Context-A recent study published in The Lancet Global Health, which looked at anaemia among men in India, found that nearly a quarter of them (23.2% in a sample of 1 lakh men) in the age group 15-54 had some form of anaemia . The study also covered 6 lakh women.

• An estimated 1.9 billion people had anaemia in 2013, which is 27% of the world’s population, and 93% of these cases occur in low- and middle-income countries. Factors such as consuming smokeless tobacco, being underweight, level of urbanisation and household wealth are associated with a higher probability of developing the disease.

Key findings

• Cases among men ranged from moderate or severe (5.1%) to severe anaemia (0.5%).
• Among age groups, men in the group 20-34 years had the lowest probability of having anaemia, while actual prevalence was lowest in the age group 50-54, at 7.8%.
• The prevalence was higher for younger age groups.
• Among men with anaemia, 21.7% had moderate or severe anaemia; among women with anaemia, 53.2% had moderate or severe anaemia.
• Among the states, the highest prevalence of any anaemia was in Bihar, with 32.9% of the men reporting it. This is followed by West Bengal (30.46%), Jharkhand (30.3%), Meghalaya (29.13%) and Odisha (28.45%).
• The lowest prevalence among men was in Manipur (9.19%), followed by Mizoram (9.78%), Nagaland (10.23%), Goa (10.68%) and Kerala (11.77%)

Anaemia

• The World Health Organization defines anaemia as a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiological needs.
• Anaemia in men can cause fatigue, lethargy, creates difficulty in concentrating, thereby reducing the quality of life and decreasing economic productivity.

Anemia Types and Causes

they’re divided into three groups:

• Anemia caused by blood loss
• Anemia caused by decreased or faulty red blood cell production
• Anemia caused by destruction of red blood cells

What is the relation between anaemia and the spread of dengue?

• Mosquitoes are more likely to acquire the dengue virus when they feed on blood with low levels of iron.
• Cells in a mosquito's gut take up iron in the blood and use it to produce reactive oxygen. The reactive oxygen kills the dengue virus.
• Supplementing people's diets with iron in places where both iron deficiency anaemia and dengue fever are a problem could potentially limit transmission of the disease, but there are many risks.

Why there is still such high prevalence of anaemia even within the developed markets?

• Poor eating habits (not eating enough fruits, vitamin C, and legumes such as and beans and peas) and lack of access to healthcare are the main causes for such a high prevalence of anaemia among women.
• Iron supplementation programs have not been successful in decreasing anaemia in India.
• Anaemia is difficult to diagnose, as the symptoms are non-specific in the mild early stages. Studies suggest that more than 50% of people with anaemia are not aware that they have the condition.
• High prevalence of conditions that can cause anaemia, such as Chronic Kidney Diseases (CKD): In people with CKD, anaemia arises due to kidney damage lowering the production of hormones that direct haemoglobin production.

The Anemia Mukt Bharat

• The Anemia Mukt Bharat- intensified Iron-plus Initiative aims to strengthen the existing mechanisms and foster newer strategies for tackling anemia, focused on six target beneficiary groups, through six interventions and six institutional mechanisms; to achieve the envisaged target under the POSHAN Abhiyan.

• The strategy focuses on testing & treatment of anemia in school going adolescents & pregnant women using newer technologies, establishing institutional mechanisms for advanced research in anemia, and a comprehensive communication strategy including mass/mid media communication material. A web-portal anemiamuktbharat.info has also been developed as part of the monitoring mechanism of the strategy, which would provide survey data on anemia across beneficiary groups, target prevalence of anemia as per POSHAN Abhiyan and quarterly HMIS based reporting of programme implementation coverage upto the district level.

• The Home-Based Care of Young Child (HBYC) programme has an objective to reduce child mortality and morbidity by improving nutrition status, growth and early childhood development of young children through structured and focused home visits by ASHAs with the support of Anganwadi workers (AWWs).

• The programme is envisaged to be implemented as an extension to the existing HBNC programme and will be rolled out in a phased manner. In the first phase (F.Y 2018-19) the programme will be rolled out in all the identified Aspirational Districts. In the second phase, all the remaining districts under Poshan Abhiyan will be included and in the third phase programme this shall be expanded to cover all the districts in the country. Under the HBYC programme, five additional home visits (in every three months) by ASHAs are proposed after the last visit on 42nd day, as in the existing HBNC programme. Thus, the contact of new-born with the health system is extended till 2nd year of birth.

• ASHA will ensure exclusive breastfeeding till 6 months of life, adequate complementary feeding after 6 months, Iron and Folic Acid supplementation, full immunization of children, regular growth monitoring, appropriate use of ORS, appropriate hand washing practices and age appropriate playing and communication for children during each home visit.