutrition point of few, said that Indian diets are cereal and pulse based, which interfere with iron absorption. Moreover, he added that the consumption of Vitamin C rich foods, which enhance iron absorption, is less. "Women have additional burden of menstruation as well as pregnancy. There is lack of awareness on this issue and even educated women are unaware as to what constitutes a good nutritional diet," said Dr Brahmam. Junk food, doctors say has replaced healthy diet these days and has increased the prevalence.

Dos & Don’ts

• Avoid drinking tea/coffee after food as this habit restricts iron absorption
• Include green leafy vegetables in the diet
• Vitamin C rich fruits enhance iron absorption