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by Rita Sorio*
The prevalence of anemia in the Americas has been estimated at 29.3%. Ironically, in Uruguay, a country known for its high red meat consumption, the prevalence of anemia in children exceeds this average. According to data from the latest national health survey on nutritional status, feeding practices and anemia [link in Spanish], 31.5% of Uruguayan children between the ages of 6 and 23 months are anemic.
Anemia has widely-recognized consequences on child growth and development processes, as well as the morbidity and mortality of mothers and children. Various authors show that anemic children score six to ten points lower on cognitive and motor development scales as compared to non-anemic children, and many of these effects on learning are irreversible.
Globally, the single most important factor contributing to the onset of anemia is iron deficiency. It is generally assumed that 50% of cases of anemia are due to this deficiency, but the percentage varies among population groups. So then, why does anemia continue to pose a problem for Uruguayan children?
Anemia in Uruguay
While early childhood anemia is a phenomenon that indiscriminately affects all sectors of the population, when examining household income data, it is evident that the prevalence of anemia among high-income households can be characterized as a mild public health problem. Children between the ages of 6 and 11 months are most affected; in this age group, anemia stands at 41%, which represents a serious public health issue.
Due to their rapid growth, children under the age of 2 require more iron per kilo of body weight than at any other point in the life cycle. Meat consumption during this stage of life is not very high, and even with the best nutrition counseling, it is near impossible to satisfy these high iron requirements. And so—despite being a country where meat is king—anemia is prevalent, and this condition presents a significant challenge to the development of future generations.
A new strategy
Recognizing this issue, the program Uruguay Crece Contigo (UCC) [link in Spanish] has embarked on a strategy to prevent anemia in children under the age of 4 through the efforts of its community workers. In their role as program staff, these workers regularly visit vulnerable households with the goal of strengthening parenting practices. Community workers also collaborate with health technicians on this anemia initiative.
One of the activities performed by these teams is the measurement of hemoglobin through capillary puncture using a device called a portable hemoglobin meter; these devices allow for at-home readings, and they can be used by the community workers.
The program began with 3,565 children, and the preliminary results have been surprising. At the end of the intervention, which followed families for an average of 10 months, the prevalence of anemia decreased from 32% to 9%. This result was obtained thanks to 1) technology that allowed for anemia to be detected in a timely manner and 2) teams of community workers who counseled families on anemia-related problems and their consequences, as well as the importance of visiting a health center and taking iron supplements.
This initiative made a big difference for Uruguay’s children. Do you think that it is worth copying in your community?
(*) Thanks go to Gabriel Corbo and Florencia Cerrutti at Uruguay Crece Contigo for their help.
Rita Sorio is a lead specialist in the IDB’s Division of Social Protection and Health (@BIDSPH), and she works at the Bank’s offices in Uruguay. Her work focuses on health systems, with an emphasis on management and planning.