Anaemia in men: Nearly quarter affected

Nearly a quarter of Indian men are victims of anaemia through existing policies focus almost exclusively on women, says a new study exploring uncharted territory.

Based on data from 29 states and seven Union Territories, the study by an international team of public health researchers from Germany, India, South Africa and the USA found that 23% of Indian men have anaemia whereas 5% has moderate or severe anaemia and 0.5% has severe anaemia.

The state-level prevalence varies from 9% in Manipur to 32% in Bihar. Barring Kerala, all southern states – Tamil Nadu, Karnataka, Andhra Pradesh and Telengana have a higher prevalence of severe anaemia than their northern, western and eastern counterparts.

Since the state-wise variations have a complex pattern, simply targeting the poor states with public health interventions like iron and folic acid won't work. For instance, Andhra Pradesh, one of India’s wealthier states, had a higher prevalence of moderate or severe anaemia in men than Bihar, the least wealthy state.

“Our research shows every fourth Indian man, aged 15-49 years have anaemia, but still men aren't included in Health Ministry's Anaemia Mukt Bharat programme,” Ashish Awasthi, one of the team members from the Public Health Foundation of India told DH.

The grass root situation hasn't changed much in the last 15 years as seen from the data collected during the National Family Health Survey-3 between 2005 and 2006. The NFHS-3 report indicates a similar anaemia prevalence of 24% among men

The individual-level predictors like less household wealth, lower education standard, living in rural areas, smoking, consumption of chewing tobacco, underweight were associated with a higher probability of anaemia in men, they reported in The Lancet.

The researchers argue it would make more economic sense to target a couple with medical interventions because district-level and state-level prevalence of anaemia among men correlated strongly with that among women notwithstanding some exceptions.

A Global Burden of Disease study published in September showed 54.4% of Indian women, aged 15-49 years, have the disease. This happened after more than a decade of a government programme to provide iron and folic acid to women in their reproductive age.

“The previous strategy hasn't worked as anaemia continues to be a formidable problem. That's why modified the strategy,” said Vinod Paul, a former professor of paediatrics at All India Institute of Medical Sciences in Delhi and a NITI Ayog member.

The new programme that seeks to reach 450 million beneficiaries by 2022 was launched last year.

“The iron and folic acid supplementation scheme fail in many parts of rural India in the absence of proper counselling. Women stop taking the tablets as the stool colour gets changed and they develop constipation,” a public health official associated with an international funding agency, who is not associated with the study, told DH