1. Hari Dev JJ

2. WHO DEFINITION
• A condition in which the haemoglobin content
of blood is lower than normal as a result of
deficiency of one or more essential nutrients
regardless of the cause of such deficiency

3. WHO cut off points for diagnosis of
Nutritional Anemia
Haemoglobin [ g/dl] MCHC [ per cent]
Adult males 13 34
Adult females, non 12 34
pregnant
Adult females , pregnant 11 34
Children, 6 months to 6 11 34
years
Children, 6-14 years 12 34

4. Causes of Anaemia
• Most frequent cause – Iron deficiency
other causes - Folate deficiency
Vitamin B12 deficiency
• Groups mainly affected
 Women of child bearing age [ 4-12 percent in
India ]
 Young children
 During pregnancy [ 2/3 of pregnant woman and ½ of
non pregnant woman in developing countries]
 During lactation

5. • Prevalence of anaemia in adolescent girls is
very high [ 72.6%]

6. PATHOGENESIS
• Inadequate intake
• Poor bioavailability of dietary iron [ impt.]
• Excessive losses of iron from body.
[ menstruation , malaria , hook worm
infestations]
• Megaloblastic anaemia – poor socioeconomic
groups.

7. Detrimental Effects
• During pregnancy- abortions, premature births, PPH,
LBW babies, increased maternal and foetal mortality
and morbidity.
• Infection - can be caused or be aggravated by
diseases, increase susceptibility to infection
• Work capacity – great reduction in work
performance

8. • Hb Less than 10g/dl – SEVERE – High dose of
iron or blood transfusion. - REFERRAL
• If Hb 10 – 12 g/dl
 Iron and folic acid supplementation
 Iron fortification
 Other strategies

9. 1.Iron and Folic Acid supplementation
National Nutritional Anaemia Prophylaxis Programme
• Launched during 4th five year plan-1970
• Programme is based on daily supplementation
with iron,folic acid –to prevent mild,
moderate cases of anaemia, to double
the quantity if pallor (+)

10. • Beneficiaries – pregnant women , lactating
mothers and children under 12 years
• DOSAGE
1.CHILDREN [ 6m – 5yrs]
• If suspected , screening test done at 6 months,
1 year , 2 years.
• 20mg iron + 100mcg FA X 100 days
• Liquid formulation – 1ml at a time

11. 2. SCHOOL CHILDREN 6 – 10 yrs
• 30mg iron + 250 mcg FA X 100 days
3. ADULT & Adolescents
• 100mg iron + 500 mcg FA X 100 days

12. 4. MOTHERS
• 100mg elemental Fe + 500 mcg FA daily until
2-3 months after the Hb level has returned to
normal.

13. 2.Iron Fortification
• Developed by National Institute of Nutrition,
Hyderabad
• Addition of ferric ortho phoshapte or ferrous
sulphate with sodium bisulphate was enough to
fortify salt with iron.
• When consumed for 12-18 months –
reduce prevalence of anaemia.
• Commercial production since 1985.

14. 3.Other Strategies
• Changing dietary habits
• Control of parasites
• Nutrition education