Iron Deficiency Anemia

Paraguay

Vitamin A

Peru

Iron

Iodine

Suriname


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	EPIDEMIOLOGICAL DATA


Anemia
Most Recent Anemia Survey: Household National Survey

Date:

1997

Groups Surveyed:

Children 0-4 years and 5-14 years of age; Pregnant Women

Sample Size:

1022

Sampling Method:

Survey consisted of 448 households from 6 strata identified in the country. A strata was determined by grouping regions/areas of the country that had similar ethnic and economic backgrounds. From this sample, children attending government health centers throughout the country, school children attending government primary and secondary schools, as well as pregnant women attending antenatal clinic were selected from throughout the country.

Estimated Anemia Prevalence:

Group	Sample size	Population in region/group (if known)	Indicator (e.g. Hb<120g/L, <110g/L, etc.)	Prevalence in sample %
Children 0-4 years	140		Hb<110 g/L	47.9
Children 5-14 years	323		Hb<120 g/L (<6 years) Hb<110 g/L (>6 years)	56.7
Pregnant Women	269		Hb<110 g/L	52.0
Adults 15-30 years	438		Hb<120 g/L	42.2
Adults 31-50 years	301		Hb<120 g/L	40.9
Adults 51 years and over	88		Hb<120 g/L	40.9
National Total	1022




	POLICY AND LEGISLATION

Legislation on IDA

	Legislation to address iron deficiency in Peru has been implemented since 1997, and covers both supplementation and fortification.
	Legislation established a national program for micronutrient prevention and control, and was established by ministerial resolution. The government has also published documents regarding national policy on iron deficiency.
	There is a national policy on iron supplementation for pregnant women.
	This policy is a universal policy and reaches 20% of pregnant women who have access to free supplementation through health services, which includes prenatal control attention.
	There is a national policy on iron supplementation for children.
	This policy targets children 6-11 months and provides supplementation as a preventive measure. Doses are 1mg/kg depending on weight/day.
	There is a national policy regarding iron fortification programs.
	This legislation focuses on wheat flour fortification with iron at 30mg/kg. It was established in 1997.


Government Agency to Address IDD
	Government Agency: Nutrition Division-Ministry of Health. The function of this agency is coordination.
	Contact Information: Walter Vilchez Dávila



	PROGRAM DATA


Supplementation - (Women)

Targeting
	Pregnant women during prenatal care.
	Approximately 574,000 women are targeted, but only 81,560 receive the supplementation for free as part of the health attention program.

	n
Capsule Information
	Ferrous sulphate at 300 mg and folic acid at 400mcg. This supplement is given along iron content at 60mg/day.


Implementation
	Pregnant women are given supplements during their prenatal control attention period. This period usually last 6 months
	Doses are given daily through blister packs which contain 10 tablets.
	The intended frequency of supplementation is daily starting from the 20th week of conception to 2 months postpartum.


Supplementation - (Children)

Targeting
	Not Reported
Targeting
Capsule Information
	Not Reported
Targeting
Implementation
	The supplementation is given through health services as part of the health attention program.
	This program started in 1999.

Fortification
	Wheat flour is the only food currently fortified with iron at 30mg of iron/kg.
	During the fortification process, premixes produced by ROCHE lab are implemented.
	The process of fortification is not monitored.

Dietary Change
	There are dietary promotion campaigns in Peru which are conducted through health centers.


Other Programs
	Other programs in Peru consist of Malaria programs.
	These programs are conducted in high risk areas which are mainly in the jungle and on the North Coast.



	MONITORING

Anemia
Current monitoring activities for iron deficiency anemia:
	Current monitoring activities in Peru consist of the 'National Monitoring of Nutritional Indicators' program.
	This and other surveys are being repeated by the National Food and Nutrition Center.
	There are laboratory facilities located at health center -type II that contain HTO, some of which can conduct Hb analysis. This process is part of the routine analysis for pregnant women.
	Field tests or HemoCue are also used in special projects that implement anemia monitoring.
	A program conducted in Peru fighting chronic malnutrition in the south Andean area implemented HemoCue field tests in areas where fortified papilla were distributed.
Anemia
Programs
	Special fortified products that are part of the food assistant program are monitored for content and distribution of iron fortification.



	PROGRAM RESOURCES

Donor and Implementing Agencies

Implementing Agency	Description of Activities	Expenditure and source of funds in current year
Implementing Agency	Description of Activities	Suppl.	Fortif.	Other (specify)
National/State governments	Ministry of Health	Yes
External Agencies

EPIDEMIOLOGICAL DATA

POLICY AND LEGISLATION

PROGRAM DATA