Malnutrition: Micronutrient Deficiencies

Iron Deficiency Anaemia (IDA)

When people do not get enough iron in their diet, their blood becomes weak and cannot carry enough oxygen around the body. Iron Deficiency Anaemia affects women and children in particular, as well as adolescents and the elderly. It makes people feel exhausted and slows down learning in children. Anaemia increases the risk of problems for mother and baby during and after delivery.

Signs of anaemia include a pale tongue and inside of the lips, tiredness and breathlessness.

Key behaviours to prevent anaemia include:
  • Increase Iron intake through:
    • Iron-rich vegetables like dark green vegetables (spinach, parsley and broccoli), millet, beans, pulses, nuts, pumpkin seeds, dates, dried fruits, wholegrains and wheatgerm.
    • Red meat, organ meats (kidney and liver), egg yolks.
    • Fortified foods available in the market or use of sprinkles.
    • Eat "Iron Helpers" such as guava, oranges, lemon or other Vitamin-C sources
    • Avoid 'Iron Blockers' like tea, coffee and milk for one hour before and one hour after eating an iron-rich meal.
  • Prevent Malaria
    • Sleep under treated mosquito nets.
    • Get treated for malaria immediately.
    • Based on Ante-Natal Care Policy, get 2 doses of Intermittent Preventive Treatment (IPT).
  • Prevent hookworm
    • Take de-worming tablets twice a year.
    • Wear shoes to avoid hookworm.
    • Dispose faeces properly.
    • Wash your hands and your nails thoroughly before preparing food and eating
  • Take iron tablets as directed by a health worker:
    • Pregnant women should take one tablet of iron and folic acid every day for 6 months. Ante-Natal Care policy.
    • Children 6-24 months should take one dose daily for 6-18 months depending upon anaemia prevalence. Infants born premature or with low-birth-weight are expected to start at 2 months. IDA Management Protocol.

All young children not on breast milk (especially those on animal's milk) should be screened regularly using pallor because they are at high risk of IDA.

Women and children found with evident pallor need to receive treatment dose of Iron based on the National IDA Management Protocol:

Vitamin A Deficiency (VAD)

Vitamin A deficiency can occur when people do not eat enough foods containing vitamin A or fat. Vitamin A deficiency can cause night blindness and permanent damage to the eyes, blindness and even death.

People at risk from vitamin A deficiency are mostly pregnant and breastfeeding mothers and children.

Key behaviours to prevent Vitamin A Deficiency (VAD):
  • Increase Vitamin A intake through consumption of yellow / orange fruits and vegetables andfortified foods available in the market.
  • Because Vitamin A is fat-soluble you should ensure you get an adequate source of fat and oil. Good sources of these that can be grown at home include sunflower oil, nuts and seeds (ground-nuts, sesame seeds, round-nuts, sunflower seeds, pumpkin seeds), peanut butter and avocado.
  • Infants should be exclusively breastfed for the first six months and continue to be breastfed up to twenty-four months.
  • Mothers should take Vitamin A within 8 weeks after giving birth (200,000 IU).
  • Children from 6 to 59 months should get Vitamin A supplementation orally every 6 months (6 months - 1 year: 100,000 IU; >1 year: 200,000 IU).

Adults with impaired immune systems and children suffering from measles, persistent diarrhoea, acute respiratory infection, chickenpox, severe malnutrition and xerophtalmia should receive treatment dose of Vitamin A according to the VAD Management Protocol.

Iodine Deficiency Disorders (IDD)

Iodine is found in fish that live in the sea or iodised salt. Iodine deficiency can cause growth problems in children as well as hinder brain development. Iodine Deficiency can lead to different grades of goitre and cretinism. Goitre (Grade 2) is characterized by a palpable and visibly enlarged thyroid with neck in normal position.

All landlocked populations that can not access sea food are at risk of IDD. Goitre is highest in adolescence, particularly girls.

Key behaviours to prevent Iodine Deficiency Disorders (IDD):
  • Purchase packaged iodized salt.
  • Store packaged iodized salt faraway from heat and from moisture.
  • Add salt before serving the food.


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