Combating Anemia In High-Risk Populations: A Comprehensive Approach To Leave No One Behind

Anaemia remains one of the most pressing public health challenges in India, affecting millions of people across all age groups and genders. Traditionally, anaemia has been seen as particularly affecting women of reproductive age, adolescent girls, and children and for good reason. The National Family Health Survey (NFHS-5) shows that nearly 57 per cent of women in India are anaemic. This high prevalence is primarily due to biological factors such as menstruation, pregnancy, and breastfeeding, all of which increase iron requirements. Anaemia in women and girls can have severe consequences. 

For instance, anaemia during pregnancy increases the risk of maternal mortality, preterm birth, and low birth weight in infants. In adolescent girls, anaemia can impair cognitive function and academic performance, limiting their future opportunities. The focus on women and girls is therefore critical, not only to improve their quality of life but also to ensure the health of future generations.

While it is true that these groups are at higher risk, this narrow focus overlooks a significant portion of the population—men and boys—who also suffer from anaemia, albeit in different ways. According to NFHS-5, about 22 per cent of men aged 15-49 and approximately 29 per cent of adolescent boys (15-19 years) in India are anaemic.  Anaemia in males often goes untreated and unnoticed.

The consequences of untreated anaemia in men and boys are far-reaching. Anaemia in men can lead to decreased physical stamina, reduced productivity, and impaired cognitive function, all of which have economic and social implications. In men, genetic conditions such as G6PD deficiency and hemoglobinopathies like thalassemia contribute to anaemia. G6PD deficiency, more common in men due to its X-linked inheritance pattern, puts them at a higher risk of hemolytic anaemia. 

For both boys and girls, anaemia can affect cognitive development, academic performance, and social behaviour, potentially impacting their future career prospects. Moreover, anaemia weakens the immune system, making them more susceptible to infections and other illnesses. Thalassemia, which affects both genders, is particularly prevalent in India, with thousands of children born each year with the disease.

Climate change is an emerging factor that exacerbates the challenge of combating anaemia. Rising temperatures, unpredictable rainfall, and extreme weather events are affecting food security, leading to poor diets and increased rates of anemia. As climate change impacts agricultural productivity, particularly in regions that rely on subsistence farming, access to iron-rich foods becomes more limited. Building resilience to climate change is therefore crucial for anemia prevention. Promoting climate-resilient crops, improving agricultural practices, and ensuring access to diverse and nutritious foods are key strategies. This includes fortifying staple foods like rice, wheat, and salt with iron and other essential nutrients, which can help mitigate the effects of food insecurity caused by climate change.

The Government of India (GOI) has already taken several steps to combat anaemia through programs like the Anemia Mukt Bharat (AMB) initiative, which aims to reduce anaemia prevalence among children, adolescents, pregnant women, and lactating mothers. Additionally, food fortification programs, where staples like rice, wheat, and salt are enriched with essential nutrients, have been rolled out to address nutritional deficiencies on a broader scale.

However, individuals and communities also play a crucial role in the fight against anaemia. On a local level, people can promote traditional practices such as cooking in iron vessels to naturally boost iron intake. Communities can also engage in awareness campaigns to educate others about the importance of a balanced diet rich in iron, the benefits of combining iron-rich foods with vitamin C, and the necessity of regular anaemia screenings.

Combatting anaemia requires a multi-faceted approach that addresses the unique needs of high-risk populations, including women, girls, men, and boys. Key strategies include:

1. Food fortification as a powerful tool in the fight against anaemia. By fortifying staple foods with iron, folic acid, and other essential nutrients, we can significantly reduce anemia rates across all age groups.

2. Iron and folic acid supplementation, particularly for women of reproductive age, pregnant women, adolescent girls, and even men with genetic predispositions, is a proven strategy for preventing and treating anaemia. .

3. Encouraging dietary diversity is critical. Promoting the consumption of iron-rich foods with Vitamin C like leafy greens, legumes, and meat, along with educating communities about the importance of a balanced diet, can help prevent anaemia. Awareness campaigns can play a significant role in shifting dietary habits.

4. Early detection is key to managing anaemia effectively. Regular screening for anaemia, particularly in high-risk populations, can help identify those in need of treatment before the condition becomes severe.

5. Community-based campaigns can help demystify anaemia and promote gender-inclusive health interventions.

The time to act is now—by focusing on anaemia across the entire population, we can ensure a brighter, healthier future for all. Leaving no one behind in the fight against anaemia is not just a goal; it is a necessity for the health and well-being of our society. By fostering a culture of health consciousness and leveraging both modern and traditional methods, individuals can help bridge the gap between public health initiatives and personal responsibility, ensuring that no one is left behind in the effort to eliminate anaemia.

The author is Director - Centre for Strategic Communications for Public Health at Swasti

Shrirupa Sengupta

Guest Author Director, Centre for Strategic Communications for Public Health at Swasti