Interventions to Reduce Iron Deficiency in Developing Countries - Essay Example

Title: Name: Course/Module: Word Count: Date: Iron deficiency in developing countries Abstract. Most healthcare programs in developing countries are geared towards minimization of sickness in order to have a more productive population and also reduce expenditure on healthcare management. Anaemia caused by iron deficiency has been a major challenge to healthcare provider’s world wide. Research initiatives have been conducted to find a lasting solution to control and manage iron deficiency anaemia. In this essay, three proposed intervention measures will be discussed on the basis of increasing iron intake and reducing iron loss in a more affordable and easy to be accessed by a large population in the rural areas of developing countries. Evaluation of national iron fortification and supplementation strategies will be analyzed, however education and provision of a diverse diet with more bioavailability of iron is a strategy that is suitable in finding a long lasting solution to iron deficiency and iron deficiency anaemia. Introduction Deficiency in iron is a widespread and common disorder that is prevalent in both developed and developing countries. It affects a large population of individuals at all ages (Baltussen et al 2678). Report by WHO indicate that deficiency in iron affects maturity of world population with anemia and deficiency in iron accounting for more than three and a half billion cases in third world countries alone (Baltussen et al 2678). Deficiency in iron by definition is a condition which stores of iron cannot be mobilized. This then causes compromised iron supply in tissues more so erythrocyte cells which require it in abundance (Yates et al 405-410). Anaemic condition arises in severe stages of deficiency in iron. This condition is known as Iron-deficiency anaemia and abbreviated as IDA. However, estimation shows that deficiency in iron is between two to five times more common than it results to anaemia (Yates et al 405-410). IDA is of economic importance because of its impact on population health which results to serious economic repercussions ((Baltussen et al 2678).The main causes of iron deficiency in developed countries is attributed to blood loss through malabsorption disorders like coeliac disease, bleeding of gastro-intestinal walls in men or through postmenopausal bleeding, and premenopausal menorrhagia in women (Frewin et al 360-363; Cox section 22.5.4). In contrast, developing countries have a combination of many factors that include high demand for iron due to high pregnancy frequency, parasitic infections for example amoebiasis, hookworm, schistomiasis or trichuriasis which results to gastrointestinal bleeding, and also loss of blood due to menorrhagia (Yip 1480S). Poor dietary supply is another major causative factor (Frewin et al 360-363; Cox section 22.5.4). Discussion. This essay examines three major nutritional intervention strategies to determine their suitability to combat iron deficiency in developing countries. They include; Fortification of stable foods with iron, dietary iron supplementations, and dietary diversification to foods that can supply more bioavailability of iron (Baltussen et al 2678). According to UNICEF and WHO intervention plan to control and prevent iron deficiency, it should have a long term and integrated approach (Baltussen et al 2678).The approach involves many disciplines with the aim of increasing intake of iron, infection control and enhancement of nutritional conditions (Baltussen et al 2678). Iron supplementation strategy involves provision of iron in dosage to a target group. The most common target group is all reproductive age women. The dosage is given based on guides as provided for by World Health Organization, which is sixty milligrams of iron to expectant women for six months (Baltussen et al 2679). However, the suitability of the strategy is ineffective because iron tablets when taken orally result in side-effects of the gastrointestinal (Cook and Reusser 648). Therefore, antenatal care programs should be informative in order for this strategy to achieve its intended goal. This can be achieved by advising women to change bad attitudes towards taking of iron tablets. In addition, required quantity of iron tablets dose should be distributed to where women live or work.(Yip 860S).Statistics from health surveys indicate that most health administration in developing countries fail to meet the recommended level of covering up to 80% expecting women in a given geographic region(Yip 860S). The second strategy is the iron fortification strategy that involves addition of folic acid together with iron to a suitable foodstuff which is then made available to a large population (Baltussen et al 2679).In most cases flour of cereals is the most appropriate foodstuff that can serve as a food agent for elemental powders of iron (Baltussen et al 2679).Recent studies by Allen and Gillespie (25-28) show that this strategy produced more positive results to populations whose diet has low iron bioavailability especially in developing countries compared to developed countries (Baltussen et al 2679). However cost-effective evaluation of iron fortification show decimal success. This can be attributed to geographic coverage levels that hinder accessibility and also limitation on the population proportion that consumes the food agent in amounts that are sufficient enough to achieve required iron levels (Baltussen et al 2679).Similarly iron supplementation strategy scored low success. Factors that render its low success are mainly due to assumed level of coverage in a geographic region which does not attain the optimal target. The second limiting factor is that, pregnant women do not comply with the dosage of iron given (Baltussen et al 2679). Comparison of suitability in attaining desirable results between the two strategies according to survey results by Baltussen, Knai and Sharan (2681) show that supplementation of iron has a higher impact on health plan than iron fortification. However, iron fortification is a more cost-effective strategy since an individual is not required to visit the provider while the supplementation strategy’s cost per unit becomes expensive as a larger geographic region is covered (Baltussen et al 2681). Although, iron fortification is a more attractive intervention strategy because of it is cost-effectiveness, it has a major challenge for choosing a suitable foodstuff that will serve as a vehicle for iron. Most developing countries have majority of population residing in the rural areas. Therefore its accessibility is poor, there is no small scale food processing industry or technology, and also less people are willing to consume processed food (Baltussen et al 2683). The third strategy to control morbidity and mortality resulting form iron deficiency is by devising means that increase dietary diversification to foods with more bioavailability of iron. Guansheng et al (1-7) report on deficiencies of zinc and iron in Chinese population show that most of the population lack diversity in their diet. According to the study, 50% of zinc and iron is gathered from staple foods. Contrastingly, the same staple foods contain phytate that block bioavailability of zinc and iron (Guansheng et al 1-7). Dietary diversification strategy therefore can be achieved by educating the rural population not to depend on staple foods alone but to have variety of feedstuff which contains enough mineral content. In addition, people need to be advised on the need to change dietary values and practices that prohibit consumption of certain foods like animal foods (Guansheng et al 1-7).Although statistics from a health survey conducted by China national nutrition in 2002, indicates that health education on dietary diversification has the highest cost per capita in comparison to biofortification and iron and zinc supplementation, when viewed in terms of long term intervention, it is the most affordable and economically viable strategy (Guansheng et al 1-7). Conclusion Based on the discussion above, it is noticeable that developing countries face a bigger task in controlling prevalence of iron deficiency anaemia. Poverty is rampant which predisposes majority of population to parasitic infection, healthcare management systems are also poorly managed which hinders implementation of intervention programs. This is attributed to lack of survey statistics or research data on prevalence of iron deficiency among the populations (Yip 861S). In order to correct this situation, there is urgent need to consider implementing sustainable strategies that involve communities in the intervention programs. There should also be emphasis on education as a long term solution especially in the area of capacity development in order to empower communities and individuals in solving problems that affect them individually (Yip 861S). Similarly education on dietary consumption diversification will provide a longer lasting solution to iron deficiency. However, improvement in dietary fortification of iron in staple foods that are easily available together with supplementation of iron will serve as a preventative and short term remedy (Yip 1488S). Works cited Baltussen, Knai, and Sharan, M. “Nutritional Epidemiology: Iron fortification and Iron supplementation are cost-effective interventions to reduce Iron deficiency in four subregions of the world.” American Society for Nutritional sciences. 0022- 3166/04. (2004): 2678-2684. Cook, and Reusser, E. “Perspective in Nutrition Iron fortification.” American Journal of Clinical Nutrition. 38 (1983): 648-659. Cox, T.M. “Iron metabolism and its disorders.” Oxford textbook of medicine. Ed. Warrell, et al. 4th ed. Oxford University Press. Oxford. (2003):22.5.4 Frewin, Henson, and Provan, D. “ABC of clinical haematology: iron deficiency anaemia.” British Medical Journal. 314(7077). (1997): 360-363. Guansheng, Ying, Yanping , Fengying, Frans, Evert, and Xiaoguang Y. “Iron and Zinc deficiencies in china: what is a feasible and cost-effective strategy?.” Public health Nutrition. Beijing. (2007):1-7. Yates, Logan, and Stewart, M. “Iron deficiency anaemia in general practice: clinical outcomes over three years and factors influencing diagnostic investigations.” Postgraduate Medical Journal. 80(945). (2004) : 405-410. Yip, R. “Forging effective strategies to combat Iron deficiency.” American society for nutrional sciences. UNICEF, Beijing, China.132. 0022-3166/02.(2002):859S- 861S. Yip, R. “Symposium” Clinical Nutrition in developing countries. “Contemporary scientific issues and international programmatic approaches”. Journal of Nutrition. 0022-3166/94.(1994):1479S-1489S. Read More