| Context: Anaemia continues to be a serious public health issue in India, particularly among women of reproductive age. According to the National Family Health Survey-5 (NFHS-5), nearly 57% of Indian women (15-49 years) are anaemic. Despite multiple national-level programs, India struggles to reduce the burden of maternal anaemia, especially when a large proportion of women enter pregnancy with undiagnosed and untreated deficiencies. |
Model Answer:
Anaemia during pregnancy poses severe risks such as preterm delivery, low birth weight, and increased maternal mortality. Current interventions primarily focus on antenatal care, but these measures often come too late. There is now growing recognition that maternal health must begin even before conception. Shifting the focus to preconception care can help address the root causes of maternal anaemia and improve neonatal outcomes.
Limitations of Current Anaemia Prevention Strategies:
- Delayed Detection and Intervention: Anaemia screening usually starts during pregnancy, by which time it is often too late to reverse the impact on maternal and fetal health.
- Over-dependence on Oral Iron-Folic Acid (IFA): Oral IFA remains the backbone of anaemia treatment, yet many women experience poor adherence due to side effects like nausea, constipation, or poor absorption.
- Neglect of Non-Iron Deficiencies Other causes like Vitamin B12 deficiency, thyroid dysfunction, and gestational diabetes are rarely screened or treated early.
- NFHS data suggests 49% of women have B12 deficiency, often misdiagnosed as iron-deficiency anaemia.
- Inadequate Community Involvement: Frontline workers such as ASHAs and Anganwadi workers are not fully empowered to educate or screen women in the preconception phase.
- Limited Use of Effective Interventions: Intravenous Ferric Carboxymaltose (IV FCM), a fast and effective treatment for moderate-severe anaemia, remains underused in India’s public health system.
Potential of a Preconception Health Approach:
- Early Risk Identification: Screening women before pregnancy enables timely detection of anaemia, thyroid imbalances, and nutritional deficiencies.
- Holistic and Individualized Care: Preconception care can tailor interventions—like injectable B12, folate, or iron infusions—for women with poor oral absorption or chronic deficiencies.
- Better Maternal and Neonatal Outcomes Correcting anemia and nutritional imbalances pre-pregnancy improves placental development, oxygen delivery, and reduces risks of low birth weight and cognitive impairments in newborns.
- Strengthening Existing Health Systems Programs like RMNCH+A, POSHAN Abhiyan, and ICDS can be reoriented to include preconception health education and screening.
- Community and Family-Centric Strategies Families play a key role in the health decisions of women; involving them in preconception awareness campaigns can increase uptake.
- Public-Private Partnerships for Advanced Therapies Access to newer therapies such as IV iron, injectable B12, and improved diagnostics can be ensured through partnerships with private health providers and CSR programs.
Conclusion:
Addressing anaemia during pregnancy is a reactive strategy that misses the critical window of opportunity before conception. A shift to proactive, preventive, and preconception-focused care can bring transformational change in maternal and neonatal health outcomes. This approach aligns with India’s broader goals under the National Health Policy 2017 and Sustainable Development Goals (SDG-3).
‘+1’ Value Addition:
- Data Point:
57% of Indian women aged 15–49 are anaemic (NFHS-5).
49% B12 deficiency among Indian women (Lancet study).
- Case Study: Tamil Nadu’s preconception care model includes haemoglobin, thyroid, and diabetes screening for newlyweds.
- Government Initiatives to be Strengthened: Anaemia Mukt Bharat (AMB), RMNCH+A, POSHAN 2.0
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