1. Nutritional anaemia

2. Nutritional anaemia: Who definition: a condition in which the Hb content of the blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency. Iron deficiency is the most frequent cause, less frequently folate or vit.B12

3. Population affected Women of child bearing age Young children During pregnancy and lactation

4. Global Prevalence of Anaemia: Pregnant Women Source: WHO (1999)

5. Global Prevalence of Anaemia: Preschool Children Source: WHO (1999)

6. Proposed New Goal: Reduce by one third the prevalence of anaemia, including iron deficiency, by 2010; and

7. Main Factors Contributing to Anaemia Iron deficiency Poor bioavailability of consumed iron Insufficient dietary iron intake Chronic and recurrent infections that interfere with food intake and absorption/utilization of iron Helminth infections, primarily Hookworm Chronic diarrheal disease HIV Malaria

8. Iron Deficiency Anaemia Global situation. Most common nutritional disorder in the world Lowers resistance to disease and weakens a child's learning ability and physical stamina Significant cause of maternal mortality, increasing the risk of hemorrhage and infection during childbirth. Nearly 2 billion people estimated to be anemic and millions more are iron deficient, the vast majority are women.

9. Causes of iron deficiency anaemia. Inadequate intake Poor bioavailability of dietary iron Excessive loss. Increased demands

10. Detrimental effects. Pregnancy Infection work capacity

11. Iron: In human body. Functions. Sources. Absorption. (Conservation) Iron losses.

12. Requirements of iron: Daily iron needed in mgAge group 0.7Infants(5-12 m) 1.0Children (1-12 y) 1.8 malesAdolescent(13-16 y) 2.4 females. 0.9Adults,males

13. Daily iron needed in mgAge group Adult females 2.8Menstruation 0.8Pregnancy(1 st half) 3.5 (2 nd half) 2.4lactation 0.7Post-menopause Requirements of iron:

14. Stages of iron deficiency: Decreased storage. Latent iron deficiency. Overt iron deficiency.

15. Diagnosis of anaemia: Cut-off points for the diagnosis of anaemia MCHCg/dl (venous) 34%13Adult males 34%12Adult females, non -pregnant 34%11Adult females, pregnant 34%11Children,6m-6years 34%12Children 6 to 14 years

16. Evaluation of iron status: Heamoglobin concentration. Serum iron concentration( less than.5mg/dl) Serum ferritin.(less than 10mcg/l) Serum transferrin saturation (less than 16%)

17. Interventions to Control Anaemia Depends on etiology For iron deficiency: supplementation and fortification For parasitic disease control: appropriate measures for prevention and presumptive treatment

18. Prevention and control: Iron supplementation Iron fortification Other strategies: -changing dietary habits. - control of parasites. - nutrition education. Treatment of severe anaemia.

19. Regular dietary intake of iron and folic rich foods for high risk groups. Health education to mothers attending antenatal and immunization clinics. Incorporation of iron rich food in weaning foods. Promotion of vit. C consumption. Promotion of growing iron rich foods in home gardens. Reduce consumption of tea especially for pregnants. Promoting consumption of iron-rich foods

20. Promoting consumption of iron and folic acid supplements: All pregnant women. Check use of supplements during immunization sessions. For monitoring distribution as well as consumption use mother and infant immunization cards.