Improving the approach to assess impact of anaemia control programs during pregnancy in India: a critical analysis

Abstract

Around 42.7% of women experience anaemia during pregnancy in low- and middle-income countries. Countries in southeast Asia (with prevalence ranging between 40 and 60%) have reported a modest decline over the past 25 years. Nearly half the pregnant women continue to be anaemic in India between 2005-06 and 2015-16, although severe anaemia has reduced from 2.2% to 1.3%.India has been committed to achieving a target of 32% prevalence of anaemia in pregnant women from 50% by 2022. There are concerns around stagnancy in the prevalence of anaemia in pregnancy despite a strong political commitment. The paper puts forth the arguments that should be considered while introspecting why India might run the risk of not achieving the expected reduction. The reported findings highlight several methodological issues such as hemoglobin cut-offs used to determine anaemia during pregnancy, method of estimation of Hb, and less emphasis on causes other than iron deficiency anemia.

Prevalence of anemia in pregnant women attending out-patient clinic: A cross-sectional study

“…13 in pregnancy is defined as hemoglobin concentration in the peripheral blood 11g/dL or less. 7 During pregnancy, expansion of plasma volume causes hemoglobin dilution. The incidence of anemia in pregnancy ranges from 40 to 80% in the tropics compared to 10 to 20% in the developed countries.…”

“…8 The etiology of the anemia is multi-factorial. 7 Iron deficiency represents the common cause of anemia in general population. 9 The other common risk factors for anemia include dietary deficiency, parasitic infestations and chronic diseases.…”

“…13 The government of India has been consistently working to address the problem of anemia through the national program. 7 The objectives of this study were to evaluate prevalence of anemia in pregnancy and to understand correlates of anemia.…”