Are Countries of the Eastern Mediterranean Region on Track towards Meeting the World Health Assembly Target for Anemia? A Review of Evidence

Abstract

Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. The contribution of IDA to anemia was found to be less than half. Other potential contributors to anemia in the region were identified, including micronutrient deficiencies, parasitic infestations, and poor sanitation. A framework of action was proposed as a roadmap to meet the targets set by the WHA.

Review of the Nutrition Situation in Jordan: Trends and Way Forward

“…In 2008, the national higher committee of nutrition in Jordan modified this process by maintaining only the first dose of 100,000 IU. Then in 2012, in response to the increased prevalence of vitamin A deficiency, the national higher committee of nutrition retained the second dose of 200,000 IU vitamin A and requested to continuously monitor and evaluate the distribution of vitamin A capsules and documents provided in the national vaccines card [ 28 , 72 ].…”

“…In children aged 6–59 months old, the prevalence in 2017–2018 was classified as a moderate public health problem [ 26 ]. Among children aged 12–59 months, the rates of anemia and iron deficiency in 2010 were categorized as mild public health concerns, while that of iron deficiency anemia was considered normal [ 26 , 27 , 28 , 46 ]. Over time, the rates of anemia did not show significant progress, whereas a decreasing trend in the prevalence of iron deficiency was observed, which may be attributed to the implementation of the national wheat flour fortification with multiple micronutrients including iron [ 47 ].…”

“…Iron deficiency anemia was based on Hb and SF levels, defined as: Hb < 11 g/dL and SF < 12 µg/L for children under 5 years; Hb < 11 g/dL and SF < 15 µg/L for pregnant women; and Hb < 12 g/dL and SF < 15 µg/L for non-pregnant WRA [ 26 , 27 ]. The interpretation of the prevalence of anemia, iron deficiency, or iron-deficiency anemia as public health problems was based on the following classifications: no public health problem, ≤4.9%; mild public health problem, 5–19.9%; moderate public health problem, 20–39.9%; severe public health problem, ≥40% [ 26 , 27 , 28 ].…”

Prevalence of Anemia, Iron Deficiency during the Second Trimester of Gestation in Pregnant Women: A Comparative Study of Walled and New Lahore City Population

“…In the current study, we found an overall prevalence of 49.5 % in pregnant women. It's a way leading towards achieving WHO Sustainable Development Goals (SDG) 2025 for the health of pregnant women [17] as according to Ayoub et al, Pakistan is on the right track to achieve these goals [19].…”

“…The National Nutritional Survey (NNS) 2018 showed that 56.6% of adolescent girls and 42.7% of women of reproductive age were to be anemic [16][17][18]. It is good that Pakistan is among the countries that are on the right track to get rid of anemia [19]. But still, a lot of work is to be done to eradicate it.…”