Introduction

  • Launched September 2018 by Ministry of Health & Family Welfare under POSHAN Abhiyaan
  • National strategy to reduce anemia prevalence by 3 percentage points per annum using life-cycle approach
  • NFHS-5 baseline: 67.1% in children 6–59 months, 59.1% in adolescent girls; major contributor to under-5 morbidity, impaired cognition, reduced school performance
  • Goal: “Anemia-free India” through nutritional + non-nutritional interventions

6×6×6 Strategy

6 Target Groups (Pediatric Focus)

  • Children 6–59 months
  • Children 5–9 years
  • Adolescents 10–19 years (boys & girls)
  • Women of Reproductive Age (15–49 years) – Non-pregnant and non-lactating women.
  • Pregnant Women
  • Lactating Women – Mothers of infants 0–6 months old.

6 Interventions

  • Prophylactic Iron-Folic Acid (IFA) supplementation
  • Periodic deworming (biannual Albendazole)
  • Intensified year-round Behaviour Change Communication (BCC)
  • Test-Treat-Track approach using digital hemoglobinometers
  • Mandatory provision of IFA-fortified foods in public programmes
  • Addressing non-nutritional causes (malaria, haemoglobinopathies, fluorosis)

6 Institutional Mechanisms

  • Intra- & inter-ministerial convergence
  • National AMB Unit + State/District units
  • Supply-chain strengthening & logistics
  • Real-time monitoring through AMB dashboard & ABDM
  • Capacity building of ASHA/ANM/AWW
  • Community ownership & sustained BCC

Age-Specific Prophylactic IFA Supplementation

6–59 months

  • Bi-weekly: 1 ml IFA syrup (20 mg elemental iron + 100 mcg folic acid); auto-dispenser bottle
  • Administered at Anganwadi centres/immunization sessions

5–9 years

  • Weekly: 1 pink sugar-coated IFA tablet (45 mg elemental iron + 400 mcg folic acid)
  • School-based + out-of-school through Junior WIFS

10–19 years

  • Weekly: 1 blue IFA tablet (60 mg elemental iron + 500 mcg folic acid)
  • School Health Programme + RKSK Saathiya sessions

Deworming

  • Biannual Albendazole on National Deworming Days (10 February & 10 August)
  • 6–23 months: ½ tablet (200 mg)
  • ≥24 months to 19 years: 1 tablet (400 mg)
  • Co-administered with IFA for synergistic effect

Screening, Diagnosis & Test-Treat Approach

  • Point-of-care digital hemoglobinometer (HemoCue/TrueHb) at all levels
  • Integrated in RBSK biannual school screening, well-baby visits, immunization, RKSK
  • Classification (WHO): Mild, moderate, severe anemia
  • Mandatory Hb testing before IFA in high-risk children

Management of Anemia (Therapeutic)

  • Mild/Moderate: Therapeutic IFA (double prophylactic dose) + dietary counseling + deworming + 3-month follow-up
  • Severe: Hospital referral, injectable iron (if oral intolerance), blood transfusion if Hb <7 g/dL or cardiac failure; investigate underlying causes (thalassemia screen, stool for occult blood, malaria)
  • Nutritional counseling: Iron-rich foods + vitamin C; avoid tea/milk with meals

Pediatrician’s Role & Integration

  • Routine OPD/IPD screening & early detection
  • Ensure 100% IFA compliance monitoring via ABDM/ABHA-linked records
  • Counsel caregivers on BCC messages, dietary diversity, hygiene
  • Link moderate/severe cases to DEIC (RBSK) for developmental assessment
  • Convergence: RBSK (Deficiencies component), RKSK (adolescent anemia), U-WIN (immunization days), POSHAN Tracker, School Health Programme
  • Private sector: Report to Ni-kshay-like portal; prescribe fortified foods

Monitoring, Recent Developments & Impact (2026)

  • AMB Dashboard + ABDM real-time tracking of IFA coverage & Hb
  • Coverage increased from 35.5% (2018–19) to 57.6% (2022–23); continued rise in 2025–26
  • Pediatrician-led audits in DEIC/SNCU for compliance
  • Outcome: Reduced stunting, improved cognitive scores, lower school absenteeism