Anaemia crisis in Indian women- Delaying pregnancy, using toilets can help Higher proportion of Indian women who were pregnant were anaemic in 2016 (50%) when compared to China (32%), Bangladesh (46%), and Nepal (40%), according to data from the World Bank
Improved sanitation facilities and delayed pregnancy in India could reduce the rates of anaemia in pregnant women faster. The prevalence of anaemia in pregnant women in India (50%) is higher than all South Asian nations except Pakistan.A one-year increase in age at pregnancy between 2002-04 and 2012-13, and a 10% reduction in open defecation could each result in a 3.5- to 3.8-percentage point reduction in anaemia in pregnant women, found a March 2018 study published in the journal Public Health Nutrition.Anaemia–low blood haemoglobin levels–which impacts half of Indian women of reproductive age, increases the risk of maternal mortality, infection, preterm delivery, poor foetal and infant health, and puts children at lifelong risk of issues involving cognitive development and physical growth.
“Multisectoral public health policies and programmes that simultaneously target women’s education, early marriage, open defecation and promotion of diets rich in iron and folic acid and low in phytate are likely to have the greatest impact on anaemia reduction among pregnant women,” according to the study, co-authored by Suman Chakrabarti, Nitya George, and Samuel Scott of the International Food Policy and Research Institute (IFPRI), Moutushi Majumder of the Public Health Foundation of India, and Neha Raykar of Oxford Policy Management. Between 2002 and 2012, the duration of the study, anaemia prevalence among pregnant women fell from 82.1% to 66.4%, women got pregnant later, were more educated, and received more antenatal care visits, the study found.But a higher proportion of Indian women who were pregnant were anaemic in 2016 (50%) when compared to China (32%), Bangladesh (46%), and Nepal (40%), according to data from the World Bank. Only Pakistan had a higher rate (51%) of anaemia among pregnant women. The world average is 40.1%.The study, which utilised data from the 2002-04 and 2012-13 District Level Health Surveys (DLHS), and the government’s National Sample Survey (NSS) consumer expenditure surveys from 2004-05 and 2011-12, did not analyse the poorest states of Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Jharkhand, Chhattisgarh and Bihar, where rates of anaemia are among the worst, because of a lack of data. “But the results are likely to hold for these states too,” Chakrabarti, co-author of the study and a senior research analyst at IFPRI, a Washington D.C.-based research organisation, said.In 2015-16, 53.1% of Indian women between the ages of 15 and 49 years who were not pregnant were anaemic, as were 50.3% of pregnant women, according to the fourth National Family Health Survey (NFHS-4). Anaemia, which reduces the capacity of blood to carry oxygen, not only affects the mother and child but also the impacts the woman’s capacity to work, and could have neuropsychological outcomes for the women, the study said.Anaemia resulted in a loss of $22.64 billion (Rs 1.50 lakh crore) to India’s gross domestic product in 2016, more than three times the health budget for 2017-18, IndiaSpend reported in November 2017. Between 2005-06 and 2015-16, the rate of anaemia in women decreased 2.3 percentage points from 55.3% to 53%, according to the NFHS-4. India is not on track to meet the World Health Assembly target of a 50% anaemia reduction among women of reproductive age between 2012 and 2025, the study said.Reduction in open defecation and delayed pregnancy could help improve the rate of reduction.In 2015-16, 48.4% households used what the government calls an ‘improved sanitation facility’–a toilet system which has either a flush to piped sewer system, flush to septic tank, flush to pit latrine, ventilated improved pit (VIP)/biogas latrine, pit latrine with slab, or a twin pit/composting toilet, which is not shared with any other household–compared to 29.1% in 2005-06, according to the NFHS-4.
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