Syllabus: GS-II & V: Health

Why in the News?

A recent analysis of NFHS-5 (2019–20) and the HIV & Nutrition Surveillance Reports shows a shocking rise in nutritional anaemia across all age groups in Assam, with some of the highest prevalence in India.

Understanding Nutritional Anaemia 

• Nutritional anaemia refers to low haemoglobin levels caused mainly by deficiency of iron, folic acid, or vitamin B12.
• It reduces the blood’s capacity to carry oxygen, affecting physical and mental performance.
• It is most common among children, adolescents, pregnant women, lactating mothers, and tea garden workers.
  

The Alarming Scenario in Assam (NFHS-5 Data)

Assam’s numbers are higher than the national average, revealing a deep-rooted nutritional crisis:

• 68.4% of children (6–59 months) are anaemic.
• 67% of adolescent girls and 39.6% of adolescent boys (15–19 years).
• 65.9% of all women (15–49 years).
• 54.2% of pregnant women.
• 36% of adult men (15–49 years).
• Higher prevalence is recorded in tea garden districts, reflecting long-standing undernutrition.
  

Why is Anaemia So High in Assam?

1. Poor Dietary Intake

• Low consumption of iron-rich foods (green leafy vegetables, lentils, meat).
• Rising dependence on fast food and processed food.
• Pollution and food adulteration reduce nutritive value.
  

2. Increased Physiological Needs

• Pregnancy, adolescence, and lactation increase demand for iron and folic acid.
  

3. Infections and Absorption Problems

• Hookworm infestation common in rural Assam.
• Poor gut health reduces nutrient absorption.
  

4. Lifestyle and Social Factors

• Urban “fast-food culture”.
• Lack of awareness and stigma around anaemia.
  

Consequences of Nutritional Anaemia

For Children

• Cognitive delay, Poor learning levels and school performance, Low immunity and frequent infections and Stunting and wasting
  

For Adolescents

• Fatigue, Reduced physical capacity, Poor academic performance and Greater risk during future pregnancy (for girls)
  

For Pregnant Women

• Premature delivery, Low birth weight, Maternal mortality and Infant mortality
• Assam already has one of the highest maternal mortality ratios.
  

For the State Economy

• Reduced productivity among adult men and women, Lower per capita income and Higher health expenditure
  

Government Efforts and Gaps

National Anaemia Control Programme & Weekly Iron and Folic Acid Supplementation provide free IFA tablets and syrup, yet:

• Most pregnant women do not receive IFA regularly.
• Only one-third of those who do receive them take them regularly.
• <10% complete the recommended 90+ tablets during pregnancy.
• Poor counselling by frontline workers.
• Low acceptance due to side-effects (gastritis, vomiting, black stool).
  

Way Forward

Strengthening Supplementation

• Ensure uninterrupted supply of IFA tablets and syrups.
• Introduce tastier, side-effect-free formulations for better compliance.

Dietary Diversification

• Promote local, affordable iron-rich foods such as mustard greens, black gram, fish, banana flower and jaggery.
• Encourage inclusion of foods that enhance iron absorption, like lemon and fermented foods.

Food Fortification

• Fortify staples like rice, flour, salt with iron, folic acid and B12.

Addressing Infections

• Regular deworming under National Deworming Day.
• Improve rural sanitation and hand-washing practices.

Strengthening Anganwadi Services

• Provide nutritional support and early screening under POSHAN Abhiyaan.

Awareness and Behaviour Change

• Community campaigns focusing on: menstrual health, adolescent nutrition, maternal nutrition and safe cooking practices.
  

Conclusion

Nutritional anaemia is both a health failure and a development challenge for Assam. Ending this crisis requires a combined strategy of balanced diet, stronger supplementation, sanitation, and community awareness. The State must prioritise anaemia reduction to improve human development and break the intergenerational cycle of malnutrition.

Exam Hook

Key Takeaways

• Assam has one of India’s highest anaemia burdens.
• Iron deficiency anaemia is the most common type.
• NFHS-5 data shows severe prevalence across all age groups.
• IFA compliance is extremely low due to supply issues and side effects.
• Multi-sectoral approach is essential: food fortification, supplementation, deworming, dietary diversification.
  

Mains Question

Q. Nutritional anaemia continues to be a major public health challenge in Assam despite decades of government intervention. Examine the causes and suggest a multi-sectoral strategy for its elimination.

Source