NATIONAL IRON PLUS INITIATIVE FOR ANEMIA CONTROL

NATIONAL NUTRITION PROGRAMS – NATIONAL IRON PLUS INITIATIVE FOR ANEMIA CONTROL

• Anemia is a major public health problem in India, especially among children, adolescent girls, pregnant and lactating women.

• According to NFHS-5 data (2019–21), more than 50% of women and children in India are anemic.

• The Government of India launched the National Iron Plus Initiative (NIPI) under the umbrella of the National Health Mission (NHM) to combat iron deficiency anemia.

• NIPI is a comprehensive strategy targeting all age groups through life cycle approach, providing iron and folic acid (IFA) supplementation along with deworming.

DEFINITION OF ANEMIA

• According to WHO, anemia is defined as a hemoglobin concentration below:

  • 11 g/dL in children (6–59 months)

  • 11.5 g/dL in children (5–11 years)

  • 12 g/dL in adolescents and non-pregnant women

  • 11 g/dL in pregnant women

RELEVANCE IN AYURVEDA

• PANDU ROGA in Ayurveda resembles the condition of anemia.

• Pandu is caused by Pitta Prakopa and Rasa Dhatu Kshaya, leading to pallor and weakness.

SANSKRIT REFERENCE – CHARAKA SAMHITA (CHIKITSA STHANA – 16/6)

पाण्डुरोगो नित्यमल्पप्राणो बलास्वेदहरो भवेत्तु।
(Pandu roga always leads to reduced vitality, strength, and sweating.)

OBJECTIVES OF NATIONAL IRON PLUS INITIATIVE (NIPI)

• To prevent and treat iron deficiency anemia across life stages.

• To reduce morbidity and mortality associated with anemia.

• To achieve anemia reduction targets under the POSHAN Abhiyaan and National Health Policy.

TARGET GROUPS AND INTERVENTIONS UNDER NIPI

CHILDREN (6–59 MONTHS)

• IFA syrup (20 mg elemental iron + 100 mcg folic acid) biweekly.

• Deworming twice a year after 12 months of age.

CHILDREN (5–10 YEARS)

• IFA tablet (45 mg elemental iron + 400 mcg folic acid) weekly.

• Deworming biannually.

ADOLESCENTS (10–19 YEARS)

• Weekly IFA supplementation (60 mg elemental iron + 500 mcg folic acid).

• Biannual deworming.

• Health and nutrition education sessions.

PREGNANT AND LACTATING WOMEN

• Daily IFA tablets (60 mg elemental iron + 500 mcg folic acid) for at least 180 days during pregnancy and 180 days postpartum.

• Deworming after first trimester (single dose Albendazole 400 mg).

WOMEN OF REPRODUCTIVE AGE (20–49 YEARS)

• Weekly IFA supplementation (60 mg elemental iron + 500 mcg folic acid).

IMPLEMENTATION MECHANISM

• Implemented by Ministry of Health & Family Welfare through National Health Mission (NHM).

• Convergence with ICDS, Education Department, and Panchayati Raj Institutions.

• Distribution by ASHA, ANMs, Anganwadi Workers, and School Teachers.

• Monitored through Mother and Child Tracking System (MCTS) and Health Management Information System (HMIS).

AYURVEDIC MANAGEMENT OF ANEMIA (PANDU)

SANSKRIT REFERENCE – SUSHRUTA SAMHITA, CHIKITSA STHANA 13/4

पाण्ड्वामयानां विनिपातदोषैः रसक्षयेणैव भवत्युपद्रवः॥
(Pandu occurs due to the vitiation of Doshas and depletion of Rasa Dhatu.)

HERBAL REMEDIES

• Mandura Bhasma, Lauha Bhasma, Punarnava, Amalaki, Triphala, Draksha, Ashwagandha

• Navayasa Churna, Panchamruta Lauha, Dhatri Lauha

• Rasayana therapy to enhance dhatu nourishment.

DIETARY ADVICE IN AYURVEDA & MODERN MEDICINE

• Ayurveda: Emphasizes Pathya Ahara like Dadima, Draksha, Shatavari, Yusha, and Takra.

• Modern nutrition:

  • Iron-rich foods: green leafy vegetables, jaggery, legumes, liver.

  • Vitamin C sources to enhance iron absorption.

  • Avoid tea/coffee around meals to prevent iron absorption inhibition.

BENEFITS OF NIPI

• Promotes life cycle approach to anemia control.

• Ensures early prevention from childhood and adolescence.

• Encourages community participation through local health workers.

• Reduces maternal and infant morbidity and mortality.

• Supports achievement of UN Sustainable Development Goals (SDG-3: Good Health & Well-being).

CHALLENGES IN IMPLEMENTATION

• Poor compliance due to side effects like nausea or constipation.

• Myths and misconceptions around iron supplementation.

• Inadequate training of ground-level health workers.

• Infrequent supply of IFA tablets/syrups.

MODERN COMMUNITY MEDICINE POINTS

• Program aligned with Anemia Mukt Bharat (AMB) strategy – 6x6x6 framework.

• Uses 360-degree communication approach for behavior change.

• Promotes WIFS (Weekly Iron and Folic acid Supplementation) in schools.

• Part of POSHAN Abhiyaan to reduce anemia by 3% annually.

ASHTANGA HRIDAYA (SUTRA STHANA 1/24)

स्वस्थस्य स्वास्थ्य रक्षणं आतुरस्य विकार प्रशमनं च ।
(The goal of Ayurveda is to maintain the health of the healthy and to treat the diseased.)