Surveillance of Anaemia: Mapping and Grading the High Risk Territories and Populations

Surveillance of anaemia is an ongoing process for assessing iron status and anaemia prevalence among individuals and the communities they live in. Measuring blood haemoglobin levels is the commonest method espoused worldwide for screening individuals and populations for anaemia and iron deficiency. World Health Organization (WHO) proposed a classification of public health significance of anaemia in populations on the basis of prevalence estimated from blood levels of haemoglobin. India falls under "Severe public health problem" category. An attempt has been made to categorise "Severe public health problem" into grades of severity that will help in prioritising the states and districts for targeted action. To adapt the "WHO Classification of anaemia as a problem of public health significance" and to use the same to identify and map high risk population groups in the southern states of India. The category of 'Severe Public Health Problem' has been graded based on prevalence of anaemia. Secondary data published in the District Level Household and Facility Survey - 4 is analysed for five states and 1 UT (Union Territory) of southern part of India. Choropleth Mapping was done to visually depict the intensity of anaemia problem across the geographic territories. Children from 6 months to 59 months were having highest prevalence of both, anaemia (68%) and severe anaemia (10%). This was followed by pregnant women aged 15 to 49 years and Girl Child 6 to 9 years. Four of the Southern states of India including Andhra Pradesh, Karnataka, Telangana and Tamil Nadu fall in the Grade 2 SPHP (Severe Public Health Problem). The sixteen districts fall under Grade 3 Severe Public Health Problem in the states of Andhra Pradesh, Karnataka and Telangana, require special focus for identifying and addressing the determinants of such high prevalence of Anaemia. These populations and territories require priority in the Government of India's Rashtriya Bal Swasthya Karyakram (RBSK) in the National Health Mission to address iron deficiency anaemia. The problem needs to be addressed through dietary diversification and improved access to foods that have high levels of bioavailable iron, including animal products apart from iron supplementation.