L‚Äčess open defecation key factor in reducing anaemia

By Rohan Gupta

Published on 21, June, 2018

India houses the biggest population of Anaemic people in the World. Around 53% of adult women and 50% of pregnant women are suffering from Anaemia according to the fourth round of India’s National Family Health Survey in 2016. 

But a study by  International Food Policy Research Institute (IFPRI) published in the Public Health Nutrition Journal in 2018, suggests that the prevalence of Anaemia among pregnant women has fallen by 16% points from 2002 to 2012. 

Although this change is commendable, the slow annual rate of Anaemia reduction from 2006 to 2016 coupled with high prevalence numbers is unlikely to meet the World Health Assembly target of a 50% Anaemia reduction among women of reproductive age from 2012 to 2025.

The study, which analysed 446 Indian districts and more than 17,000 pregnant women aged 15-49 years, found three socio-demographic factors which have led to a reduction in Anaemia namely – reduction of open defecation in villages, increased age of pregnancy and better education among women. It was observed that the age of pregnancy rose by an average of 2.2% while rural open defecation saw a 22% decrease form 2002-12. Their impacts on anaemia reduction was a 7% and 9% decrease respectively. 

According to the author Samuel Scott, lead researcher, IFPRI South Asia region,” Women of reproductive age experience a disproportionately large burden of anemia due to menstrual blood losses as well as higher nutrient requirements and increased blood volume during pregnancy.”

The study found some unfavourable trends like 6-7% increase in urbanization over the same decade which could’ve accounted for 1.7% increase in anaemia cases. According to the author Scott, urban migration increases the risk of anaemia in some cases due to unsanitary environmental conditions in urban slums and inadequate consumption of nutrient-rich food as it’s relatively more expensive than villages.

The study also noted a reduction in both iron and phytate supply partly due to lower consumption of rice and wheat. It was observed that if India households meet the recommended intake levels of Iron issued by India’s National Institute of Nutrition, anaemia would be reduced considerably.  A 30mg increase in intake of Iron per capita from 2012 predicts a 30% reduction in Anaemia levels. 

The study suggests that along with the social changes like reduced open defecation, if diets are made richer in folic acid and iron, incidence of anaemia could be reduced to a larger extent and decline will be long-lasting. Anaemia is vital issue as research has shown that anaemia in women could lead to reduced work capacity, increased likelihood of maternal mortality, risk of infection, preterm delivery, and poor fetal and infant health.