ANAEMIA MUKT BHARAT (AMB)

2. About Anaemia Mukt Bharat (AMB)

Anaemia Mukt Bharat (AMB), launched in 2018 by the Government of India, aims to reduce the prevalence of anaemia among women, children, and adolescents. To Reduce the prevalence of anaemia among all six target groups by 3 percentage points per year between 2018 and 2022. Achieve a national prevalence of anaemia below 5% by 2030.

2.1. The key features of Anaemia Mukt Bharat (AMB)

Target Beneficiaries

Interventions

1. Iron and folic acid supplementation: Biweekly 1 ml syrup for children, weekly tablets for adolescents and adults.
2. Intensified Behaviour Change Communication (BCC): Raising awareness about anaemia, its causes, and preventive measures.
3. Dietary diversification: Promoting consumption of iron-rich foods and micronutrient-rich fruits and vegetables.
4. Deworming: Addressing intestinal worm infections that can contribute to anaemia.
5. Management of pregnant women: Early registration, antenatal checkups, iron and folic acid supplementation, nutritional counselling.
6. Testing and Treatment: Early diagnosis and management of anaemia through haemoglobin testing and treatment with iron-folic acid or other appropriate interventions.

Institutional Mechanisms

1. Mission Convergence: Collaboration between various ministries and departments.
2. Convergence at the State and District Level: Coordinating efforts through State Nutrition Missions and District Nutrition Action Plans.
3. Strengthening Community Participation: Engaging local communities through Anganwadi workers, ASHAs, and others.
4. Monitoring and Evaluation: Regular data collection and analysis to track progress and identify areas for improvement.
5. Capacity Building: Training healthcare workers and other stakeholders on anaemia prevention and management.
6. Innovation and Technology: Utilizing technology for data management, communication, and monitoring.

• The program follows a "6X6X6" strategy, targeting six beneficiary groups with six interventions through six institutional mechanisms.
• AMB focuses on a life cycle approach, addressing anaemia across different stages of life from childhood to adulthood.
• The program prioritises prevention through preventive IFA supplementation and behaviour change communication.
• AMB aims to reduce the prevalence of anaemia by 3 percentage points per year across target groups.
• The program allows for customisation of interventions based on local needs and contexts.
• AMB encourages community involvement in program implementation and monitoring.
• The program utilises digital tools for data collection, monitoring, and communication.

2.2. Challenges faced by Anaemia Mukt Bharat (AMB)

Despite its comprehensive approach, Anaemia Mukt Bharat (AMB) faces various challenges in achieving its goals. 

Implementation

• Shortages of healthcare workers, especially in rural areas, can hinder program implementation and access to services.
• Ensuring regular and timely availability of iron-folic acid supplements and other essential supplies across the country remains a challenge.
• Lack of awareness and active participation from communities can hinder behaviour change and the adoption of preventive measures.
• Seamless integration of AMB with existing health initiatives like Anganwadi services and National Health Mission programs is crucial for optimal impact.

Programmatic challenges

• AMB primarily focuses on nutritional interventions but needs to address other causes like malaria, parasitic infections, and hemoglobinopathies.
• Ensuring adherence to iron-folic acid supplementation schedules among beneficiaries can be difficult due to various factors.
• Promoting consumption of iron-rich and micronutrient-rich foods requires tackling affordability, accessibility, and cultural preferences.
• Ensuring accurate and timely data collection and analysis is crucial for tracking progress and identifying gaps.

Sustainability and long-term impact

• The program relies heavily on government funding and ensuring long-term financial sustainability is critical.
• Factors like poverty, sanitation, and lack of education can contribute to anaemia and require broader interventions.
• Continuous training and capacity building of healthcare workers and community leaders are essential for sustained program effectiveness.
• Collaboration with private sector players and civil society organizations can leverage additional resources and expertise.

3. What is wasting and stunting?

Wasting and stunting are terminologies used in the context of child malnutrition and growth assessment. They refer to different forms of undernutrition and indicate distinct aspects of a child's nutritional status.

Wasting

• Wasting is a form of acute malnutrition characterized by rapid weight loss or a failure to gain weight at the expected rate for a child's age.
• It is typically assessed by measuring a child's weight about their height. A child is considered wasted if their weight-for-height is significantly below the established standards.
• Wasting is indicative of recent and severe nutritional deficiency, often resulting from acute food shortage, illness, or other factors leading to a rapid decline in nutritional status.
• Wasted children are at an increased risk of mortality and are generally more susceptible to infections and illnesses due to the compromised immune system.

Stunting

• Stunting is a form of chronic malnutrition characterized by impaired growth and development resulting in short stature for a child's age.
• It is assessed by comparing a child's height to the established height-for-age standards. A child is considered stunted if their height-for-age is significantly below the reference values.
• Stunting reflects long-term nutritional deprivation, often starting in utero or during the early years of life. It is an indicator of persistent inadequate nutrition and chronic health issues.
• Stunted children may experience cognitive and developmental delays, reduced physical capabilities, and increased susceptibility to various health problems. Stunting is associated with long-term consequences that can affect the individual's well-being into adulthood.

4. What are the Various forms of malnutrition?

Malnutrition is a condition that results from an inadequate or imbalanced intake of nutrients, leading to health problems. There are several forms of malnutrition, each with its specific characteristics. The major forms of malnutrition include:

Undernutrition

• Stunting is characterized by impaired growth and development, leading to short stature for a child's age. It indicates chronic malnutrition and is associated with long-term health and developmental issues.
• Wasting involves a rapid weight loss or failure to gain weight at the expected rate for a child's age. It is a sign of acute malnutrition and is associated with increased vulnerability to infections and higher mortality risk.
• Underweight is a composite measure reflecting a child's weight about their age. It considers both stunting and wasting and provides an overall assessment of undernutrition.

Micronutrient Deficiency

• Iron Deficiency Anemia Results from insufficient iron intake, leading to reduced production of haemoglobin and impaired oxygen transport in the blood.
• Vitamin A Deficiency Can cause night blindness, increase susceptibility to infections, and negatively impact vision and immune function.
• Iodine Deficiency Disorder (IDD) is a Lack of iodine can lead to goitre, mental retardation, and other developmental issues.

Overnutrition

Protein-Energy Malnutrition (PEM)

• Kwashiorkor is A type of PEM characterized by protein deficiency, leading to oedema (fluid retention), skin lesions, and impaired growth.
• Marasmus is Another type of PEM characterized by severe energy deficiency, resulting in emaciation, muscle wasting, and overall body weakness.

Eating Disorders

• Anorexia Nervosa involves an extreme fear of gaining weight, leading to self-imposed starvation and excessive weight loss.
• Bulimia Nervosa is characterized by episodes of overeating followed by compensatory behaviours such as vomiting or excessive exercise.

Hidden Hunger

The difference between hunger and nutrition

6. The beneficiaries of the Integrated Child Development Service (ICDS) Scheme

The Integrated Child Development Services (ICDS) Scheme in India primarily targets the holistic development of children under the age of six and pregnant and lactating mothers. The beneficiaries under the ICDS Scheme include:

1. Children (0-6 years): The primary focus of the ICDS is on young children, especially those in the age group of 0 to 6 years. The services aim to provide a package of six services, including supplementary nutrition, immunization, health check-ups, referral services, pre-school non-formal education, and nutrition and health education.
2. Pregnant Women: Pregnant women are among the beneficiaries as the scheme aims to ensure their well-being during pregnancy. This includes providing nutritional support, health check-ups, and awareness of maternal and child health.
3. Lactating Mothers: The ICDS Scheme extends its services to lactating mothers to promote proper nutrition and health during the breastfeeding period. It includes support for the mother's health, nutrition, and breastfeeding practices.
4. Adolescent Girls: Some components of the ICDS Scheme also target adolescent girls, addressing their nutritional needs and providing awareness about health and hygiene.

The ICDS Scheme operates through Anganwadi Centers, which are community-based centres providing these services at the grassroots level. The services offered aim to break the cycle of malnutrition and ensure the overall well-being and development of children in their early years.

7. The Way Forward

Anaemia Mukt Bharat plays a crucial role in addressing anaemia in India. Understanding different forms of malnutrition and its distinction from hunger is essential for promoting healthy eating habits and overall well-being.

Source: The Indian Express