Coverage of iron and folic acid supplementation in India: progress under the Anemia Mukt Bharat strategy 2017–20

Abstract

High prevalence of anemia is a severe public health problem in India. In 2018, India launched the Anemia Mukt Bharat (AMB) strategy that focuses on six beneficiary groups for coverage, six institutional mechanisms for health system strengthening and six programmatic interventions to accelerate reductions in anemia prevalence. This paper uses the Health Management Information System (HMIS) data (2017–18 to 2019–20) to examine gains in IFA coverage across Indian states. A coverage based AMB index is computed to review performance across states. After the launch of AMB strategy, the IFA supplementation coverage between 2017–18 and 2019–20 has increased for all beneficiary groups (pregnant women from 78% to 90%; lactating mothers from 34% to 49%; school going adolescent girls (boys) from 23% to 40% (21% to 42%); out-of-school adolescent girls from 6% to 23%; children 5–9 years from 8% to 3%; and, children 6–59 months from 7% to 15%). Coverage was relatively low for target groups being served through a multi-departmental convergence mechanism (health and other departments such as education department for schools or women and child development department for anganwadi centres) than compared to those served by health department alone. However, no major gender disparities are noted in the coverage of IFA supplementation among school-going girls and boys. Bulk of the variations in coverage is attributable to state-specific differences. Training and sensitization workshops for state and district officials are found to be associated with increased coverage across beneficiary groups. The paper argues that despite following international best practices in the field it is important to harness synergy in program implementation across line departments to eliminate coverage inefficiencies.

Use of antenatal and delivery care services and their association with maternal and infant mortality in rural India

“…The National Iron Plus Initiative (NIPI) of India recommends that every pregnant woman should consume 100 mg of elemental iron and 500 mcg of folic acid daily for 100 days during pregnancy. Also, the current Anaemia -Mukt Bharat (Anaemia-Free India), a strategy launched in 2018, aims to achieve the targets of POSHAN Abhiyaan (POSHAN: Prime Minister’s Overarching Scheme for Holistic Nutrition Mission), has taken every possible initiative to attain reduction of prevalence of maternal and child anaemia by three percentage points per year 41 . Therefore, finding of this study is consistent with the recommendation of IFA consumption to increase maternal and infant survival.…”

Public health supply chain for iron and folic acid supplementation in India: Status, bottlenecks and an agenda for corrective action under Anemia Mukt Bharat strategy

“…children (6-59 months), adolescent girls (15-19 years), adolescent boys (10-19 years), women of reproductive age (WRA), pregnant women and lactating mothers. The AMB programme for IFA supplementation serves 26 million pregnant women, 13 million lactating mothers, and 73 million school-age children and adolescents (5-19 years) and 17 million children under of 5-69 months [9].…”

Compliance of Iron Supplementation and Determinants among Adolescent Girls: A Systematic Review

“…Randomized controlled trials demonstrated that weekly oral iron and folic acid supplementation was as effective as daily supplementation in iron deficiency anemia patients, with fewer side effects and better compliance ( 6 , 7 ). The administration of iron tablets in adolescence is also beneficial to improve the status of anemia and increase iron stores in the early stages of pregnancy ( 8 ).…”