Anemia control among women and its association with heavy menstrual bleeding and contraception: Implications for South Asia

Menstrual disorders, Iron Deficiency (ID), and Iron Deficiency Anemia (IDA) affect approximately half a billion women worldwide. The prevalence of anemia in south Asian countries is 40- 57%, and it has not declined significantly over the last few decades. Heavy menstrual bleeding is the most common cause of iron deficiency and iron deficiency anemia (FIGO), however, the relationship between iron deficiency and heavy ,menstrual bleeding is poorly appreciated.  Further, FIGO has estimated that the prevalence of Heavy Menstrual Bleeding (HMB) is much higher than previously estimated, and that it exist in as many as 50% women and is frequently normalised by women and health care providers. Iron deficiency and iron deficiency anemia have profound impacts on the lives of women  and their newborns, yet the interventions strategies for control of anemia so far have focused on supply side interventions (such food fortification, dietary diversity, iron supplementation) and an approach of control of blood loss has not been implemented at scale.  
Methodology: Desk review of anemia control policies and FP vision documents was done for three countries (India, Nepal, Bangladesh). Discussion with stakeholders (policy makers, researchers, UN agencies, development partners) was done to understand their perspectives on programmatic options.