Iron interventions for women and children in low-income countries

Abstract

The WHO estimates that 41% of women and 27% of children suffer from anemia due to iron deficiency. The consequences of iron deficiency anemia include suboptimal mental and motor development in young children, increased risk of maternal mortality, and decreased economic productivity of adults. Recent research also provides evidence that maternal iron deficiency in pregnancy increases neonatal morbidity and mortality. This short review briefly highlights how iron interventions might be positioned within 4 global health initiatives: making pregnancy safer, saving newborn lives, infant and young child feeding, and fortification. The importance of iron nutrition is recognized in the context of child nutrition, fortification, and biofortification, and it is likely that meaningful advances will be made through these initiatives in the coming decade. However, iron nutrition is not yet well integrated into the programmatic agendas for reducing morbidity and mortality of pregnant women and neonates. Iron supplementation in pregnancy has been advocated for decades as a means of controlling anemia, but this outcome has not been sufficient to motivate strong programs and policies, and the evidence base is still sparse for high-priority clinical outcomes. To act on the current evidence for maternal and neonatal health will require stronger advocacy within circles that have not traditionally included nutritionists. Successful implementation will require greater attention to antenatal care for pregnancy women and prioritization of iron-promoting actions (including iron supplementation and deworming) within that platform.