Bengaluru: Karnataka has recorded a sharp improvement in iron-folic acid (IFA) consumption among pregnant women, with nearly eight in 10 mothers taking the supplements for at least 100 days during pregnancy, according to the National Family Health Survey (NFHS)-6.The proportion rose to 78.9% from 44.7% in NFHS-5, while the share of women consuming IFA for 180 days or more increased from 26.7% to 66.4%.Folic acid is essential during pregnancy as it aids the development of the baby’s brain and spinal cord, reducing the risk of serious birth defects known as neural tube defects. It also supports the production of healthy red blood cells and helps prevent anaemia in pregnant women, lowering the risk of complications during pregnancy and childbirth.Doctors said folic acid is especially important during the first trimester.“The increased consumption shows that there is greater awareness among pregnant women as well as doctors. Earlier, we would often see women coming to clinics only after the first trimester and missing the crucial window for folic acid supplementation. These days, such cases are far less common. With many women conceiving in their 30s, they are also more aware of the importance of iron-folic acid in preventing neural tube and spinal defects in babies,” said Dr Hemavathi Srinivasan, obstetrician and gynaecologist at Srinivasa Health Centre.Doctors also noted that while iron-folic acid consumption has improved, factors such as continuity of use, supply issues and postpartum consumption should also be taken into account.Explaining why there may be a drop in the proportion of women who continue taking the supplements beyond 180 days, Dr Madhva Prasad, associate professor of obstetrics and gynaecology at St John’s Medical College Hospital, said, “In busy antenatal clinics, doctors prescribe iron-folic acid supplements during the initial visit. During subsequent visits, they often advise patients to continue the same medication without issuing a fresh prescription. In many such cases, patients forget to continue regularly or their intake becomes patchy. Many mothers also stop taking these supplements during the postpartum period, which is another concern. We started with the goal of ensuring women take iron-folic acid supplements for 100 or 180 days, but we should now move towards collecting data from the pre-conception stage to six months postpartum.”Public health experts, meanwhile, argued that the government’s focus should be on ensuring women meet their iron and folic acid requirements through a nutritious and diverse diet rather than relying solely on supplementation.Dr Sylvia Karpagam, public health doctor and researcher, said, “Given the extent of malnutrition in the country, it is highly unlikely that people have only one nutritional deficiency, even though iron deficiency is the most common. Anaemia cannot be reduced through iron supplementation alone. The primary goal should be to ensure a diverse diet that includes both plant- and animal-based sources of folate and other nutrients. Medicalising what is fundamentally a food and nutrition issue is not the solution. Unless we focus on dietary diversity, iron supplementation alone will not be enough.” Dr Karpagam and several other public health activists have also flagged the omission of certain indicators, including anaemia, from NFHS-6.
