Why in news?

• Questions related to anaemia are slated to be dropped from the National Family Health Survey (NFHS-6) scheduled to begin on July 6.
• The omission comes after health experts questioned the efficacy of the method being used to estimate haemoglobin levels.

What’s in today’s article?

• National Family Health Survey (NFHS)
• News Summary

National Family Health Survey (NFHS):

• The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
• The first National Family Health Survey (NFHS-1) was conducted in 1992-93. Subsequent NFHS’ were conducted as below –
  • NFHS-2 was conducted in 1998-99
  • NFHS-3 was conducted in 2005-06
  • NFHS-4 was conducted in 2015-16
  • NFHS-5 was conducted in 2019-21
• The main objective of the NFHS has been to provide reliable and comparable data relating to health and family welfare and other emerging areas in India.
• All the rounds of NFHS have been conducted by the International Institute for Population Sciences (IIPS), Mumbai, as the national nodal agency.
• Nodal Ministry: Ministry of Health & Family Welfare

News Summary

Anaemia

• About
  • According to the World Health Organization (WHO), anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal.
  • Haemoglobin is needed to carry oxygen.
  • If there are too few red blood cells, or not enough haemoglobin, there will be a decreased capacity of the blood to carry oxygen to the body’s tissues.
  • This results in symptoms such as fatigue, weakness, dizziness and shortness of breath among others.
• Factors
  • The most common nutritional cause of anaemia is iron deficiency although deficiencies in folate, vitamins B12 and A are also important causes.
  • Certain chronic diseases, such as kidney disease, liver disease, cancer, or autoimmune disorders, can interfere with the production of red blood cells.
  • Inherited conditions, such as sickle cell anemia or thalassemia, affect the structure or function of red blood cells, leading to chronic anemia.

India’s anaemia burden

• India’s anaemia burden has grown alarmingly with NFHS-5 (2019-21) finding that:
  • 57% of women in the age group 15-49 and
  • 67% children between six months and 59 months are anaemic (from the corresponding 53% and 58.6% respectively in NFHS-4 (2015-16)).
• The Health Ministry has noted that anaemia is a public health challenge.

What prompted the change?

• WHO cut-offs for haemoglobin may not be suited to India
  • The WHO defines:
    • anaemia in children aged under five years and pregnant women as a haemoglobin concentration <110 g/L at sea level, and
    • anaemia in non-pregnant women as a haemoglobin concentration <120 g/L.
  • Experts had cautioned that there is a danger of anaemia being over-diagnosed in India as it follows WHO cut-offs for haemoglobin.
  • This may not be suited to India, because the cut-off point depends on the age, gender, physiological status, altitude and other factors.
• Differences in the way blood is drawn for sampling in NFHS
  • Various studies also pointed to differences in the way blood is drawn for sampling in NFHS.
  • The NFHS survey measured haemoglobin in a drop of capillary blood that oozes from a finger prick.
  • This, as per the report, can dilute the blood and give a falsely lower value.
  • The recommended method of venous blood sampling, as per the report, gives a more accurate value.

Shift in assessment of anaemia in India

• According to the Health Ministry, assessment of anaemia in India is being shifted to the new Diet and Biomarkers Survey in India (DABS-I).
• DABS-I was launched in December 2022 to map diet, nutrition and health status and provide the correct estimate of anaemia among the rural and urban population.
• The survey will define food and nutrient adequacy by collecting individual dietary intake data of different age groups of people.
• The study will also provide nutrient composition data on cooked and uncooked foods from various regions of the country for the first time.

Why the focus is on anaemia?

• Data on anaemia remains an important indicator of public health due to following reasons:
  • Impact on morbidity and morality
    • Anaemia is related to morbidity and mortality in the population groups usually considered to be the most vulnerable — pregnant women and children under five.
  • Effect on reproductive health
    • A prevalence study on anaemia is useful to monitor the progress of reproductive health.
  • Impact on economy
    • Also, iron-deficiency anaemia reduces the work capacity of individuals and entire populations, with serious consequences for the economy and national development.