Medical devices

Anaemia prevention and control

Anaemia is the world’s second leading cause of disability and thus one of the most serious global public health problems. Anaemia affects over half of pre-school children and pregnant women in developing countries and at least 30-40% in industrialized countries. In poorer malaria endemic countries anaemia is one of the commonest preventable causes of death in children under 5 years and in pregnant women.

Reducing the burden of anaemia will make a major contribution to achieving several UN Millennium Development Goals. Since the greatest burden of anaemia falls on the most "hard-to-reach" individuals, any programme that aims to reduce anaemia will need to be accessible by these groups. Primary health care policies and pro¬grammes must be a cornerstone of health care systems. Interventions which have been shown to impact on anaemia include improving nutrition and iron status and treating helminth and malaria infections.

The WHO Anaemia Working Group first met in June 2000 to review the relationship between haemoglobin concentrations and clinically symptomatic anaemia, with particular focus on cut-off levels for blood donation. This is why the Secretariat of the Group has traditionally been housed in the Department of Essential Health Technologies.

The WHO/UNICEF statement on anaemia underlines its multifactorial aetiology; hence the Group is now represented by diverse WHO programmes that need to address the prevention and control of anaemia. Roll Back Malaria is exploring the use of haemoglobin levels as a marker of success of malaria control interventions.

Early detection of anaemia in pregnant women is reflected in the vision of the Making Pregnancy Safer initiative. HIV/AIDS guid elines state that a haemoglobin estimation and HIV test are the absolute minimum before anti-retroviral therapy, meaning that simple, reliable and affordable screening tools must be widely available if 3 million people are to receive ARVs by 2005.

One such tool is the Haemoglobin Colour Scale, now commercially available to assist remote settings in the detection and management of anaemia.

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