The document discusses nutritional anemia, including its definition, causes, effects, and strategies for prevention and treatment according to WHO guidelines. It notes that iron deficiency is the most common cause of anemia, which particularly affects women of childbearing age, young children, pregnant women, and those who are lactating. Prevention strategies highlighted include iron and folic acid supplementation programs, iron fortification of foods like salt, and other measures like nutrition education and parasite control.

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