Anemia, a condition characterized by a decrease in the number of erythrocytes or a hemoglobin concentration below normal values for each specific population, is a significant global public health concern. Anemia mainly affects growing children, pregnant women, and women in the postpartum (puerperal) period. In 2019, it was estimated that around 37% of pregnant women suffered from anemia. Maternal anemia is associated with lower birth weight and an increased risk of maternal mortality.
Despite efforts, anemia rates have shown minimal improvement over the past two decades. Recognizing this issue, ª the 65th World Health Assembly held in Geneva in May 2012 established a global goal to halve the prevalence of anemia in women of reproductive age. The ambitious target aimed for a relative reduction of 5.3% anemia rates per year between 2012 and 2025, with the objective of reducing the number of non-pregnant women with anemia to approximately 230 million. However, progress towards this goal has been unsatisfactory to date, necessitating the implementation of strategies with a different approach.
It is imperative to develop a comprehensive approach involving multiple sectors and actors. Such an approach would outline several key areas of action to enhance coverage and improve the uptake of interventions, leading to four main desired outcomes. The sectors of nutrition and health, food and agriculture, water sanitation, education, social protection, finance, and more, will play pivotal roles in this new approach.
One significant advantage of such an approach is that it addresses the potential root causes of anemia, recognizing that factors including low socioeconomic status, lack of education, poverty, limited access to clean drinking water, and inadequate healthcare services have a profound impact on global health, which can manifest as anemia. Furthermore, it acknowledges that many causes beyond poor nutritional status causes anemia (although this factor remains crucial).
Malnutrition negatively affects cognitive development, school performance, and productivity. Delayed growth (also known as intrauterine growth retardation), iodine and iron deficiencies, combined with insufficient cognitive stimulation, represent several risk factors that prevent an estimated 200 million children from reaching their full potential.
Once the risk factors are understood, interventions can be implemented. Such interventions include: promoting the consumption of specific micronutrients like folate, vitamin B12, vitamin A, iron through supplements and food fortification. Additionally, measures to prevent malaria and helminth infections, promoting planning planning and the use of contraceptive methods, treating gynecological disorders such as heavy menstrual bleeding, avoiding unnecessary cesarean sections, and advocating for delayed clamping of the umbilical cords are other interventions expected to decrease the prevalence of anemia and improve hemoglobin levels.
Another critical aspect involves optimizing delivery services across all healthcare sectors and fostering research, learning, and innovation.
By implementing these actions, the nutritional status of many populations will improve, leading to reduced rates of infection, inflammation, chronic diseases, and gynecological and obstetric disorders like abnormal uterine bleeding. Moreover, these strategies aim to enhance the screening and management of hereditary red blood cell abnormalities.
In adopting a multifaceted approach, communities stand to create a transformative impact on anemia reduction, fostering healthier communities and empowering individuals to reach their full potential.
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ª: Hess SY, Owais A, Jefferds MED, Young MF, Cahill A, Rogers LM. Accelerating action to reduce anemia: Review of causes and risk factors and related data needs. Ann N Y Acad Sci. 2023;1523(1):11-23. doi:10.1111/nyas.14985
Written by Dr. Nestor Ferrer, Ob/Gyn; Edited by Kaitlyn Gosakti