Lok Sabha Question No. 2482 (UNSTARRED), answered on 2016-03-11
Subject: Anaemia Among Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: POONAMBEN HEMATBHAI MAADAM

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

## LOK SABHA UNSTARRED QUESTION NO. 2482

## TO BE ANSWERED ON 11 TH MARCH, 2016

## ANAEMIA AMONG WOMEN

## 2482. SHRIMATI POONAMBEN MAADAM:

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

(a)  whether  the  Government  is  aware of  the  prevalence  and  determinants  of anaemia  among women in India;

(b) the mechanism put in place by the Government for  rural  women  suffering  from anaemia particularly  for  women  of  the  lower income  groups  and  that  of  women  with low  body  mass index;

(c) whether the Government provide assistance to States/UTs to establish diagnostic clinics for tests and facilitate medication to provide specialised and susta ined treatment of anaemic women and if so, the details thereof; and

(d) the steps taken/proposed to be taken by the Government to spread awareness of such diseases in the country particularly in the rural and tribal areas?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

(a) & (b): As  per  National  Family  Health  Survey  (NFHS) - III  (2005 - 06),  prevalence  of anaemia in women is 55.3%.  State - wise prevalence of anaemia in women of reproductive age group (15 - 49 years) is placed at A nnexure.

The main determinants of anaemia among women are  iron loss during menstruation and post - partum  haemorrhage,  increased  iron  requirement  due  to  tissue,  blood  and  ener requirements during pregnancy, teenage pregnancy, repeated pregnancies with l ess than 2 years interval, poor iron stores from infancy,  insufficient quantity of iron and iron enhanc and  low  bioavailability  of  dietary  iron,  iron  loss  due  to  parasite  load  (e.g.  malaria worms),  Haemoglobinopathies  (Sickle  cell anaemia  and  Thalassemia)  along - with    poor environmental sanitation, unsafe drinking water and inadequate personal hygiene.

The steps taken by Government to prevent and treat anaemia amongst women are as follows

- i. Ministry of Health and Family Welfare in 20 13 launched 'National Iron Plus Initiative' as a comprehensive strategy to combat the public health challenge of Iron Defici Anaemia prevalent across the life cycle. There are age specific interventions wit and Folic Acid Supplementation and Dewo rming for improving the haemoglobin levels and reducing the prevalence of anaemia for all age groups, that is children 6 - 59 months, 5 -10 years, adolescent girls and boys (11 - 19  years), pregnant and lactating women and women in reproductive age group (20 -49 years).
- ii. Universal screening of pregnant women for anaemia is a part of ante - na al care and all pregnant  women  are  provided  iron  and  folic  acid  tablets  during  their  ante - natal  visits through the existing network of sub - centers and primary health centres and other health facilities  as  well  as  through  outreach  activities  at  Village  Health  &  Nutritio (VHNDs).
- iii. Every pregnant woman is given iron and folic acid, after the first trimester, to be tablet daily for 6 months during ante - at l and post - natal period.  Pregnant women, who are found to be clinically anaemic, are given additional tablet for taking two table
- iv. Government of India has given directions to the States for identification and trac severely anaemic cases a t all the sub centres and PHCs for their timely management.
- v. Health and nutrition education through IEC & BCC to promote dietary diversificati inclusion of iron folate rich food as well as food items that promotes iron absorpti
- vi. To  tackle  the problem  of  anemia  due  to  malaria  particularly  in  pregnant  women  and children,  Long  Lasting  Insecticide  Nets  (LLINs)  and  Insecticide  Treated  Bed  N (ITBNs) are being distributed in endemic areas.
- vii. Health  management  information  system  &  Mother  Child  track ing  system  is  being implemented   for reporting the cases of anemic and severely anaemic pregnant women
- viii. MCP Card and Safe Motherhood Booklet is being distributed to the pregnant women fo educating them on dietary diversification and promotion of consump tion  f IFA
- ix. 184 High Priority Districts (HPDs) have been identified and prioritized for Reprodu Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.

( c) : Ministry  of  Health  & Family  welfare  approve  funds  to  the  states  as  per  the  proposa submitted by them in their Annual Project Implementation Plan (PIP). This includes scre and  management  of    Anemia,  including  Haemoglobinopathies  (Sickle  cell  anaemia  and Thalassemia), p rocurement of IFA Tablets and Albendazole for pregnant and lactating women in reproductive age group (20 -49 years), Adolescents girls and boys(11 - 19 years) and children 6 -59 months, 5 - 10 years and any other specific proposal  as per  the State's PIP.

(d): The other steps taken by Government to spread awareness on Anemia in the country are

1. Information, Education and Communication (IEC) material in the form of posters, hoardi wall - writings and audio -visuals have been developed to promote prevention of anaemia .
2. Videos and job - aids  for  nutrition and health education  has also been disseminated to the States/UTs .

## Annexure

| State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   | State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   | State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   | State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   | State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   | State-wise prevalence of anaemia in women of reproductive age group (15-49 years)   |
|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|
| Sr. No.                                                                             | STATES                                                                              | Women 15-49 years who are anaemic (%)                                               | Women 15-49 years who are anaemic (%)                                               | Women 15-49 years who are anaemic (%)                                               | Women 15-49 years who are anaemic (%)                                               |
| Sr. No.                                                                             | STATES                                                                              | (NFHS 3, 2005 -06)                                                                  | NFHS 4 (2015-16)                                                                    | DLHS-4 2012-13)                                                                     | AHS-CAB (2014)                                                                      |
|                                                                                     | All India                                                                           | 55.3                                                                                | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 1                                                                                   | AN Islands                                                                          | NA                                                                                  | 65.8                                                                                | 70.1                                                                                | NA                                                                                  |
| 2                                                                                   | Andhra P.                                                                           | 62.9                                                                                | 60.2                                                                                | 68.1                                                                                | NA                                                                                  |
| 3                                                                                   | Arunachal P.                                                                        | 50.6                                                                                | NA                                                                                  | 56.7                                                                                | NA                                                                                  |
| 4                                                                                   | Assam                                                                               | 69.5                                                                                | NA                                                                                  | NA                                                                                  | 90                                                                                  |
| 5                                                                                   | Bihar                                                                               | 67.4                                                                                | 60.4                                                                                | NA                                                                                  | 87.2                                                                                |
| 6                                                                                   | Chandigarh                                                                          | NA                                                                                  | NA                                                                                  | 47.7                                                                                | NA                                                                                  |
| 7                                                                                   | Chhattisgarh                                                                        | 57.5                                                                                | NA                                                                                  | NA                                                                                  | 76.4                                                                                |
| 8                                                                                   | D N Haveli                                                                          | NA                                                                                  | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 9                                                                                   | Daman & Diu                                                                         | NA                                                                                  | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 10                                                                                  | Delhi                                                                               | 44.3                                                                                | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 11                                                                                  | Goa                                                                                 | 38                                                                                  | 31.4                                                                                | 63.4                                                                                | NA                                                                                  |
| 12                                                                                  | Gujarat                                                                             | 55.3                                                                                | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 13                                                                                  | Haryana                                                                             | 56.1                                                                                | 63.1                                                                                | 57.7                                                                                | NA                                                                                  |
| 14                                                                                  | Himachal P.                                                                         | 43.3                                                                                | NA                                                                                  | 44                                                                                  | NA                                                                                  |
| 15                                                                                  | J & K                                                                               | 52.1                                                                                | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 16                                                                                  | Jharkhand                                                                           | 69.5                                                                                | NA                                                                                  | NA                                                                                  | 83.5                                                                                |
| 17                                                                                  | Karnataka                                                                           | 51.5                                                                                | 44.8                                                                                | 62.5                                                                                | NA                                                                                  |
| 18                                                                                  | Kerala                                                                              | 32.8                                                                                | NA                                                                                  | 32.7                                                                                | NA                                                                                  |
| 19                                                                                  | Lakshadweep                                                                         | NA                                                                                  | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 20                                                                                  | Madhya P.                                                                           | 56                                                                                  | 52.4                                                                                | NA                                                                                  | 83.7                                                                                |
| 21                                                                                  | Maharashtra                                                                         | 48.4                                                                                | 48                                                                                  | 65.3                                                                                | NA                                                                                  |
| 22                                                                                  | Manipur                                                                             | 35.7                                                                                | 26.4                                                                                | 65.3                                                                                | NA                                                                                  |
| 23                                                                                  | Meghalaya                                                                           | 47.2                                                                                | 56.5                                                                                | 53.9                                                                                | NA                                                                                  |
| 24                                                                                  | Mizoram                                                                             | 38.6                                                                                | NA                                                                                  | 64.1                                                                                | NA                                                                                  |
| 25                                                                                  | Nagaland                                                                            | NA                                                                                  | NA                                                                                  | 50.2                                                                                | NA                                                                                  |
| 26                                                                                  | Odisha                                                                              | 61.2                                                                                | NA                                                                                  | NA                                                                                  | 77.7                                                                                |
| 27                                                                                  | Puducherry                                                                          | NA                                                                                  | 53.4                                                                                | 52.2                                                                                | NA                                                                                  |
| 28                                                                                  | Punjab                                                                              | 38                                                                                  | NA                                                                                  | 52.7                                                                                | NA                                                                                  |
| 29                                                                                  | Rajasthan                                                                           | 53.1                                                                                | NA                                                                                  | NA                                                                                  | 82.6                                                                                |
| 30                                                                                  | Sikkim                                                                              | 60                                                                                  | 35.2                                                                                | 70.6                                                                                | NA                                                                                  |
| 31                                                                                  | Tamil Nadu                                                                          | 53.2                                                                                | 55.4                                                                                | 49.2                                                                                | NA                                                                                  |
| 32                                                                                  | Telengana                                                                           | NA                                                                                  | 56.9                                                                                | 57.7                                                                                | NA                                                                                  |
| 33                                                                                  | Tripura                                                                             | 65.1                                                                                | 54.5                                                                                | 45.6                                                                                | NA                                                                                  |
| 34                                                                                  | Uttar P.                                                                            | 49.9                                                                                | NA                                                                                  | NA                                                                                  | NA                                                                                  |
| 35                                                                                  | Uttarakhand                                                                         | 55.2                                                                                | 45.1                                                                                | NA                                                                                  | 92.9                                                                                |
| 36                                                                                  | West Bengal                                                                         | 63.2                                                                                | 62.8                                                                                | 76.3                                                                                | NA                                                                                  |