Pediatric anemia in India: Current Scenario, Challenges, and Solutions

Date: 28.01.2021 (Thursday)

Time: 3.00 PM to 5.00 PM

WEBINAR-6 of AMB WEBINAR SERIES

ORGANISED BY- NCEAR-A, PANS

SUMMARY

Ministry of Health and Family Welfare, Government of India, has launched the Anemia Mukt Bharat (AMB) program in 2018 with an ambitious target of three percent annual reduction in the burden of anemia. AMB recognizes research as an important component of the program and established the National Centre of Excellence and Advanced Research on Anemia Control (NCEAR-A) at All India Institute of Medical Sciences (AIIMS), New Delhi, to support the AMB program in incorporating scientific and community perspectives for control of anemia.

An online webinar on “Pediatric Anemia in India: Current scenario, Challenges, and Solutions” was organized under the aegis of Anemia Mukt Bharat (AMB) Webinar Series on 28th January 2021. The webinar was 6th in the series and was co-hosted by NCEAR-A, and Pediatric and Adolescent Nutrition Society (PANS), with an intent to bring together diverse global and national level eminent speakers who have committed themselves to core areas of paediatrics and anemia and simultaneously share their experiences and knowledge on pediatric anemia in India. We hope that deliberations from this event will support the program managers and policymakers in the decision-making for the cause of pediatric anemia under Anemia Mukt Bharat.

The webinar was chaired by Prof. Shashi Kant, Head of the Department, CCM & Lead, NCEAR-A at AIIMS, New Delhi and Dr. Sila Deb, Additional Commissioner, Child Health, and I/C Nutrition, MoHFW, GoI, who was unable to join. Dr. Sant Rayn Pasricha, Associate Professor at Walter and Eliza Hall Institute of Medical Research (WEHI), Australia was the lead speaker of webinar and the sessions were moderated by Dr. Surbhi Gupta from NCEAR-A. The webinar was attended by 140 participants. Agenda for the webinar is annexed.

The welcome address was delivered by Dr. Sanjay Kumar Rai, President, IPHA and Dr. Piyush Gupta, Chairperson PAN Society, President IAP 2021 where they both extended a warm welcome to all the speakers and panellists.

Dr. Pasricha discussed on “Benefits and risks of universal iron supplements and multiple micronutrient powders in infants” emphasised that both Multiple Micronutrient powders and iron supplements reduce anemia and iron deficiency in the immediate and medium term. Second speaker, Dr. A. K. Rawat, spoke on the topic “Impact of anemia in Pediatric age group”. He emphasised that physiological changes in children with anemia depend on duration, severity, onset, and associated comorbid conditions. He highlighted the fact that most anemic children remain asymptomatic and visit nearby health facility when disease reaches the severe state. Third speaker, Ms. Kashish Vohra, discussed ‘Pediatric anemia in NFHS-4, CNNS, and NFHS-5’ and elaborated that there has been a stagnation or increase seen in the anemia prevalence among pediatric age group and to address that we need to shift from a national to state specific approach. The fourth speaker, Dr. Parag Gaikwad, discussed “Pediatric anemia and infections- clinical insight”. He highlighted various infectious and genetic causes of anemia in children and their sequelae. The final speaker for the day was Dr. Preeti Singh shared insights on ‘Newer research areas in pediatric anemia in India’. Dr Singh deliberated on the need to bridge the gap between our desire to control and reduce anemia among children and the challenges toward implementing of an effective program.

Panel discussion of the webinar was focused on Way forward for control of pediatric anemia in India. The chairpersons for the panel were Dr. Ajay Khera, CR, EngenderHealth, India and Dr. Praveen Kumar, Secretary PAN Society. The panel comprised of Dr. Archana Chowdhury, National Program Manager, Newborn Care and IYCN, Nutrition International, Dr. Raghvendra Singh, Associate Professor, MAMC & associated medical institutes, Dr. Vivek Singh, Health specialist, UNICEF, and Dr. William Joe, Assistant Professor, Institute of Economic Growth.

To summarize the panel discussion, appropriate procurement, availability, accessibility for Iron folic acid supplements with uninterrupted supply must be prioritized. States should be pragmatic in planning there needs of IFA and placing the requests. To address non- nutritional causes like Malaria and Tb through various vertical programmes, a synergy is required amongst frontline workers. Children and pregnant women should be screened for hemoglobinopathies on available platforms. Peripheral smear and Complete Blood count will give a better picture in ascertaining the cause behind anemia. Coordination between all the centers of excellence is required. Bringing health, nutrition, and WASH together will go a long way in reducing the pediatric anemia in India. A relook in social and behavior change communication is required in Anemia Mukt Bharat at the peripheral level. Regular monitoring and review is required at different levels. Engaging youth in public campaigning groups is required to bring awareness at a larger level. Based on recently released NFHS-5 state factsheet iron deficiency anemia or pattern of other causes over time is still indecisive. IFA coverage for pediatric age group started at 5% and has now reached up to 20%. States should develop indicators on non-nutritional causes. Focus of the program should be brought on lactating mothers. Anemia Mukt Bharat program has not been able to implement in all the states completely. It should be tracked as immunization program. If IFA supplementation, procurement, Test, treat, talk, and non-nutritional causes are addressed together then pediatric anemia will be reduced.

The closing remarks for the webinar were given by Dr Kapil Yadav, NCEAR-A, CCM, AIIMS, New Delhi. Dr. Yadav thanked all the speakers, IAP, PANS members who had come together on one platform and deliberated on pediatric anemia. He mentioned that with renewed focus on pediatric anemia, IFA coverage will be increased up to 100 % across all the states. However, the focus on iron deficiency should remain as it continues to be the single most important cause of pediatric anemia in India. He focussed to overcoming the hesitancy for iron folic acid supplementation among clinicians. Dr. Yadav finally congratulated Dr. Vani Sethi for convening this group and pushing forward, organisers for a content driven webinar with high scientific temperament.

ANNEXURE

Agenda

Chair: Dr. Shashi Kant, NCEAR-A, CCM, AIIMS, New Delhi, India

Dr. Sila Deb, Additional Commissioner, Child Health, and I/C Nutrition, MoHFW, GoI

Time

Session

Speaker

3:00- 3:10 pm

Welcome address

Dr. Sanjay K. Rai, President, IPHA

Dr. Piyush Gupta, Chairperson PAN Society, President IAP 2021

3:10- 3:30 pm

Lead Speaker:

Benefits and risks of universal iron supplements and multiple micronutrient powders in infants

Dr. Sant Rayn Pasricha, Associate Professor, Walter and Eliza Hall Institute of Medical Research (WEHI), Australia

3:30- 3:45 pm

Impact of anemia in pediatric age group

Dr. A.K. Rawat, Chairperson, PAN

3:45- 4:00 pm

Pediatric anemia in NFHS-4, CNNS, and NFHS-5

Ms. Kashish Vohra, NCEAR-A

4:15- 4:30 pm

Pediatric anemia and infections: a clinical insight

Dr. Parag Gaikwad, Secretary, PAN

4:00- 4:15 pm

Newer research areas in pediatric anemia in India

Dr. Preeti Singh, Treasurer, PAN

4:30- 4:50 pm

Panel discussion:

Way forward for control of

pediatric anemia in India

Chair:Dr. Ajay Khera, CR, EngenderHealth, India

Dr. Praveen Kumar, Secretary PAN Society

Speakers:

Dr. Archana Chowdhury , National Program Manager, Newborn Care and IYCN, Nutrition International

Dr. Raghvendra Singh, Associate Professor, MAMC & associated medical institutes

Dr. Vivek Singh, Health specialist, UNICEF

Dr. William Joe, Assistant Professor, Institute of Economic Growth

4:50- 5:00 pm

Concluding remarks

Dr. Kapil Yadav, NCEAR-A, CCM, AIIMS, New Delhi, India

AMB Webinar on “Pediatric Anemia in India: Current scenario, Challenges, and Solutions”At a Glance

Dr. Shashi Kant chairing AMB webinar

Dr. Piyush Gupta delivering welcome address during AMB webinar.

Dr. Sant Rayn Pasricha presenting on “Benefits and risks of universal iron supplements and multiple micronutrient powders in infants”

Dr. Ajay Khera chairing the panel discussion during AMB webinar.

Dr. Kapil Yadav giving closing remarks during AMB webinar.

Panelists and speakers during the panel discussion AMB webinar

National Centre of Excellence and Advanced Research on Anemia Control (NCEAR-A),

Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi