Bengaluru: Karnataka has recorded a sharp improvement in iron and folic acid (IFA) supplementation among pregnant women, with nearly eight in 10 mothers consuming the supplements for at least 100 days during pregnancy, according to National Family Health Survey (NFHS)-6.The proportion of pregnant women who consumed IFA tablets for at least 100 days increased to 78.9%, up from 44.7% in NFHS-5. The share of women taking IFA supplements for 180 days or more rose from 26.7% to 66.4%, reflecting substantial gains in adherence to recommended maternal nutrition practices.Folic acid is essential during pregnancy as it aids in 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 rise in iron-folic acid (IFA) consumption reflects growing awareness among both pregnant women and healthcare providers,” said Dr Hemavathi Srinivasan, obstetrician and gynaecologist at Srinivasa Health Centre.“Earlier, many women visited clinics only after the first trimester, missing the critical window for folic acid supplementation. Such cases have become much less common now. With more women conceiving in their 30s, there is greater awareness of the role of iron and folic acid in preventing neural tube defects and spinal abnormalities in babies,” she said.Doctors, however, 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 could 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 postpartum period. 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 pre-conception stage to six months postpartum.”Public health experts, meanwhile, argued the govt’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, 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.”
