NATIONAL NUTRITIONAL ANAEMIA PROPHYLAXIS PROGRAMME IN INDIA

DR. MAHESWARI JAIKUMAR

DEFINITION• Nutritional anaemia is a DISEASE

SYNDROME caused by Malnutrition.

• “A condition in which the hemoglobin content of blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency” -WHO

THE PROBLEM WORLD:• Highest prevalence is in developing countries.

• Found more among women of child bearing age, pregnant mothers, lactating women & young children.

• 4% women & 12% children suffer from this problem

INDIA• Iron deficiency anaemia is the most

widespread micronutrient deficiency that affects all age groups.• URBAN-72.2% of children < 3 yrs are

anaemic.• RURAL - 81.2% of children < 3 yrs

are anaemic.

DISRICT LEVEL HEALTH SURVEY 2002-’04

• Prevalence of anaemia among adolescent girls-72.6%.

CAUSES1. Inadequate intake.2. Poor bio availability of dietary iron due

to excessive loss of iron from the body.

3. Menstruation.4. Hook worm infestations.5. Malaria.6. Children born at close intervals.

EFFECTS OF ANAEMIA1. Increases the MMR.2. Abortion & Premature births.3. Post partum haemorrhage.4. LBW.5. Infection.6. Impairment of maximum work capacity.7. A greater significance on the countrie’s

economy

INTERVENTIONS• 1. Estimation of haemoglobin –

degree of anaemia.

• 2. Hb levels 10-12 g/dl (for normal intervention).

• 3. Hb levels < 10g/dl (transfusion)

NNAPP (IV FYP)• The programme is based on daily

supplementation with iron & folic acid tablets to beneficiaries.

• The beneficiaries are “at risk” groups.

AT RISK

1. Pregnant women.

2. Lactating mothers.

3. Children < 12 yrs

ELIGIBILITY CRITERIA• Determined by the Hb levels.

• 10-12g/dl – IFA tablet.

• <10g/dl – the client is referred to the nearest PHC.

DOSAGE MOTHERS:• 1 tab IFA (100 mg of elemental iron

& 0.5 mg folic acid) daily.

• 100 mg elemental iron contains 300mg ferrous sulphate).

• The daily administration should be continued for 2 to 3 Mo.

• Repeated Hb estimation after this is necessary. (3-4 Mo interval).

• The period of supplementation will depend on the response of the beneficiary.

CHILDREN• Screening test may be done – 6 Mo &

1-2 yrs.

• 1 tab IFA (20 mg elemental iron -60 mg ferrous sulphate) and 0.1 mg folic acid.

• The supplementation is given daily

• The treatment is given for 100 days.

• For children 6-60 Mo, ferrous sulphate & folic acid is provided in a liquid formulation.

• 1 ml is dispensed each time.

• School children (6-10 yrs) are provided 30mg elemental iron & 250mcg folic acid /day for 100 days.

• Adolescents are given the same dose & duration as that of adults.

IRON FORTIFICATION• Refers to the addition of ferric ortho

phosphate or ferrous sulphate with sodium bisulphate to edible salt.

• When consumed for 12-18 Mo reduces prevalence of anemia.

• Commercial production of iron fortifies salt was started in 1985.

• Salt is a universally consumed commodity and hence all segments of the society will benefit.

• No special delivery system is required.

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