Look at social, cultural factors to tackle iron deficiency: Experts

The high levels of anaemia and iron deficiency in Karnataka can't be resolved unless socio-cultural factors are considered and a comprehensive approach is taken, experts say.

Children and women in the state are especially affected by anaemia. November 26 is observed as 'international iron deficiency day'.

According to the National Family Health Survey-5 (NFHS 2020-21), 65.5 per cent of children aged 6-59 months in Karnataka are anaemic.

In the 15-49 year age group, around 48 per cent women are anaemic compared to 19 per cent men.

Adolescent girls (in the 15-19 age group) are also severely affected - 49 per cent, compared to 26.5 per cent of adolescent boys with anaemia. Globally, iron deficiency is estimated to be responsible for half of all anaemia cases.

Across all categories, the numbers in NFHS-5 had increased by 1-5 per cent compared to the NFHS-4 survey of 2015-16.

This was despite the Anaemia Mukt Bharat campaign launched under the National Health Mission in 2018, aimed at reducing anaemia prevalence among women and children by 3 per cent annually.

Under the campaign, iron and folic acid supplements are given to vulnerable groups, along with testing and treatment.

The strategy also mentions increasing intake of iron-rich food through diet diversity and quantity, using local resources.

Public health researcher Prasanna Saligram says, "The larger issue is poverty and the lack of food availability. Government campaigns medicalise the issue and look at supplements as a quick-fix, which doesn't work."

He adds that cultural factors such as women eating last in the household and hence, getting lesser nutrients, should also be recognised.

Saligram says anaemia is now recognised as having effects throughout the person's life cycle.

"Anaemia is usually an inter-generational issue. It has serious debilitating effects on children's physical and intellectual growth. Studies show that in the long term, it can cause a host of diseases, including diabetes."

Madhusudhan B V Rao of the Centre for Budget and Policy Studies says the focus of campaigns is still largely on supplements.

"Supplementing nutrition means that the main nutrition source is inadequate, so one needs to assess what's happening there," he says.

Local alternatives

"Nutritional counsellors are needed at the anganwadi level, who understand what local people are eating, what are the nutrition gaps and which of the cheap, local alternatives like gourds and drumsticks are available to bridge the gap. Based on this, supplementary nutrition programmes should be flexible, at least at district level. Currently, decisions are made at the top."

Girls more affected than boys

The comprehensive national nutrition survey of 2016-18 among children found that those aged 1-5 years were the most affected by anaemia in Karnataka - around 35 per cent, compared to around 40 per cent at the national level. Of them, a majority (around 40 per cent) had iron deficiency anaemia.

Across children of all age groups in Karnataka, girls had worse deficiency compared to boys.

The survey found that among children aged 1-9 years, anaemia was more prevalent among those with no diet diversity and those not consuming green, leafy vegetables, eggs and animal source foods. It was also more prevalent among poor, rural households and SC/ST groups.