Manila, 14 March 2006—One out of every two women of reproductive age in developing countries suffers from iron deficiency anaemia, and without treatment, a woman’s health, especially when pregnant, is further compromised, with potentially dire consequences also to her child.

“About 40% to 50% of women in their reproductive years are anaemic, but are unaware of this because it is a silent disease,” said Dr Tommaso Cavalli-Sforza, Regional Adviser in Nutrition and Food Safety.

The WHO Regional Office for the Western Pacific is promoting a new approach to this problem, based on one iron and folic acid tablet a week to be taken regularly by women of reproductive age, doubling the dose of iron when pregnant. The scheme is patterned after successful pilot tests in Cambodia, the Philippines and Viet Nam. Under the programme, some 30 000 women in each country were targeted to receive iron-folic acid tablets for one year. Whenever possible (in most cases) women were asked to buy the supplements. Social marketing and community mobilization were used to promote the sales.

Prior to this initiative, anaemia control programmes had focused on pregnant women only.

The new initiative shifts from treatment to a preventive approach, covering not only pregnant women, but all menstruating women, considering that about half of women in developing countries are anaemic even before pregnancy.

“Pregnant women, especially the poor and those with less access to health services, make their first visit to antenatal clinics too late,” said Dr Cavalli-Sforza. “Good nutrition, including adequate iron status is particularly important in the first trimester to avoid having undernourished babies with low birth weight. About 40% of women are anaemic even before pregnancy and their condition often worsens when they become pregnant.”

Iron deficiency anaemia, affecting more than 3.5 billion people in developing countries, has dire consequences at all ages.

For infants and children they include:

• impaired motor development and coordination;
• impaired language development and poor performance in school;
• psychological and behavioural effects (inattention, fatigue, etc.);
• decreased physical activity due to fatigue; and
• increased morbidity.

In adults of both sexes anaemia causes:

• decreased physical work, resistance to fatigue and earning capacity; and
• increased morbidity.

In pregnant women anaemia increases:

• morbidity and mortality in the mother and fetus; and
• low birth weight, which means inadequate development of the fetus and infant.

The new anaemia prevention initiative includes strategies to ensure the availability and affordability of the iron-folic acid tablets, coupled with intensive social marketing and community mobilization.

Preventive supplementations can be successfully promoted especially in institutions such as schools and factories, by raising awareness and promoting active participation in the prevention and control of iron deficiency anaemia.

Results of the projects that provide the evidence base for the new initiative are published in a supplement of Nutrition Reviews: "Preventive Weekly Iron-Folic Acid Supplementation Can Improve Iron Status of Reproductive Age Women: Experience in Cambodia, the Philippines and Viet Nam" (Volume 63, Supplement 1, December 2005). This publication is also available through the website of the Regional Office for the Western Pacific (http://www.wpro.who.int/health_topics/nutrition/).