Neelam Mohan | Ensuring healthy start to life: Why fixing adolescent anaemia is urgent
Nearly one in five babies born in India are born with low birth weight.
By : Neelam Mohan
Update: 2026-08-12 20:20 GMT
The Government of India’s flagship “Anaemia Mukt Bharat Abhiyaan” recently
added low birth weight babies, born under 2.5 kg, to the programme’s ambit
for the first time.
Nearly one in five babies born in India are born with low birth weight. This
puts babies at high risk of developing anaemia within the first few months of
life, which can affect a child’s cognitive development and performance at
school. Beyond the immediate risks of infection and malnutrition in infancy,
research increasingly links low birth weight to a higher lifetime risk of non-
communicable diseases such as heart disease, chronic kidney disease and
metabolic disorders. These conditions often surface only decades later but can
severely impact the quality of life. Given the severe impact of anaemia,
addressing the issue in these infants early is, therefore, an investment that
pays off well into adulthood.
Iron deficiency and severe anaemia in women, before and during pregnancy,
can restrict oxygen and nutrient delivery to the foetus. This frequently leads to
preterm delivery or intrauterine growth restriction, resulting in a low birth-
weight baby. The fact that one in every two pregnant women in India is
anaemic means addressing this is an absolutely critical issue that impact
future generations. Correcting anaemia before pregnancy ensures a healthy
start for newborn.
It is in this context that the release of the Anaemia Mukt Bharat (AMB)
Abhiyaan operational guidelines, in June 2026, by Union health and family
welfare minister J.P. Nadda, assumes particular significance. Given the urgent
need to address anaemia before pregnancy, the new guidelines’ strengthened
focus, among the many important advancements, on addressing anaemic in
adolescents stands out as one of the most consequential.
Anaemia lies at the intersection of child health and maternal health, with
adolescence serving as the critical bridge between them. With nearly six in ten
adolescent girls and one in three adolescent boys affected by anaemia, the
challenge extends across the adolescent population.
The revised guidelines rightly recognise that anaemia during adolescence is
not simply a concern for the present. It is a determinant of future maternal
health, birth outcomes and the well-being of the next generation. Addressing it
early creates benefits that extend across the life course and starting during
adolescence is pivotal.
As a paediatrician, I rarely encounter adolescent anaemia as a medical
emergency. Rather, it looks like a slipping report card. A teenager who used to
excel at sports, now sits out the games. Or a once eager learner often loses
focus during classes. Fatigue is mistaken, time and again, for laziness or a
difficult phase. Left unrecognised, these seemingly ordinary symptoms can
affect learning, physical development, productivity and long-term health.
The revised guidelines respond to this reality by embedding adolescent
anaemia within the broader framework of the National Health Mission. Rather
than treating it as an isolated condition, they integrate prevention, screening,
treatment and counselling into existing school health services, adolescent
health programmes and community-based platforms. This life-course
approach acknowledges that improving adolescent health requires sustained
engagement, not one-time interventions. The programme itself reflects a
welcome evolution.
The 6x6x6 strategy now becomes 7x7x7, with the addition of a new beneficiary
group, a new intervention, and an additional institutional mechanism. Equally
significant is the expansion of the T3 approach of Test, Treat and Talk into a
T4 approach that adds Track, placing sustained follow-up on par with
counselling, diagnosis and treatment.
The operational protocol laid out for adolescents is comprehensive and field-
ready. Going forward, annual screening will take place through Rashtriya Bal
Swasthya Karyakram (RBSK) Mobile Health Teams in schools and anganwadi
centres, and opportunistic screening will be conducted by frontline health
workers. A structured treatment pathway using the IFA Blue tablet has been
advised as well as defined timelines for retesting. Most importantly, a clear
referral pathway that ensures every adolescent completes their treatment
successfully will also be implemented. The line-listing of anaemic adolescents,
shared with ANMs and school teachers, will further strengthen the continuum
of care.
Another welcome addition is the introduction of “Eating Right” as a dedicated
intervention.
Iron supplementation alone cannot solve anaemia if dietary habits remain
unchanged. By combining treatment with sustained nutrition counselling and
promoting iron-rich diets during adolescence, the guidelines acknowledge that
lasting improvements require behaviour change alongside clinical care.
In addition, the Abhiyaan’s emphasis on Jan Bhagidari, or community
participation, will encourage active involvement of parents during parent-
teacher meetings, the vigilance of school teachers, and the reinforcement of
healthy nutrition practices at the community level.
These are all important steps toward translating this clinical protocol into
sustained, everyday practice.
The Indian Academy of Paediatrics warmly welcomes these revised
operational guidelines and reaffirms its commitment to supporting the
government’s efforts to strengthen adolescent, maternal and child health. As
part of this commitment, the Indian Academy of Paediatrics is working to
strengthen awareness and preventive action on adolescent health through its
network of paediatricians across the country. Through this, we hope to
complement the government’s efforts by encouraging healthier practices at the
community level.
Breaking the cycle of anaemia requires us to intervene before young girls
become mothers. By placing adolescents at the centre of India’s anaemia
strategy and combining testing, treatment, nutrition counselling and
sustained tracking, the revised AMB Abhiyaan offers an opportunity to
improve not only the health of today’s adolescents, but also that of the
generations that will follow. Few investments in public health have the
potential to deliver such enduring returns.
Dr Neelam Mohan is the president of the Indian Academy of Paediatrics