Problem Identification
- High prevalence of anaemia: Over 57% of women of reproductive age in India suffer from undiagnosed anaemia.
- Symptoms ignored: Fatigue, dizziness, and weakness are often dismissed as routine.
- Critical timing: By the time pregnancy begins, many women already have dangerously low haemoglobin levels.
Relevance : GS 2(Health)
Consequences of Anaemia at Conception
- Increased risk of:
- Preterm birth
- Low birth weight
- Maternal complications: e.g., pre-eclampsia, post-partum hemorrhage
- Reduced iron transfer to fetus → infant anaemia
- Maternal and perinatal morbidity and mortality increases
Need for a Paradigm Shift
- Current maternal health efforts are focused during pregnancy.
- For long-term improvement:
- Shift to preconception care
- Focus on woman’s health before conception
- Ask not just “Are you ready for motherhood?” but “Is your body ready for pregnancy?”
Limitations of Current Anaemia Management
- Oral Iron-Folic Acid (IFA) is the standard, but:
- Side effects: nausea, diarrhea, constipation
- Poor absorption, especially in chronic anaemia
- Low adherence in women
- Oral iron’s effectiveness is reduced due to Hepcidin-regulated absorption
Suggested Interventions
- Intravenous Ferric Carboxymaltose (IV FCM):
- Rapid restoration of haemoglobin and iron stores
- Not affected by Hepcidin
- Suitable for moderate to severe anaemia
- Vitamin B12 and Folate injection:
- 49% women have B12 deficiency
- Essential for RBC formation and neurological development
- Oral iron alone is insufficient without addressing B12
- Thyroid and blood sugar screening:
- Undiagnosed hypothyroidism/hyperthyroidism can mask or worsen anaemia
- Gestational diabetes often detected late → risks to fetal health
Community & Policy-Level Actions
- Community awareness:
- Involve families to promote preconception check-ups
- Grassroots healthcare workers:
- ASHAs and Anganwadi workers should integrate preconception education in maternal health programs
- Normalize preconception check-ups:
- Treat as essential as antenatal care
Policy Recommendations
- Expand interventions:
- Broaden IV FCM usage
- Combine B12, folate, and iron injectables
- Improve oral IFA strategies:
- Rethink dosing patterns (alternate day, twice weekly)
- Make preconception care routine and institutionalised
Long-Term Vision
- Addressing anaemia before pregnancy is key to:
- Healthier mothers
- Smarter, healthier future generations
- Maternal health is a societal imperative, not just a medical concern
Conclusion
- No woman should begin pregnancy anaemic.
- Preconception health care must become standard, urgent, and transformative.
- Action is not optional — it’s essential for national health and development.
