Addressing Pediatric Anemia in India: Can the Lack of Operational Evidence be Holding Back Action.
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Date
2015
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Abstract
Objectives: In India, 79% of children less than three years are anemic. Intermittent iron
supplementation, home-fortification with multiple micronutrient powders (MMP), and delayed cord
clamping are scientifically recommended interventions to prevent pediatric anemia. Little is known
about the extent to which these interventions are integrated into programs in India.
Examine to what extent anemia control programs in India incorporate scientific recommendations
and analyze their operational evidence-base.
Methodology: We critically reviewed published (2000-2012) and grey literature, and government
and non-government program documentation.
Results: Published literature on interventions to reduce pediatric anemia in India is scant; there
are six efficacy studies (1-delayed cord clamping; 1-use of MMP; 3- iron supplementation; 1-
fortified milk) and no effectiveness studies. Intermittent iron supplementation delivered by frontline
workers is the only intervention included in government programs. Only 2 of the 22 NGO programs
reviewed provided iron supplements. Little is known about the operational successes and
challenges on the demand and supply-side of the programs and of effectiveness of these
programs. Neither national nor NGO programs include newer interventions such as MNPs or
delayed cord-clamping.
Conclusions: A poor evidence base on challenges and solutions to delivering iron
supplementation in India precludes from strengthening operational strategies for iron
supplementation. Lack of evidence on the efficacy and effectiveness of other recommended
interventions prevents identification of alternate strategies for addressing pediatric anemia in India. A research agenda that focuses on closing these operational and effectiveness knowledge gaps is
essential to make progress towards reducing the burden of anemia in India.
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Avula Rasmi, Menon Purnima, Singh Kavita, Kadiyala Suneetha. Addressing Pediatric Anemia in India: Can the Lack of Operational Evidence be Holding Back Action. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 854-855.