More than 60% of pregnant women in Rajasthan were given iron folic acid (IFA) tablets to prevent and cure anaemia, but only 17% consumed them, shows a study of data from the state health department and the National Family Health Survey (NFHS).
This means that thousands of IFA tablets were not consumed or were thrown away, health department officials say.
Experts said anaemia in pregnancy is associated with high maternal morbidity, a measure of sickness or disease, and mortality in the state. Persistence anaemia during the second trimester is associated with premature births.
A pregnant woman is said to be anaemic if the amount of haemoglobin in her blood is less than 11 gram per decilitre (gdl).
For increasing the haemoglobin level, pregnant women are given IFA tablets – each tablet containing 100 mg iron with 0.5 mg folic acid – to be taken once daily for 100 days after the first trimester of pregnancy.
According to data from the state health department, in 2015-16, out of 1.9 million pregnant women registered for ante-natal care (healthcare provided to pregnant women during pregnancy), 1.1 million were given IFA tablets at the time of registration at health centres. This was 62.92% of total registrations.
However, according to the NFHS-4 (2015-16), percent of pregnant women who consumed IFA for 100 days or more was a mere 17.3. This is much lower than the national average – In India, 30.3% pregnant women consumed the tablets for 100 days or more.
{{/usCountry}}However, according to the NFHS-4 (2015-16), percent of pregnant women who consumed IFA for 100 days or more was a mere 17.3. This is much lower than the national average – In India, 30.3% pregnant women consumed the tablets for 100 days or more.
{{/usCountry}}Minakshi Singh, a nutrition specialist at Unicef, Rajasthan, said that IFA supplementation is essential for an increase in haemoglobin level in pregnant women.
“Evidence also suggest that birthweight increases due to IFA supplementation and as per the National Institute of Nutrition (NIN), the recommended dietary allowance (RDA) during pregnancy is 14mg additional requirement per day,” she adds.
But data shows that most pregnant women in Rajasthan did not consume these important tablets and continued to be anaemic.
NFHS-4 data shows that 46.6% of pregnant women in reproductive years (15-49) in Rajasthan were anaemic. In India, this figure was 50.3%.
Rajasthan’s director of public health, Dr VK Mathur, says IFA tablets are given to pregnant women when they visit health centres for ANC. “We give them 100 tablets to be taken one each day, but we have seen that many of them don’t take it for 100 days because the supplementation causes constipation, nausea and vomit,” he said.
Dr Mathur said they were trying their best to ensure that all pregnant women take the tablets but concedes that intensive monitoring of IFA consumption was not possible.
“ASHA (accredited social health activists) visit pregnant women and ask them if they were taking the IFA tablets or not but there are chances of women lying to the health workers,” he said.