Almost half of the adolescent girls and women of reproductive age in Maharashtra are anemic. Though the government has been trying hard to reduce the percentage of anemic women through schemes like Anemia Free India, most of the women/girls are not aware that free iron tablets are given under this scheme. The doctors stress the more efforts are needed to create awareness about this scheme.
Sarita (name changed), an 18 years old thin girl, has been waiting outside the counselling centre that gives counselling to adolescents under the Rashtriya Kishor Swasthya Yojna at District Hospital in Pune. Sarita, who is in 12th standard at a local college and stays with her family in a one-room home at a slum in Pune, has been visiting the centre for the last three months.
Kanchan Sawant, who is a counselor at the centre, said, “She was 37 kgs three months ago when she first visited her. Basically, she was experiencing palpitations due to anxiety, and she had come to visit a psychiatrist. The Psychiatrist sent her to me after prescribing medicines. After the counselling, I had given her iron tablets to take daily. Now, after three months, she weighs 41 kgs. Her anxiety and weakness have decreased.”
Sarita was unaware that she could get free iron tablets at any government hospital. Sawant said, “Many adolescents who visit me are anemic and referred here by other doctors like physicians, gynecologists and so on. These girls who are from financially backward families are married off early and deliver kids who are also anemic.”
Anemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet the body’s needs. Its symptoms range from weakness, fatigue, dizziness to impaired cognitive development and morbidity among children. Anemia in pregnancy is associated with postpartum hemorrhage, neural tube defects, low weight birth, premature births, stillbirths and maternal deaths. In extreme cases, anemia can even cause death.
As per the National Family Health Survey 2016, in Maharashtra, about 47.9% non-pregnant, 49.3% pregnant, and 485 women of all ages are anemic. And 53.8% kids of (1-59 months) are anemic. As per NFHS, about 26 girls are married off before the age of 18, and around 115 before 21. And 6% have babies before 18 years of age.
Reduction of anemia is an important objective of the Poshan Abhiyan launched in 2018. “Anemia Mukta Bharat” has been designed to comply with the targets of National Nutrition Strategy of NITI Aayog and Poshan Abhiyan. It aims to reduce anemia by 3% among children (0-59 months), adolescent girls (10-19 years) and reproductive age women (20-49 years old) from 2018-22.
Under the scheme, Prophylactic Iron and Folic Acid supplements (60 mg tablets) are given to reproductive-age women, adolescent girls, kids of all ages per week, and daily to pregnant women. In addition, tests and treatment of anemia and a behavior-change communication campaign to increase iron intake through food are also done.
Iron tablets are available in all government hospitals, including primary health centres, with Accredited Social Health Activist (ASHA) and Anganwadi workers (AWW). However, girls/women are hardly aware of this facility and response to the scheme so far has been poor.
Dr Ashish Bharati, Maharashtra State Family Welfare Department, Pune, confirms that the response to the scheme is poor. He says, “We have a centre here at the department. Forget about others, even employees at the department do not show interest to get tablets. We have to force them.”
Sawant underlined the same saying most of the adolescents are not aware that they are anemic and they can get free iron tablets. Though they refused to share the number of beneficiaries at their departments, they confirmed that it is abysmally low. Both stressed need to put more efforts to create awareness about the scheme.