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SCENARIO IN INDIA
POSSIBLE INTERVENTIONS
ANEMIA
This is a medical situation in which the concentration of haemoglobin in blood
drops down to abnormally low levels.
Causes
This happens due to deficiency of one or several of the following nutrients: iron,
folic acid and vitamin B12. When compared data wise the anemia cases due to
deficiency of iron is the most widespread in comparison to others. Folic acid
deficiency anemia cases are rare and even rarer are the anemia cases caused
due to deficiency of vitamin B 12. There are other causes like chronic infections,
such as malaria and hereditary hemoglobinopathies.
Out of the above, multiple reasons of anemia can coexist in an individual.
However considering the anemia caused due to nutritional deficiency the most
common case if due to deficiency of iron and hence the report would look at
those cases mainly in the children.
Classification Criteria
As per the criteria set by World Health Organization, the following table shows
the cut off of haemoglobin in blood used to classify people from different age
groups as anaemic.
Overall, girls and boys are about equally likely to be undernourished. Undernutrition is higher in rural areas and is strongly correlated with the level of
maternal education showing a two-fold difference between non-educated
mothers and 10-year and above educated mothers. This may be linked to a
stark difference in access to a nutritious diet and complementary feeding at
6-9 months.
Most children under age three are anemic (79.2%). The prevalence is slightly
higher in rural areas and among non-educated mothers. High prevalence of
anemia may be linked to poor variety of diet, poor hygienic conditions and
limited access to iron supplementation.
effort to expand access to IFA. Three to five ORCs were established in each
Village Development Committee (VDC) depending on the population, leading to a
total of 15,000 ORCs throughout the country. These were run once a month by
maternal and child health workers (MCHWs) and village health workers (VHWs)
from the sub-health post (SHP) and were supplied a kit with basic medications.
Nepal adopted a community-based delivery platform improved supply and
logistics. After careful monitoring it found out the following things:
Much of the problem of low compliance was due not to lack of supplies,
but rather to the limited understanding on the part of health workers
about the importance of iron deficiency.
There had been little attention paid to increasing the awareness of the
target groups about iron deficiency and its prevention, and this resulted in
little or no demand for IFA and other anemia reduction interventions.
A major constraint to success of anemia programs to date had been that
anemia control was considered synonymous with iron supplementation
and did not address other preventable causes of anemia. To be effective
and sustainable, a more comprehensive and integrated approach was
required, with interventions such as de-worming treatment and malaria
prevention included in the overall strategy.
STUNTING
Stunting is a condition of reduced growth rate among human beings. To talk of
figures, more than 62 million children suffer from this condition in India. It exists
when either the height or the weight of a child corresponding to an age is below
the 5th percentile on the reference growth curve, and is mostly prevalent in the
children aged below 5 years. Not only does it restricts physical growth, but also
causes a deficiency in cognitive abilities such as IQ level, and increases the
chances of illnesses like Diabetes and heart strokes at a later stage in life. The
suffering children tend to stay away from social groups and become lethargic.
Almost 48% of Indian children (61 million) with age lesser than five are suffering
from stunting, which translates into the serious fact that 3 out of 10 stunted
children in the World belong from India.
Causes
Initial research suggested that it is mainly caused due to malnutrition since many
families, being poor and large in size, are not able to earn money enough to
nourish their children after birth or during prenatal stage. The lack in nutritional
intake limits the amount of energy available for work and hence children arent
able to perform satisfactorily.
Nutritional interventions have been made in the past to tackle the nourishment
problem but as it turned out, it cant be the sole solution. Off late it has been
found that stunting can even affect well fed children, poor sanitation and hygiene
levels being the causal agents. From studies, it emerged that open defecation,
which is a shabby practice, still exists in most parts of the country and is more
prevalent than any other country in the World. Though construction of public
toilets and awareness campaigns have happened in the past and is further
picking pace, growth in population is negating any such positive effort. Another
reason that affects child nutritional level is the education level of their mothers.
For example, the proportion of underweight children is 63% in case of mothers
who cant read or write in contrast with 43% children with mothers having 10 or
more years of education.
PROGRAMMES UNDERTAKEN TO COUNTER STUNTING
Despite an overall decrease in developing countries, stunting remains a major
public health problem in many of them. Childhood stunting is one of the most
significant impediments to human development, globally affecting approximately
162 million children under the age of 5 years. First, improving optimal
breastfeeding practices is key to ensuring a childs healthy growth and
development.
Program in Brazil
Stunting among children aged under 5 years also dropped from 37.1% in 1974 to
7.1% in 2007. Five key factors have contributed to Brazils successes in
combating malnutrition: