Context: Recently, Indian Institution of Technology (IIT) Delhi has released “The Association Between Ambient PM 2.5 Exposure and Anaemia Outcomes Among Children Under Five Years of Age in India”.
Key Findings of the Report

• The study included 98,557 children in the individual analysis across 636 districts, based on the findings of the National Family and Health Survey 2015–2016 (NFHS-4).
• About 63% of the included children were found to be anaemic.
• Children with anaemia were on average slightly younger compared with children without anaemia, tended to be from lower wealth index levels, and had higher percentages of maternal anaemia.
• Extended periods of exposure to PM 2.5 can lead to anaemia among children under the age of 5 years.
• For every 10 micrograms per meter cube increase in PM 2.5 levels exposure, there is a decrease of 0.07 grams per dL in average haemoglobin levels.
• Researchers are waiting for the full results of the NFHS 5 to see if there is a correlation between a decrease in pollution and anaemia.
• They will also analyse the impact of the National Nutrition Mission and the National Clean Air Programme on anaemia and the health of children.
• It highlighted that strengthening programmes like Poshan Abhiyaan without curtailing air pollution or bringing down its exposure to children, will not help in reducing anaemia.
• The introduction of the National Iron Plus Initiative in 2011 sought to expand the beneficiaries of the National Nutritional Anaemia Prophylaxis Programme to children with 6–59 months of age and although anaemia decreased by about 11% between 2006 and 2016, it remains a major issue.

Significance

• This is the first study in India, where an association between exposure to PM 2.5 and anaemia in children under the age of 5 years in India has been examined and established.
• So far numerous other studies have looked at other detrimental health impacts of particulate matter and anaemia separately.
• Studies linking both of these have been low in number and those that have been carried out have been mostly in the US, Europe and China.

About Anaemia

• According to the World Health Organization (WHO), anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal.
• Haemoglobin is needed to carry oxygen and if a person has too few or abnormal red blood cells, or not enough haemoglobin, there will be a decreased capacity of the blood to carry oxygen to the body’s tissues.
• The optimal haemoglobin concentration needed to meet physiologic needs varies depending upon age, sex, elevation of residence, smoking habits and pregnancy status.

Causes

• Nutritional deficiencies, particularly iron deficiency.
• Deficiencies in folate, Vitamins B12 and A.
• Haemoglobinopathies (medical term for a group of blood disorders and diseases that affect red blood cells).
• Infectious diseases, such as malaria, tuberculosis, HIV and parasitic infections.

Symptoms

• In its severe form, it is associated with fatigue, weakness, dizziness, shortness of breath and drowsiness.

Treatment

• WHO oversees several programmes across all WHO Regions to help reduce the prevalence of anaemia through treatment and prevention.
• In 2016, WHO started a five-year project to review its global guidelines for haemoglobin cut-offs used to define anaemia with the aim to provide evidence-informed recommendations on assessing anaemia in individuals and populations.  

Vulnerability

• Anaemia is a serious global public health problem that particularly affects young children and pregnant women.
• WHO estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anaemic. 
• Globally, India carries the largest burden of anaemia, especially among women and children.
• According to the NFHS-4, 53.1% of women in India with 15–49 years of age and 58.5% of children under five were anaemic.

Initiatives for Anaemia in India
National Nutrition Anemia Control Programme

• Aims at decreasing the prevalence and incidence of anemia in women of reproductive age.
• Focuses on three vital strategies: Promotion of regular consumption of foods rich in iron, provisions of iron and folate supplements in the form of tablets to the high risk groups and identification and treatment of severely anemic cases.
• Implemented through the Primary Health Centers and its sub centers.

National Iron Plus Initiative

• Aims to reach the age groups for supplementation of Iron and Folic Acid.

The Global Alliance for Improved Nutrition

• Alliance of public and private sector partners launched during the Special Session on Children (SSC) meeting to save lives and improve health by eliminating vitamin and mineral deficiencies.