Nutritional anaemia--a major controllable public health problem.

Nutritional anaemia, due chiefly to iron deficiency, is widely prevalent in many parts of the world. There is increasing evidence that even mild anaemia affects health and reduces productivity and that a high prevalence of anaemia has profound socioeconomic consequences. The pathogenesis of nutritional anaemia is now reasonably well understood. Measures avilable for combating it include: therapeutic supplementation for accessible population groups with a high prevalence of anaemia, such as pregnant women and schoolchildren; iron fortification of one or more widely consumed foodstuffs; management of those conditions, such as hookworm infestation, that increase requirements for haemopoietic nutrients; and education of the public, and of all categories of health personnel, regarding the importance of anaemia and the ways of controlling it. Experience has shown that there is no simple solution to the problem and in each area where iron deficiency anaemia is prevalent it will probably be necessary to develop and combine many or all of these measures. In each community it will be necessary to introduce these measures so that their effectiveness can first be studied in a pilot trial. When this has been successfully completed it should be followed by a field trial under realistic conditions, and only when this has proved successful should a regional or national programme be introduced. However, the problem is complex and it is only by sustained effort of all concerned that it will prove possible to develop adequate public health control of nutritional anaemia.