Iron supplementation and anaemia in India: necessary, but no longer sufficient
DOI:
https://doi.org/10.56450/JEFI.2025.v3i03.001Abstract
Anaemia in India remains one of the most persistent public health challenges despite decades of iron–folic acid (IFA) supplementation programmes. National policy has appropriately emphasised iron supplementation as the cornerstone of prevention and treatment of iron-deficiency anaemia. However, contemporary national data and biomarker evidence make one conclusion unavoidable: while iron supplementation remains necessary, it is no longer sufficient to achieve meaningful population-level reductions in anaemia. The next phase of India’s strategy must move beyond tablet distribution toward diagnostic precision, targeted therapeutic intensity, and systematic action on non-iron causes.
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References
1. Ministry of Health and Family Welfare (Government of India). National Family Health Survey (NFHS-5) 2019–21: India fact sheet. New Delhi: MoHFW; 2021.
2. Ministry of Health and Family Welfare (Government of India), UNICEF, Population Council. Comprehensive National Nutrition Survey (CNNS) 2016–2018: National report. New Delhi: MoHFW; 2019.
3. Petry N, Olofin I, Hurrell RF, et al. The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries. Nutrients. 2016;8(11):693.
4. Ministry of Health and Family Welfare (Government of India). Guidelines for Control of Iron Deficiency Anaemia. New Delhi: MoHFW; 2013.
5. Finkelstein JL, Cuthbert A, Weeks J, Venkatramanan S, Larvie DY, De-Regil LM, Garcia-Casal MN. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2024 Aug 15;8(8):CD004736.
6. Low MS, Speedy J, Styles CE, De-Regil LM, Pasricha SR. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016 Apr 18;4(4):CD009747.
7. National Health Mission. Anaemia Mukt Bharat strategy. New Delhi: MoHFW; updated 2026.
8. Nicholson L, Axon E, Daru J, Rogozińska E. Effect and safety of intravenous iron compared to oral iron for treatment of iron deficiency anaemia in pregnancy. Cochrane Database Syst Rev. 2024 Dec 9;12(12):CD016136.
9. Ministry of Health and Family Welfare (Government of India). Operational Guidelines on Intravenous Iron Treatment in Pregnant Women and Lactating Mothers. New Delhi: MoHFW; 2025.
10. Wang CY, Babitt JL. Hepcidin regulation in the anemia of inflammation. Curr Opin Hematol. 2016 May;23(3):189-97.
11. Patil SR, Arnold BF, Salvatore AL, Briceno B, Ganguly S, Colford JM Jr, et al. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial. PLoS Med. 2014 Aug 26;11(8):e1001709.
12. Sumedha D, Anita K. Prevalence of beta thalassemia carriers in India: a systematic review and meta-analysis. J Community Genet. 2023 Dec;14(6):527-541.
13. Joe W; Rinju; Patel N, Alambusha R, Kulkarni B, Yadav K, Sethi V. Coverage of iron and folic acid supplementation in India: progress under the Anemia Mukt Bharat strategy 2017-20. Health Policy Plan. 2022 May 12;37(5):597-606.
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