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ANEMIA PROPHYLAXIS   PROGRAMME
Definition♦   Anemia - insufficient Hb to carry out O2 requirement    by tissues.♦   WHO definition : Hb conc. < 11 gm %♦ ...
WHO Classification of AnaemiaDegree        Hb%      Haematocrit (%)Moderate      7-10.9     24-37%Severe        4-6.9     ...
Magnitude of Problem♦   Globally, is about 30 %♦   In developing countries &    India, incidence is around    40 – 90%.♦  ...
Reason For Increased             Incidence Of Anemia♦   Poor pre-pregnancy iron balance due to –    untreated systemic dis...
Reason For Increased               Incidence Of Anemia♦   Low socioeconomic status and poor hygiene♦   Chronic malnutritio...
Complications - Pregnancy      IUGR                    CCF                   PIH              INFECTIONIUD          IUH   ...
Complications - Labour                PPHInstrumental               Foetal   delivery     CCF       DistressMATERNAL      ...
Available studies on prevalence of nutritionalanemia in India show that 65% infant andtoddlers, 60% 1-6 years of age, 88% ...
launched in 1970to prevent nutritional anemia in mothers andchildren.1 tablet of iron and folic acid daily for a period...
The Ministry of Health and Family Welfare has revised theguidelines on IFA supplementation related to the NationalNutriti...
For children (6-60 months), ferrous sulphate and folic acid should beprovided in a liquid formulation containing 20 mg el...
 School children, 6-10 year old, and adolescents, 11-18 year olds,should also be included in the National Nutritional Ana...
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Anaemia prophylaxis programme

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Transcript of "Anaemia prophylaxis programme"

  1. 1. ANEMIA PROPHYLAXIS PROGRAMME
  2. 2. Definition♦ Anemia - insufficient Hb to carry out O2 requirement by tissues.♦ WHO definition : Hb conc. < 11 gm %♦ CDC definition : Hb conc. < 11gm % in 1st and 3rd trimesters and < 10.5 gm% in 2nd trimester♦ For developing countries : cut off level suggested is 10 gm %
  3. 3. WHO Classification of AnaemiaDegree Hb% Haematocrit (%)Moderate 7-10.9 24-37%Severe 4-6.9 13-23%Very Severe <4 <13%
  4. 4. Magnitude of Problem♦ Globally, is about 30 %♦ In developing countries & India, incidence is around 40 – 90%.♦ Responsible for 40% of maternal deaths in third world countries.♦ Important cause of direct and indirect maternal deaths
  5. 5. Reason For Increased Incidence Of Anemia♦ Poor pre-pregnancy iron balance due to – untreated systemic diseases & menstrual disorders♦ Improper supplementation of iron in pregnancy ( late registration and poor follow up)♦ Repeated childbearing♦ Lack of awareness and illiteracy
  6. 6. Reason For Increased Incidence Of Anemia♦ Low socioeconomic status and poor hygiene♦ Chronic malnutrition♦ Poor availability of iron due to predominantly veg diet, diet low in calories but rich in phytates. Food and religious taboos♦ GI infections and infestations (e.g. Kala azar, worm infestations)
  7. 7. Complications - Pregnancy IUGR CCF PIH INFECTIONIUD IUH Medical PRETERM Disorder LABOUR
  8. 8. Complications - Labour PPHInstrumental Foetal delivery CCF DistressMATERNAL MorbidityPERINATAL Mortality
  9. 9. Available studies on prevalence of nutritionalanemia in India show that 65% infant andtoddlers, 60% 1-6 years of age, 88% adolescentgirls (3.3% has hemoglobin <7 gm./dl; severeanemia) and 85% pregnant women (9.9%having severe anemia. The prevalence ofanemia was marginally higher in lactatingwomen as compared to pregnancy. Thecommonest is iron deficiency anemia.
  10. 10. launched in 1970to prevent nutritional anemia in mothers andchildren.1 tablet of iron and folic acid daily for a period of100 days.taken up by Maternal and Child Health (MCH),Division of Ministry of Health and Family Welfare.Now it is part of RCH programme.
  11. 11. The Ministry of Health and Family Welfare has revised theguidelines on IFA supplementation related to the NationalNutritional anaemia Prophylaxis programme.The infants between 6-12 months should also be included inthe programme as there is sufficient evidence that irondeficiency affects this age also.Children between 6 months to 60 months should be given20mg elemental iron and 100 mcg folic acid per day per childas this regimen is considered safe and effective.National IMNCI guidelines for this supplementation to befollowed.
  12. 12. For children (6-60 months), ferrous sulphate and folic acid should beprovided in a liquid formulation containing 20 mg elemental iron and100mcg folic acid per ml of the liquid formulation. For safety reason,the liquid formulation should be dispensed in bottles so designed thatonly 1 ml cab be dispensed each time.The current programme recommendations for pregnant and lactatingwomen should be continued.
  13. 13.  School children, 6-10 year old, and adolescents, 11-18 year olds,should also be included in the National Nutritional AnaemiaProphylaxis Programme (NNAPP).Children 6-10 year old will be provided 30 mg elemental iron and250 mcg folic acid per child per day for 100 days in a year.Adolescents, 11-18 years will be supplemented at the same doses andduration as adults. The adolescent girls will be given priority.Multiple channels and strategies are required to address the problemof iron deficiency anaemia. The newer products such as doublefortified salts / sprinkles/ ultra rice and other micro nutrientcandidates or fortified candidates should be explored as an adjunct oralternate supplementation strategy.
  14. 14. THANK YOU
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