Anaemia: Features, Types & Prevention

• Context (TH): The Ministry of Ayush and the Ministry of Women and Child Development have signed a MoU for the nutritional improvement in adolescent girls to control Anaemia under Mission Utkarsh.

About Anaemia

• Anaemia is a common blood disorder characterised by a reduction in the number of red blood cells (RBCs) or a decrease in the amount of haemoglobin (the protein that carries oxygen) in the blood.
• It leads to reduced Physical Performance, Poor concentration, memory issues, and irritability.
• Severe Anaemia can lead to heart problems, organ damage, and even death.

Causes of Anaemia

• Iron Deficiency: Iron is essential for RBC production.
• Vitamin Deficiencies: Lack of vitamin B12 or folate can also lead to Anaemia.
• Chronic Diseases: Certain chronic conditions (e.g., kidney disease, inflammatory disorders) affect RBC production.
• Blood Loss: Excessive bleeding (due to menstruation, injury, or gastrointestinal issues) reduces RBCs.
• Inherited Disorders: Some genetic conditions affect RBC structure or production.

Key Features of Anaemia

• Condition in which the body lacks enough healthy red blood cells or haemoglobin, a protein in red blood cells that carries oxygen to the body’s tissues.
• Symptoms: Fatigue, Pale Skin, Shortness of Breath, Dizziness and Headaches, Cold Hands and Feet, Brittle Nails and Hair.
• Not typically fatal if treated, but if left untreated or undiagnosed, it can lead to severe complications.
• Typically diagnosed through a blood test measuring haemoglobin levels, hematocrit, and RBC count.
• Treatment for anaemia varies by cause: iron-deficiency anaemia is treated with iron supplements, vitamin B12 and folate deficiencies with their respective supplements, and severe cases may require blood transfusions or treatment for underlying conditions.
• More prevalent in low-income and developing countries such as Africa and Asia (50-60 % in pregnant women) due to poor nutrition, especially iron-deficient diets, and limited access to healthcare.

Different Forms

• Iron-deficiency anaemia: Caused by insufficient iron, leading to reduced haemoglobin production, often due to poor diet or blood loss. Can cause heart failure and other complications.
• Vitamin-deficiency anaemia: Resulting from a lack of vitamins B12 or folate, essential for red blood cell production, often due to poor nutrition or absorption issues.
• Aplastic anaemia: A rare condition where the bone marrow fails to produce enough red blood cells, often linked to autoimmune diseases or chemical exposure. Can lead to life-threatening complications.
• Anaemia of chronic disease: Occurs in chronic illnesses like cancer or kidney disease, where the body’s response impairs red blood cell production.
• Sickle cell anaemia: A genetic disorder causing misshapen red blood cells that block blood flow and reduce oxygen delivery. Can reduce life expectancy.
• Thalassemia: An inherited disorder where abnormal haemoglobin is produced, causing red blood cell destruction. Can reduce life expectancy.
• Hemolytic anaemia: Characterized by the rapid destruction of red blood cells (RBC), which can result from infections or autoimmune diseases. Can lead to life-threatening complications.
• Fanconi anaemia: A rare genetic condition that causes bone marrow failure, leading to low blood cell production.

Anaemia in Pregnancy

• Anaemia during the first 100 days of pregnancy increases the risk of CHD due to insufficient iron, which is crucial for fetal development, particularly in forming the baby’s heart.
• Iron deficiency can impair oxygen delivery to the fetus, disrupting normal heart development.
• Other nutrient deficiencies, such as folate and vitamin B12, may also contribute to this link by affecting cell division and tissue growth, further hindering proper heart formation.

Treatment and Prevention

• Iron Supplements: For iron-deficiency Anaemia.
• Dietary Changes: Consuming iron-rich foods (leafy greens, red meat, legumes).
• Vitamin Supplements: Addressing deficiencies.
• Blood Transfusions in severe cases.

India’s Anaemia Burden

• Anaemia affects various demographic groups across the country. As per NFHS-5 (2019–21), anaemia affects 67.1% of children (6–59 months), 57% of women, 52.2% of pregnant women, and 25% of men aged 15–49 in India.
• States like Bihar and Ladakh report higher rates of anaemia among pregnant women, with prevalence rates of 63.1% and 78.1%, respectively.

Government Efforts to Combat Anaemia

• Anaemia Mukt Bharat: Launched in 2018 under POSHAN Abhiyaan. Aims to reduce anaemia among children (6–59 months), adolescents (10–19 years), and women (15–49 years) by 3% annually.
  • Focuses on six interventions, including iron-folic acid (IFA) supplementation, deworming, and delayed cord clamping.
• POSHAN Abhiyaan (National Nutrition Mission): Launched in 2018 to improve nutritional outcomes for children, pregnant women, and lactating mothers.
• Weekly Iron and Folic Acid Supplementation (WIFS) Programme: Targets school-going adolescent girls and boys (10–19 years). Provides weekly iron and folic acid tablets and biannual deworming.
• National Iron Plus Initiative (NIPI): Provides iron and folic acid supplementation across life stages, from infancy to adulthood. Focuses on high-risk groups including pregnant and lactating women.
• Integrated Child Development Services (ICDS): Provides supplementary nutrition, health check-ups, and referral services for children under 6 years and pregnant/lactating women.
• Mid-Day Meal scheme: Offers nutritious meals in schools to improve child health and reduce micronutrient deficiencies, including iron.

Mission Utkarsh

• Mission Utkarsh aims to control Anaemia among adolescent girls using Ayurvedic interventions.
• Initially, the initiative will be launched in five aspirational districts across five states as a pilot project.
• The program aims to transform the most underdeveloped districts of the country by focusing on improving their socio-economic indicators.
• 15 central ministries or departments will work together to elevate districts from the bottom to state and national averages.
• The aim is nutritional improvement among approximately 95,000 adolescent girls in anaemia-prone districts.