Lok Sabha Question No. 3979 (UNSTARRED), answered on 2023-03-24
Subject: Anaemic Women and Children
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Hasnain Masoodi

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3979 TO BE ANSWERED ON 24 TH  MARCH, 2023

## ANAEMIC WOMEN AND CHILDREN

## 3979.   SHRI HASNAIN MASOODI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) the steps being taken by the Government to tackle the situation of rise in percentage of anaemic children between the age group of 6-59 months from 53 percent in (NFHS-4, 201516) to 73 percent in (NFHS-5, 2019-21) in J&K;

- (b)  whether  the  Government  has  identified  High  Priority  Districts  (HPDs)  in  Jammu  and Kashmir to prioritize the reproductive health of women and children against anaemia;
- (c) if so, the details thereof and if not, the reasons therefor;

(d) whether the Government has taken steps for the reduction in the total number of anaemia cases in India by the end of 2024 and if so, the details thereof; and

(e) the details on the age specific Government interventions for the reduction in anaemia among women and children in the country, State/UT-wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)

In  2018,  the  Government  of  India  launched  the  Anaemia  Mukt  Bharat  (AMB)  strategy  to reduce prevalence of anaemia in women, children and adolescents through life cycle approach. The  6X6X6  strategy  aims  to  reduce  anaemia  among  six  beneficiaries  age  groups  through implementation of six interventions and six institutional mechanisms. The UT of Jammu and Kashmir is implementing Anaemia Mukt Bharat strategy as per GOI guidelines.

(b) and (c)

In the UT of Jammu and Kashmir, all Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) services are provided across all the districts. Further, two aspirational  districts  (Kupwara  district  and  Baramulla  district)  are  identified  under  the Aspirational District programme to prioritize the reproductive health of women and children, including anaemia.

(d) and (e)

The  steps  taken  by  Government  including  the  age  specific  interventions  for  reduction  in anaemia among women and children across the country are provided at Annexure I.

## Steps taken by the Ministry of Health and Family Welfare for reduction in anaemia among women and children across the country

- i. Prophylactic Iron Folic Acid Supplementation to all six beneficiaries age group

| Age group                                                                               | Dose and Regime for IFA supplementation                                                                                                                                                                                                                                                                                              |
|-----------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 6 - 59 months of age                                                                    | • Biweekly, 1 ml Iron and Folic Acid syrup • Each ml of Iron and Folic Acid syrup containing 20 mg elemental Iron + 100 mcg of Folic Acid                                                                                                                                                                                            |
| 5- 10 years children                                                                    | • Weekly, 1 Iron and Folic Acid tablet • Each tablet containing 45 mg elemental Iron + 400 mcg Folic Acid, sugar-coated, pink colour                                                                                                                                                                                                 |
| School going adolescent girls and boys, 10-19 years of age and Out of school adolescent | • Weekly, 1 Iron and Folic Acid tablet • Each tablet containing 60 mg elemental iron + 500 mcg Folic Acid, sugar-coated, blue colour                                                                                                                                                                                                 |
| Women of reproductive age (non-pregnant, non-lactating) 20-49 years                     | • Weekly, 1 Iron and Folic Acid tablet • Each tablet containing 60 mg elemental Iron + 500 mcg Folic Acid, sugar-coated, red colour • All women in the reproductive age group in the pre-conception period and upto the first trimester of the pregnancy are advised to have 400 mcg of Folic Acid tablets, daily                    |
| Pregnant women and lactating mothers (0-6 months child)                                 | • Daily, 1 Iron and Folic Acid tablet starting from the fourth month of pregnancy (that is from the second trimester), continued throughout pregnancy (minimum 180 days during pregnancy) and to be continued for 180 days, post-partum • Each tablet containing 60 mg elemental Iron + 500 mcg Folic Acid, sugar-coated, red colour |

## ii. Periodic deworming

-  MoHFW  is  implementing  National  Deworming  Day  (NDD)  programme  under which biannual mass deworming for children and adolescents in age group 1-19 years is carried on designated dates - 10 th February and 10 th August every year
-  Pregnant  women  are  provided  services  under  the  strategy  through  antenatal  care contacts (ANC clinics/ VHND) for deworming (in the second trimester)
- iii. Intensified year-round Behaviour  Change  Communication  (BCC)  Campaign  for compliance  to  IFA  and  deworming;  Appropriate  Infant  and  Young  Child  Feeding (IYCF);  Increase  intake  of  iron-rich,  protein-rich  and  vitamin  C-rich  foods;  dietary diversification
- iv. Testing and Treatment of anemia using digital methods (Digital Invasive Haemoglobinometer) in field settings, Sub Health Centres, Health and Wellness Centres; and Semi-auto analyzer in health facilities PHC and above; and point of care treatment. Anaemia Management protocols to be followed are mentioned in Operational Guidelines for Anaemia Mukt Bharat
- v. Management of severe anaemia in pregnant women by administration of IV Iron Sucrose/ Blood transfusion
- vi. Providing incentives to ASHA for identification and follow-up of high risk pregnancies including severe anaemia in pregnant women
- vii. Provision of IFA fortified food in government funded public health programmes
- viii. Addressing non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
- ix. Strengthening supply chain management of Iron and Folic Acid supplements
- x. Convergence and coordination with other line departments and ministries for strengthening implementation
- xi. National Centre of Excellence and Advanced Research on Anaemia Control (NCEARA)  at  AIIMS,  Delhi  engaged  in  capacity  building  of  health  care  providers  and development of training toolkit.

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