Opinion Bihar can build on its recent gains in healthcare by investing more in fighting anaemia in women

An often-overlooked pathway through which women’s health shapes the next generation is iron-deficiency anaemia. It is common, frequently mild, and yet has direct consequences for a mother’s resilience in pregnancy and childbirth and for a child’s early growth and brain development. Because its signs build slowly and are socially normalised, anaemia too often slips between awareness and action. Myths and misconceptions surrounding available solutions also slow progress.

The reality is that one in every two women between the ages of 15 and 49 years in India is anaemic (57 per cent); in Bihar, this number is even higher (63.5 per cent), undermining all the progress made by the state in maternal health indicators. Between 2004-06 and 2021-23, the state’s Maternal Mortality Ratio (MMR) dropped from 312 to 104 deaths per 100,000 live births; however, anaemia remained widely prevalent.

To address this, I believe in the triple A approach — awareness, availability, accessibility. Efforts to create awareness are crucial in promoting health-seeking behaviour. The imperative is to work with household decision-makers. The availability of iron supplements, diagnostics, and intravenous therapies has expanded, but ensuring steady supplies at all levels of care will make access more reliable. Accessibility has improved through outreach camps and referral pathways, though continued attention is needed to reach women in remote areas as well as adolescents and lactating mothers.

All this aligns with the Test-Track-Treat strategy of India’s flagship anaemia reduction programme, Anaemia Mukt Bharat (AMB), launched in 2018. The program is multifaceted. Through a mix of preventive therapy, early diagnostics via digital screening tools, newer safe and effective treatment options, and robust monitoring and follow-up mechanisms, it aims to reduce anaemia in children, adolescents and women, in line with global goals.

Interventions such as preventative care via Iron and Folic Acid (IFA) supplementation and routine testing through digital tools are currently being rolled out countrywide. For pregnant women who don’t respond well to IFA side effects, intravenous iron therapies are available, which offer a safe and efficient remedy to anaemia. Today, a single-dose intravenous supplement can correct anaemia in late pregnancy, safeguarding against life-threatening conditions such as postpartum haemorrhage (PPH) and pre-eclampsia.

Increased government commitment and interventions in already running programmes have culminated in the creation of a perfect moment for anaemia reduction in Bihar. Last month, the All India Institute of Medical Sciences (AIIMS) in Patna brought together government officials, experts and development organisations for a series of discussions on maternal anaemia and critical steps toward addressing it. The biggest takeaway of the meet was this: Without urgently addressing maternal anaemia, the state’s health, social and economic indicators would continue to be adversely affected.

This year, the Bihar government plans to roll out intravenous ferric carboxymaltose (IV FCM), which can treat lakhs of pregnant women who suffer from moderate or even severe anaemia well into the second and third trimesters. With guidelines and protocols in place, the government will focus on maximising implementation in select districts before scaling this program up statewide. As a partner in the state government’s efforts to strengthen health systems, including toward anaemia reduction, AIIMS Patna is committed to providing robust technical assistance.

This is in line with the institute’s overall role — to support government health programmes at the national and state levels. Our mandate is to look at all sides of health care, including promotive, preventive, curative, rehabilitative, and even palliative care. We work to support a number of national and state programs, including AMB.

Our teams have been working in Gaya and Purnea districts to support progress on district-level AMB program roll out, including by identifying opportunities for collaborating with Health, ICDS and Education departments. We have provided technical support to the State Health Society (SHS) to organise training programs and participated in analysing and forecasting IFA usage requirements in districts.

To protect the progress Bihar has made in maternal health, we must remember that every investment in women’s health is an investment in the next generation. The path forward must be collaborative and involve closing supply-chain gaps, building district capacity for IV-FCM and digital screening, strengthening referral pathways, and pairing technical scale-up with community engagement. What is essential now is a steady effort from government, health workers, development partners and communities to ensure that existing policies are translated into reliable care. By addressing maternal anaemia, Bihar can safeguard mothers today while investing in the health of generations to come.

The writer is executive director and CEO, AIIMS Deoghar and former executive director and CEO, AIIMS Patna