National programmes against anaemia, vitamin A deficiency and IDD
Three national programmes target hidden hunger: Anemia Mukt Bharat (2018), vitamin A prophylaxis (1970) and NIDDCP (NGCP 1962, renamed 1992).
The three programmes at a glance
| Problem | Programme and year | Main strategy |
|---|---|---|
| Nutritional anaemia | National Nutritional Anaemia Prophylaxis Programme (1970); National Iron Plus Initiative (2013); Anemia Mukt Bharat (2018) | IFA for every age group, deworming, testing and treatment, fortified foods, behaviour change |
| Vitamin A deficiency | National prophylaxis programme against nutritional blindness (1970) | Six-monthly vitamin A doses for children 9 months-5 years, with diet and immunisation |
| Iodine deficiency disorders | National Goitre Control Programme (1962), renamed NIDDCP (1992) | Universal salt iodisation, monitoring, education |
Anemia Mukt Bharat: the 6 × 6 × 6 strategy
- Six target groups: children 6-59 months, children 5-9 years, adolescents 10-19 years, women of reproductive age, pregnant women, lactating mothers.
- Six interventions: (1) prophylactic IFA supplementation; (2) periodic deworming; (3) year-round behaviour change communication, including delayed cord clamping; (4) testing and treatment of anaemia with digital point-of-care Hb tests; (5) IFA-fortified foods in government food programmes; (6) tackling non-nutritional causes such as malaria, haemoglobinopathies and fluorosis in endemic areas.
- Six institutional mechanisms: coordination within the health ministry, a national Anemia Mukt Bharat unit, a national centre of excellence on anaemia, convergence with other ministries, a stronger IFA supply chain, and a dashboard and digital portal for monitoring.
- Target set in 2018: lower anaemia by 3 percentage points a year.
IFA supplementation under Anemia Mukt Bharat
| Group | Form and frequency | Iron + folic acid |
|---|---|---|
| Children 6-59 months | IFA syrup, twice a week | 20 mg + 100 µg per 1 mL dose |
| Children 5-9 years | Pink tablet, once a week | 45 mg + 400 µg |
| Adolescents 10-19 years | Blue tablet, once a week | 60 mg + 500 µg |
| Women of reproductive age (not pregnant or lactating) | Red tablet, once a week | 60 mg + 500 µg |
| Pregnant women | Red tablet, daily for 180 days from the second trimester | 60 mg + 500 µg |
| Lactating mothers | Red tablet, daily for 180 days after delivery | 60 mg + 500 µg |
Vitamin A prophylaxis programme
- Started in 1970 to prevent nutritional blindness; now part of child health services under the National Health Mission.
- 1 lakh IU at 9 months with the measles-rubella vaccine; 2 lakh IU at 16-18 months with the booster vaccines, then every 6 months up to 5 years: 9 doses in all.
- Given by mouth with a marked spoon by the ANM or anganwadi worker, often in six-monthly rounds.
- Supported by measles immunisation, breastfeeding, diarrhoea control and promotion of green leafy vegetables and yellow fruits.
NIDDCP: components
- Surveys to find the size of the IDD problem in districts.
- Supply of iodised salt in place of common salt; the sale of non-iodised salt for direct human use is banned.
- Resurveys about every 5 years to measure the impact.
- Laboratory monitoring of salt iodine and urinary iodine; salt-testing kits in the field.
- Health education and publicity, including Global IDD Prevention Day on 21 October.
- Iodised salt must carry at least 30 ppm iodine at production and 15 ppm at the consumer level.
In a school, the nutrition graduate checks that weekly blue IFA tablets are given on a fixed day after a meal, helps organise deworming day, tests the kitchen salt with a kit, and teaches girls why iron and iodine matter.
2 marks: “What is the 6 × 6 × 6 strategy of Anemia Mukt Bharat?” Six target groups, six interventions and six institutional mechanisms to lower anaemia in India (launched 2018).
5 marks: “Write a note on the National Iodine Deficiency Disorders Control Programme.” NGCP 1962 renamed NIDDCP 1992; components: survey, iodised salt, resurvey, laboratory monitoring, education; 30 and 15 ppm; ban on non-iodised salt.
10 marks: “Describe the national programmes for the prevention of anaemia, vitamin A deficiency and iodine deficiency disorders.” Summary table; Anemia Mukt Bharat 6×6×6 with IFA doses and colours; vitamin A schedule; NIDDCP components; problems and the role of nutrition education.
1962 iodine; 1970 iron and vitamin A; 1992 NIDDCP; 2013 NIPI; 2018 Anemia Mukt Bharat. IFA colours: pink for 5-9, blue for 10-19, red for women.