Bangladesh Government renews its commitment to reduce anaemia in pregnant women

Roxana Quader

Ms Roxana Quader, Additional Secretary, Ministry of Health and Family Welfare, Government of Bangladesh, announced that based on the success of MI’s pilot on IFA supplementation in two districts, the government has decided to replicate this program across 10 additional districts.

DHAKA, BANGLADESH – Based on new study results from the Micronutrient Initiative, the Bangladesh Government recommitted to strengthening its Iron and Folic Acid (IFA) Supplementation Program to protect pregnant women from anaemia and their newborns from complications.

The study showed that anaemia could be reduced in pregnant women if they were provided with proper counseling on consuming iron and folic acid tablets, access to trained health staff and community workers and adequate supplies of medicines, giving the Government of Bangladesh strong evidence to strengthen its programs.

The findings of the study were discussed at a workshop titled “Strengthening Iron and Folic Acid Supplementation Program to Reduce Anaemia among Pregnant Women” at Hotel Lakeshore in Dhaka on Thursday March 19, 2015.

Those who attended included senior government officials, including: Ms Roxana Quader, Additional Secretary, Ministry of Health and Family Welfare; Dr Shah Newaz, Additional Director General, DGHS; Dr Md. Alamgir Ahmed, Director, IPHN and line director NNS; John McCullough, Micronutrient Initiative (MI), Regional Director, Asia; and Heather McBride, Deputy Director Planning and Lead Analyst, High Commission of Canada. Dr Deepika Nayar Chaudhery, MI Deputy Regional Director, Asia and Dr S M Mustafizur Rahman, Director, MI Bangladesh also participated in the workshop.

According to BDHS 2011, around half of all pregnant women in Bangladesh are anaemic.

Anaemia due to iron deficiency is known to lead to complications during pregnancy and childbirth. While it puts women at increased risk of maternal mortality, it also increases the risk of a pre-term delivery, low birth weight baby, disadvantaging the child right from the start. Consumption of IFA tablets reduces both iron deficiency and the chances of complications during pregnancy.

The study was conducted in 2014 to measure the impact of a pilot project jointly implemented by the Institute of Public Health Nutrition and the Micronutrient Initiative, with support from the Ministry of Health and Family Welfare (MoHFW) in Satkhira and Narsingdhi districts.

The results from this project, supported by the Government of Canada’s Department of Foreign Affairs, Trade and Development,  show that more pregnant women received IFA tablets, consumed them and were convinced of the need for supplementation. Compared to only 51% women in 2011, nearly 98% women in the two districts received IFA in 2014. Not only did more women receive IFA, they also took the required number of tablets to protect themselves sufficiently from anaemia.

The study revealed that the proportion of women consuming more than 90 IFA tablets during the course of their pregnancy increased from 33% in 2011 to 88% in Narsinghdhi and 38% to 80% in Satkhira districts.

Encouraged by this success, the MoHFW has decided to replicate the program in 10 additional low performing districts: Gaibanda, Jamalpur, Barishal, Jessore, Sunamganj, Kishoreganj, Noakhali, Bogra, Sirajganj and Sherpur.  MI will again support the government in this process.

“We are very happy with the results that MI has shown in the IFA project. In the coming years, we would like the program to cover all the districts with the resources of the government. As a trusted partner of the government, we hope MI will be able to play a prominent role in this exercise,” said Ms Roxana Quader, Additional Secretary, MoHFW.

MI Regional Director Asia, John McCullough said, “It is our proud privilege to partner with the Bangladesh Government in addressing this major but often neglected public health program. We are in turn re-motivated and committed to supporting the MoHFW in scaling up the IFA program knowing that it will not only reduce maternal mortality and complications in pregnancy, but also ensure that new borns get off to the right start in life, which is no more than they deserve.”

The study also analysed the knowledge levels of  pregnant women in the two districts and showed more than 70% women were aware of at least one method to overcome the side effects of IFA tablets.

This level of awareness is  encouraging as these women are now able to deal with any side effects, thereby helping them to continue with the remaining course of IFA tablets. The high knowledge levels were found to be directly linked to efficient counseling by frontline workers.

The study also showed 94% of pregnant women reported that frontline workers discussed the benefits of consuming one IFA tablet daily during ante-natal checks or home visits and counseled them on various aspects related to overcoming anaemia including eating iron-rich and nutritious food.

Within this project, MI worked with the government to strengthen the process of procuring the required quantity of IFA tablets and ensuring it reached the rural distribution centers on time. MI also worked with the government to ensure procurement of improved quality tablets, which came in blister packs to avoid any spoilage through humidity. As against 50% procurement in 2011, the procurement level increased to nearly 80% in 2014.

MI supported the training of around 4,000 health and family planning managers and workers, following which workers were able to provide efficient services to the pregnant women, including counseling them to encourage consumption of IFA tablets at the facility and household levels.