Joined up approach to tackling anaemia and iron deficiency is needed in South East Asia

By Nathan Gray

- Last updated on GMT

Joined up approach to tackling anaemia and iron deficiency is needed in South East Asia

Related tags East asia Southeast asia

A renewed focus on multiple short term and long term strategies is needed to battle the high prevalence of iron deficiency and anaemia in South East Asia, research warns.

The study, published in Current Medicine Research and Practice,​ despite the large number of anaemic children live in South East Asian countries, the impact of interventions till date has been varied and unsatisfactory as the prevalence has either increased or shown marginal improvements in these countries.

According to study author, Atul Kotwal from from ACMS and the Indian Armed Forces Medical Services, a concerted effort towards prevention and control is now needed.

“It is time that iron deficiency anaemia is tackled by appropriate interventions utilising various strategies, delivered through an efficient system while ensuring availability, accessibility, affordability and acceptability of interventions,”​ he wrote.

A global problem in SEA

Iron deficiency is the most common nutritional disorder in the world, and affects a large number of children and women in developing countries. However, it is also significantly prevalent in many developed countries. 

According to Kotwal, over 30% of the global population – “a staggering 2 billion people”​ –are anaemic, many due to iron deficiency.

The high prevalence of advanced iron deficiency and anaemia (known as IDA) in the countries of SEA has important economic and health consequences, warned the Indian researcher.

“The association of IDA with physical productivity losses in adults, maternal mortality, preterm labour, low birth weight, and infant mortality are well known,”​ he wrote – adding that in children iron deficiency is known to affect cognitive and motor development and increases susceptibility to infections and overall growth.

Kotwal noted that effective interventions to improve iron status will result in large health benefits and a reduction in the prevalence of iron deficiency among children.

However, such reductions are dependent on well-designed policy and programmes, coupled with efficient and effective implementation, he warned.

“The data clearly show that in SEA countries, except Thailand, there has been little appreciable change in IDA over last few decades,”​ he said – warning that issues of concern include a failure to recognise the causes of IDA; a lack of political commitment; inadequate planning of control programmes; and an inadequate thrust on nutritional solutions such as dietary diversification, nutrition education, and food fortification.

SEA strategy

A mixed policy approach that combines both long and short term strategies could include the promotion of dietary diversification, anthelminthic treatment, mass fortification, home fortification of foods, and provision of supplements, Kotwal noted.

He added that ‘multiple and multi-pronged’ strategies are needed for prevention and control strategies to work. However, he warned that economic, behavioural and programmatic factors impact the effectiveness of such interventions at mass scale.

Media campaigns, legislation for successful implementation of fortification and supplementation programs, promotion of dietary diversification, fortification and supplementation are required to tackle the issue of iron deficiency and anaemia among children in SEA countries, he suggested. 

“The need of the hour is immediate action and implementation of several complementary strategies towards enhancing nutritional status of children in SEA countries,”​ warned Kotwal.

“Political will, priority setting and locally effective strategies are required immediately.”

Source: Current Medicine Research and Practice
Volume 6, Issue 3, Pages 117–122, doi: 10.1016/j.cmrp.2016.05.009
“Iron deficiency anaemia among children in South East Asia: Determinants, importance, prevention and control strategies”
Author: Atul Kotwal

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