The irrevocable connection between Anaemia and maternal health

General Studies Paper 2

CONTEXT

• A study conducted on anaemic pregnant women of low-and middle-income countries has found that there is a strong link between anaemia and postpartum haemorrhage, with the risk of death or near miss very high.
• Anaemia and Pregnancy
• Of late anaemia has been in the news in India, what with the government proposing to remove a question on it from the National Family Health Survey (NFHS) and instead do a more elaborate test to determine haemoglobin levels in the blood as part of the Diet and Biomarker (DAB) survey.
• Anaemia has a very strong link with postpartum haemorrhage (excessive vaginal bleeding after delivery), and the risk of death or near miss is very high.
• As per the study, by the WOMAN (World Maternal Antifibrinolytic )-2 trial collaborators, worldwide, more than half a billion women of reproductive age are anaemic.
• Each year, about 70,000 women who give birth die from postpartum haemorrhage, almost all of them in low-and middle-income countries.

BLOOD LOSS AND SHOCK

• There was clear evidence from the study that lower haemoglobin values had a direct relationship with volume blood loss, and clinical postpartum haemorrhage.
• Anaemia reportedly reduces the oxygen- carrying capacity of blood, and therefore, women with anaemia cannot tolerate the same volume of bleeding as healthy women, and become shocked after a smaller volume blood loss.
  • The study also eventually found that a clinical diagnosis of postpartum haemorrhage was highly specific for clinical signs of shock and irrevocably associated with worse maternal function.

PREVENTING ANAEMIA- GOVERNMENT INITIATIVES

• Health is a State subject and the primary responsibility for strengthening health care services including implementation of national programs lies with the respective State/UT government.
• The Ministry of Health and Family Welfare provides financial and technical support to States/UTs under the National Health Mission.
• In 2018, the Government of India launched the Anaemia Mukt Bharat (AMB) strategy with the target to reduce anaemia in the vulnerable age groups such as women, children and adolescents.
• Weekly Iron and Folic Acid Supplementation (WIFS): This Programme is being implemented to meet the challenge of high prevalence and incidence of anaemia amongst adolescent girls and boys.
• Health Management Information System & Mother Child Tracking System: It is being implemented for reporting and tracking the cases of anaemic and severely anaemic pregnant women.
• Universal Screening of Pregnant Women for Anaemia: It is a part of Ante-Natal Care (ANC) and all pregnant women are provided iron and folic acid tablets during their ante- natal visits through the existing network of sub-centres and primary health centres and other health facilities as well as through outreach activities at Village Health & Nutrition Days (VHNDs).
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): It has been launched to focus on conducting special ANC check up on 9th of every month with the help of Medical officers to detect and treat cases of anaemia.

CONCLUSION

• However, the rising levels of anaemia in the country is a source of concern and mandates that any project to bring down anaemia in the country must be on mission mode.
• Any public outreach programme must be mindful of the cultural, social realities and have a sense of the attitudes of the people they are targeting.
• If these factors are not sewn into a public health programme, the outcomes may be far from what was sought or planned.