Why Anemia is still a Challenge in Pregnant Women in India?

Abstract

Ab s t r ac t Background: Anemia is a serious global public health problem that particularly affects young children and pregnant women. India ranks 170 out of 180 countries for anemia among women, according to global nutrition survey, 2016. Despite so many government measures and active participation of various NGOs, anemia is still looming large at India’s horizon and the target of eradicating anemia from our country looks more unachievable. Aim and objective: The objective of the present survey was to assess knowledge, attitude, and practice (KAP) of Indian Obstetricians toward anemia and its management in their routine clinical practice, which refers to situation at real-life scenario or daily clinical practice in India. Materials and methods: This was a prospective, cross-sectional, observational, questionnaire-based survey conducted among Indian obstetricians and gynecologists. Total 20 multiple-choice questions (MCQs), on various practical aspects of anemia management, were developed by Safe Motherhood Committee, Federation of Obstetric and Gynecological Societies of India (FOGSI). The data were collected, analyzed, and summarized in frequency and percentage. Results: The knowledge gaps could easily be understood by the practices followed by the participants in the screening and diagnosis of anemia during pregnancy. The frequency of hemoglobin (Hb) estimation done by the participants in the second trimester was about 10% only. Out of the total of 1,974 obstetricians, majority of them (71.9%) did not perform thalassemia screening routinely, whereas only about 28% screen their patients for thalassemia either by Hb electrophoresis or by Mentzer index. Nearly 50% of caregivers are still not routinely performing deworming before initiating the oral iron therapy thus optimal iron response is not achieved in their patients. Conclusion: The present KAP survey highlights that anemia continues to be an important public concern to pregnant women. Majority of obstetricians and gynecologists are adequately working in diagnosis and management of anemia with the need of knowledge and practice upgradation for effective management of anemia. A way forward: Organizing of workshops at all levels of the society, and in all the corners of the country, will thus help in bridging the existing knowledge gaps and correct the faulty practices; thus, improving the health status of pregnant females and ultimately make the World Health Organization (WHO) goal of “Health for All by 2030” achievable.