eprintid: 12076
rev_number: 12
eprint_status: archive
userid: 167
dir: disk0/00/01/20/76
datestamp: 2023-05-05 04:31:21
lastmod: 2023-05-05 04:31:21
status_changed: 2023-05-05 04:31:21
type: article
metadata_visibility: show
contact_email: nagaraju.thudumu@icrisat.org
creators_name: Rai, R K
creators_name: Kumar, S S
creators_name: Gupta, S S
creators_name: Parasannanavar, D J
creators_name: Anish, T S N
creators_name: Barik, A
creators_name: Varshney, R K
creators_name: Rajkumar, H
creators_gender: Male
creators_gender: Male
creators_gender: Male
icrisatcreators_name: Gupta, S S
icrisatcreators_name: Varshney, R K
affiliation: Department of Economics, University of Goettingen (Goettingen)
affiliation: Centre for Modern Indian Studies, University of Goettingen (Goettingen)
affiliation: Society for Health and Demographic Surveillance (Suri)
affiliation: Department of Global Health and Population, Harvard T H Chan School of Public Health (Boston)
affiliation: World Vegetable Center, South and Central Asia (Hyderabad)
affiliation: Indian Institute of Liver and Digestive Sciences, Liver Foundation (Kolkata)
affiliation: ICRISAT(Patancheru)
affiliation: National Institute of Nutrition (Hyderabad)
affiliation: Government Medical College Thiruvananthapuram (Thiruvananthapuram)
affiliation: Suri District Hospital (Suri)
affiliation: Murdoch University (Murdoch)
affiliation: National Institute of Nutrition (Hyderabad)
country: Germany
country: India
country: USA
country: Australia
title: Shooting shadows: India’s struggle to reduce the burden of anaemia
ispublished: pub
subjects: s2.17
subjects: s32
divisions: GRP_ACI
full_text_status: public
keywords: Anaemia, Iron deficiency anaemia, Micronutrients, Iron supplements, Food policy
note: This work was supported by the West Bengal State Department
of Health and Family Welfare, India [Memo number: 114-P&B/
HFW-27011/114/2019-NHM SEC], and this research grant was
awarded to R. K. R. and A. B. The funders had no role in the
design or conduct of the study, collection or analysis or interpretation of the data and preparation or review or approval of the manuscript.
R. K. R. conceived and designed the study. R. K. R. performed the analysis and prepared the first draft. S. S. K., S. S. G., D. J. P., T. S. N. A., A. B., R. K. V. and H. R. critically reviewed content and commented on subsequent versions of the manuscript. All authors approved final content presented in the study.
abstract: Despite several efforts by the Government of India, the national burden of anaemia remains high and its growing prevalence (between 2015–2016 and 2019–2021) is concerning to India’s public health system. This article reviews existing food-based and clinical strategies to mitigate the
anaemia burden and why they are premature and insufficient. In a context where multiple anaemia control programmes are in play, this article proposes a threefold strategy for consideration. First, except the Comprehensive National Nutrition Survey, 2016–2018, which measured Hb concentration among children and adolescents aged 1–19 years using venous blood samples, all national surveys use capillary blood samples to determine Hb levels, which could be erroneous. The Indian government should prioritise conducting a nationwide survey for estimating the burden of anaemia and its clinical determinants for all age groups using venous blood samples. Second, without deciding the appropriate dose of Fe needed for an individual, food fortification programmes that are often compounded with layering of other micronutrients could be harmful and further research on this issue is needed. Same is true for the pharmacological intervention of Fe tablet or syrup supplementation programmes, which is given to individuals without assessing its need. In addition, there is a dire need for robust research to understand both the long-term benefit and side effects of Fe supplementation programmes. Third and final, the WHO is in process of reviewing the Hb threshold
for defining anaemia, therefore the introduction of new anaemia control programmes should be restrained.
date: 2022-04-06
date_type: published
publication: British Journal of Nutrition
volume: 129
publisher: CAB International Publishing
pagerange: 416-427
id_number: 10.1017/S0007114522000927
refereed: FALSE
issn: 1475-2662
official_url: https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/shooting-shadows-indias-struggle-to-reduce-the-burden-of-anaemia/C52C0209A5D8794E4C62B449DF5AB0CB
related_url_url: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=%22Shooting+shadows%3A+India%E2%80%99s+struggle+to+reduce+the+burden+of+anaemia%22&btnG=
related_url_type: pub
funders: This work was supported by the West Bengal State Department of Health and Family Welfare, India
citation:   Rai, R K and Kumar, S S and Gupta, S S and Parasannanavar, D J and Anish, T S N and Barik, A and Varshney, R K and Rajkumar, H  (2022) Shooting shadows: India’s struggle to reduce the burden of anaemia.  British Journal of Nutrition, 129.  pp. 416-427.  ISSN 1475-2662     
document_url: http://oar.icrisat.org/12076/1/British%20Journal%20of%20Nutrition_129_416%E2%80%93427_2023.pdf