Lok Sabha Question No. 1119 (UNSTARRED), answered on 2022-07-22
Subject: Anemia Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Rajashree Mallick, Vishnu Dutt Sharma

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION Q. No. 1119 TO BE ANSWERED ON 22 nd  JULY 2022

## ANEMIA CASES

## 1119.   SHRIMATI RAJASHREE MALLICK: SHRI VISHNU DATT SHARMA:

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

- (a) whether anemia among women (15-49) has gone up from 53 percent to 57 percent as per the comparative data report under National Family Health Surveys (NFHS-4 to NFHS-5);
- (b) if so, the reasons for the increase in anemia thereof;
- (c) the number of anemic women in the country, State/UT-wise as per NHFS-4 and NHFS-5;
- (d) the details of steps taken/proposed to be taken by the Government to address the problem;
- (e) whether under Anemia Mukt Bharat programme, the Government has ensured at least one antenatal check-up  for  all pregnant  women  in  their  second  or  third  trimester  by a physician/specialist and if so, the details thereof; and
- (f)  whether special emphasis has been placed on early diagnosis, adequate and appropriate management of women with malnutrition, if  so,  the  details  thereof  and  if  not,  the  reasons therefor?

## ANSWER

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

- (a) to (c): The details of the anemic women (15-49 years) in the country, State/UT-wise as per NFHS-IV to NFHS-V is at Annexure-I.

As per the WHO report on Global Prevalence of Anaemia 2011, 50% cases of anaemia are attributed  to  the  iron  deficiency.  Other  causes  of  anaemia  include  other  micronutrient deficiencies  (e.g.  folate,  riboflavin,  Vit-A  and  B-12),  acute  and  chronic  infections  (e.g. malaria,  cancer,  tuberculosis,  parasitic  infections  and  HIV),  and  inherited  or  acquired disorders that affect haemoglobin synthesis (e.g. haemoglobinopathies).

(d) to (f): In 2018, the Government of India has launched the Anaemia Mukt Bharat (AMB) strategy under POSHAN Abhiyaan with the target for reducing anaemia in women, children and  adolescents  in  life  cycle  approach.  The  strategy  aims  to  cover  children  6-59  months, children  5-9  years,  adolescents  10-19  years,  women  of  reproductive  age  (15-49  years), pregnant women and lactating women through newer interventions implemented via robust institutional  mechanisms.  The  details  of  the  steps  taken  by  the  Government  to  address  the problem of anaemia are placed at Annexure II.

The  anaemia  prevalence  among  the  pregnant  women  aged  15-49  years  in  the  country  is 52.2%  (NFHS-5).  Under  National  Health  Mission,  Pradhan  Mantri  Surakshit  Matritva Abhiyan (PMSMA) focusses on comprehensive ANC checkups on 9 th of every month for all pregnant women in their second or third trimester by Medical officers/ Obstetricians/Gynaecologist  to  detect  and  treat  cases  of  anaemia  and  other  high  risk pregnancies.

The Supplementary Nutrition Programme is implemented by Ministry of Women and Child Development,  GoI  for  addressing  malnutrition  in  women  especially  pregnant  women  and lactating mothers.

State/UT wise comparative anaemia prevalence in Women (15-49 years) NFHS-4 v/s NFHS5

| S. No.   | State/ UT         | Women 15-49 years who are anaemic (<12.0 g/dl) (%)   | Women 15-49 years who are anaemic (<12.0 g/dl) (%)   |
|----------|-------------------|------------------------------------------------------|------------------------------------------------------|
| S. No.   | India             | NFHS-5 57.2                                          | NFHS-4 53.1                                          |
| 1        | A&N               | 57.6                                                 | 65.8                                                 |
| 2        | Andhra Pradesh    | 59.0                                                 | 60.2                                                 |
| 3        | Assam             | 66.4                                                 | 46.1                                                 |
| 4        | Bihar             | 63.6                                                 | 60.4                                                 |
| 5        | DNH&DND           | 62.6                                                 | 73.4                                                 |
| 6        | Goa               | 38.9                                                 | 31.4                                                 |
| 7        | Gujarat           | 65.1                                                 | 55.1                                                 |
| 8        | Himachal Pradesh  | 53.4                                                 | 53.6                                                 |
| 9        | Jammu &Kashmir    | 67.3                                                 | 49.0                                                 |
| 10       | Karnataka         | 47.8                                                 | 44.8                                                 |
| 11       | Kerala            | 36.5                                                 | 34.7                                                 |
| 12       | Lakshadweep       | 26.0                                                 | 46.3                                                 |
| 13       | Ladakh            | 93.7                                                 | 78.4                                                 |
| 14       | Maharashtra       | 54.5                                                 | 47.9                                                 |
| 15       | Meghalaya         | 54.4                                                 | 56.4                                                 |
| 16       | Manipur           | 29.3                                                 | 26.4                                                 |
| 17       | Mizoram           | 34.8                                                 | 24.7                                                 |
| 18       | Nagaland          | 29.3                                                 | 27.7                                                 |
| 19       | Sikkim            | 42.1                                                 | 35.2                                                 |
| 20       | Telangana         | 57.8                                                 | 56.9                                                 |
| 21       | Tripura           | 67.4                                                 | 54.5                                                 |
| 22       | West Bengal       | 71.7                                                 | 62.8                                                 |
| 23       | Arunachal Pradesh | 40.8                                                 | 43.5                                                 |
| 24       | Chandigarh        | 60.1                                                 | 75.9                                                 |
| 25       | Chhattisgarh      | 61.2                                                 | 47.3                                                 |
| 26       | NCT of Delhi      | 50.2                                                 | 54.7                                                 |
| 27       | Haryana           | 60.6                                                 | 63.1                                                 |
| 28       | Jharkhand         | 65.7                                                 | 65.3                                                 |
| 29       | Madhya Pradesh    | 54.7                                                 | 52.4                                                 |
| 30       | Odisha            | 64.4                                                 | 51.2                                                 |
| 31       | Punjab            | 58.8                                                 | 54.0                                                 |
| 32       | Puducherry        | 55.5                                                 | 53.4                                                 |
| 33       | Rajasthan         | 54.7                                                 | 46.8                                                 |
| 34       | Tamil Nadu        | 53.6                                                 | 55.4                                                 |
| 35       | Uttar Pradesh     | 50.6                                                 | 52.5                                                 |

## Annexure II

## Details of the steps taken by the Government to address the problem of anaemia include:

- i. Prophylactic Iron and Folic Acid Supplementation in all six target age groups
- ii. Intensified year-round Behaviour Change Communication (BCC) Campaign for: (a) improving  compliance  to  Iron  Folic  Acid  supplementation  and  deworming,  (b) enhancing  appropriate  infant  and  young  child  feeding  practices,  (c)  encouraging increase in  intake  of  iron-rich  food  through  diet  diversity/quantity/frequency  and/or fortified foods with focus on harnessing locally available resources, and (d) ensuring delayed cord clamping after delivery (by 3 minutes) in health facilities
- iii. Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
- iv. Addressing non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
- v. Management of severe anaemia in pregnant women is done by administration of IV Iron Sucrose/Blood transfusion
- vi. Providing incentives to the ANM for identification and follow-up of pregnant women with severe anaemia in high priority districts (HPDs)
- vii. Training  and  orientation  of  Medical  Officers  and  front  line-workers  on  newer Maternal Health and Anaemia Mukt Bharat guidelines
- viii. Awareness by ASHAs through community mobilization activities and IEC and BCC activities.
- ix. Counselling on nutrition, dietary diversification and consumption of 180 IFA tablets in ANC and PNC period each.
- x. Convergence  and  coordination  with  other  line departments  and  ministries for strengthening implementation
- xi. Engaging National Centre of Excellence and Advanced Research on Anaemia Control (NCEAR-A) at AIIMS, Delhi in capacity building of health care providers
- xii. Development of AMB Training Toolkit for capacity building of health care providers in  anaemia  management  and  AMB  e-Training  Modules  are  developed  to  facilitate training  of  the  health  care  providers  through  virtual  platform  amid  COVID  19 pandemic  which  has  posed  a  challenge  in  capacity  building  through  physical trainings.

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