Reducing and preventing iron deficiency anaemia
Iron deficiency anaemia arises when a person's diet lacks adequate iron, leading to serious health complications.
Problem
Solution
Evidence
In India, this condition is a pervasive public health crisis, affecting over 52% of pregnant women and 67% of young children.
Severe long-term impacts include impaired cognitive and physical development, poor reproductive outcomes, a higher risk of depression, and diminished work capacity.
This widespread micronutrient deficiency not only harms the lives of children and pregnant women but also affects economic progress in the long term.
Although India is making strong strides toward achieving the zero-dose goal set by the Immunization Agenda 2030, millions of children in India still do not receive their vaccinations.
Our country suffers the death of one child every four minutes as a result.
The significant number of preventable diseases and deaths persist despite India’s early contributions to vaccine research and development, its current position as a leading global producer of vaccines, and significant progress in strengthening vaccine supply over recent years due to government investment.
The high number of unvaccinated children can be attributed to a range of factors, including socio-economic disparities and cultural beliefs that might hinder vaccine acceptance.
One effective approach to addressing some of these challenges is a combination of targeted communication strategies and active community engagement, both of which are crucial for building trust and combating misinformation within communities.
Specifically:
Caregivers receive SMS notifications and voice calls about upcoming opportunities to have their children vaccinated.
Local immunisation ambassadors are enlisted who receive one text message and one voice call every month asking them to remind their friends, family, and other community members of the value of immunisation.
A large-scale randomised controlled trial was conducted to identify interventions that lead to uptake in vaccination rates. The effort was led by a team from MIT's Abdul Latif Jameel Poverty Action Lab (J-PAL), including two recent Nobel laureates, Esther Duflo and Abhijit Banerjee.
The study was conducted in Haryana, which has one of the lowest immunisation rates in the country, at around 39%.
Testing various solutions, they found that a combination of immunisation ambassadors and SMS reminders increased the number of children going to government-run immunisation camps by 25% and was more cost-effective than other interventions tested. Many other studies have also proved the efficacy of SMS interventions in increasing uptake in vaccine adoption.
One promising strategy for preventing or reducing iron deficiency anaemia is through food fortification. This approach involves enriching staple foods—such as rice, milk, edible oil, salt, and flour—with essential micronutrients to combat iron deficiency anaemia on a large scale.
Extensive research has shown that fortifying wheat flour, in particular, can significantly lower rates of iron deficiency anaemia.
These studies highlight remarkable improvements in haemoglobin levels and overall health among populations that consume fortified flour regularly.
Additionally, fortification is proven to be:
Highly cost-effective, as adding micronutrients to food is inexpensive.
Scalable, as fortification can be seamlessly integrated by existing food producers and distributors without requiring consumers to make significant changes to their eating habits.
In India, the government has long championed this approach, beginning with the iodisation of salt in the early 1960s. The central government actively promotes fortification across states, encouraging its integration into safety-net programs and urging open-market manufacturers to fortify their products, ensuring broader access to nutrient-rich foods.
Numerous studies demonstrate the impact of fortification. Fortification is recognised as one of the most cost-effective public health measures by the World Health Assembly.
In a resolution adopted in May 2023, delegates at the World Health Assembly described large-scale food fortification as
‘a powerful, evidence-informed and cost-effective intervention to fight the consequences of vitamin and mineral deficiencies’.
In India, an RCT in 2012 found that food fortification reduced iron deficiency rates among students from 62% to 21%.
A global meta-analysis of several studies from 2021 found that consumption of iron-fortified wheat flour reduced rates of anaemia by 27%, and prior studies have indicated rates as high as 41%.
There is moderate evidence that strategies to reduce anaemia through fortification have resulted in an increase in IQ points in primary-age school children.
Non-profit partner
Impactful Giving partners with Fortify Health, a non-profit organisation committed to combating iron deficiency anaemia in India.
Fortify Health enables the fortification of wheat flour (chakki atta) with essential micronutrients like iron, folic acid, and Vitamin B12—recognised to be a highly cost-effective and evidence-based solution to combating anaemia. Read more about Fortify Health here.
Reducing and preventing Iron deficiency anemia
Cost to support fortified chakki atta for an individual: Less than INR 50 ($0.60)
INR 5000 : Support fortified chakki atta for 100 individuals
INR 10,000 : Support fortified chakki atta for 200 individuals
INR 25,000 : Support fortified chakki atta for 500 individuals
Frequency
One time
Amount
₹5,000.00
₹12,500.00
₹20,000.00
Other
0/100
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