Nation battles anaemia

Medical personnel instruct women how to take folic acid tablets to prevent anaemia. — VNA/VNS Photo Huu Oai

However, it has been shown that supplements of iron and folic acid can prevent the resulting anaemia that causes the problem.

A National Institution of Nutrition (NIN) survey in 2008 indicated that the prevalence of anaemia among pregnant women was 36.5 per cent, non-pregnant women 28.8 per cent and children under five years 29.2 per cent.

The proportion was much higher in the north-west where more than 56 per cent of both expecting mothers and female adolescents had anaemia.

According to NIN, the rates in Viet Nam are moderate compared to many other countries, but it is worrying when the rates rise.

For example, the prevalence of anaemia among pregnant women rose from 33 per cent in 2000 to 36.5 per cent in 2008.

At the same time, the rate among children declined, which the deputy director of NIN's Food and Nutrition Training Centre, Nguyen Do Huy, attributed to the success of the Protein-Energy Malnutrition (PEM) programme during the past 10 years.

Anaemia, however, has been largely ignored by local and national authorities.

"Apart from worsening health conditions and the growth of unhygienic environments, the nation also lacks investment in anaemia prevention," said Huy.

Intervention is proving to be workable in a local context. A Viet Nam story on anaemia prevention in one province was presented as a success at the regional meeting on nutrition in Colombo, Sri Lanka, last week.

With the support of the World Health Organisation (WHO) and Melbourne University, Australia, weekly iron and folic acid supplements and de-worming tablets were distributed to women in the northern mountain province of Yen Bai. The tactic is aimed at reducing anaemia and improving iron stores in women of reproductive age.

In the first phase in 2006, it covered 50,000 women aged 15 to 49 in two districts. In 2008, it was then expanded to 250,000 women throughout the province.

The results were rewarding. In two-and-a-half years, the prevalence of anaemia was reduced from 38 per cent to 19 per cent and hookworm infections dropped from 76 per cent to 22 per cent.

The birth weight of infants rose about 130g higher than before the project started, according to WHO in Viet Nam.

WHO attributed the success to strong involvement from local authorities and residents. The existing health system geared up to provide proper health education and communication methods to the target group.

The director of Yen Bai Province's Centre of Malariology, Parasitology and Entomology, Hoang Ngoc Thu, said the project was extremely good. He said it helped local women improve physical and mental health.

"Apparent signs of fatigue are waning, while birth weight is rising," Thu said.

But as Thu admitted, although residents were eager to take the supplements and tablets weekly, they would not be willing to pay for them once the project ceased.

"It's pretty cheap, merely 800 dong (US$4 cents) per month for a woman," he said. "We tried to persuade them to buy by joking that it was equal to a packet of sweets each month," he said.

"But we failed. They replied that amount of money would be enough to buy salt for the whole family for a month. They don't think that having anaemia is a life and death matter."

Thu added that the province, because it was poor, would be unable to fund a similar project.

Iron deficiencies challenge the whole nation. WHO Western Pacific Regional Office adviser on nutrition, Dr Luca Tommaso Cavalli-Storza, said if the weekly supply of iron and acid folic supplements was developed on a national scale, Viet Nam could eliminate anaemia within 10 years.

Yet, he conceded that financing was the real challenge.

Cavalli-Storza suggested the Government could either buy all the tablets or women could be encouraged to buy them at affordable prices.

WHO's national technical officer for its Maternal and Child and Nutrition Unit, Hoang Thi Bang, suggested the Government could expand finance allocated to existing and successful programmes like PEM to include anaemia prevention.

Huy from NIN said the 2011-20 national nutrition strategy, which had been submitted to the Government for approval, could be the first stone in a plan to lay foundations for anaemia prevention.

But both Huy and Bang agreed that iron supplements were only be a temporary solution. For long-term purposes, food fortification should be intensified.

According to scientists, women develop iron-deficiency anaemia due to inadequate dietary intake and losses through hookworm infection.

This impaired a women's health and productivity and, if present during pregnancy, led to impaired foetal growth, resulting in low birth weight, premature delivery and increased illness in the new-borns' first 28 days. — VNS