Anaemia Mukt Bharat Strategy

More than half of India’s women and children are anaemic. Anaemia Mukt Bharat (AMB) is the national plan to bring that number down. This lesson explains who it covers, what it does and how it changed in 2026.

1.1 What is anaemia?

Anaemia means the blood has too few red blood cells or too little haemoglobin. Haemoglobin is the part of the blood that carries oxygen. Without enough of it, the organs and tissues do not get enough oxygen. Doctors call a person anaemic when haemoglobin falls below a cut-off. The cut-off depends on age and sex.

The cut-offs in the NFHS tables are:

• Children 6 to 59 months: below 11 g/dl.
• Pregnant women: below 11 g/dl.
• Non-pregnant women and adolescent girls: below 12 g/dl.
• Adolescent boys: below 13 g/dl.

A g/dl is a gram of haemoglobin in every decilitre (one-tenth of a litre) of blood.

1.2 When and why was it launched?

The Government of India launched AMB in 2018. It sits under POSHAN Abhiyaan. Mukt is the Hindi word for free. The Health Ministry designed it after a review of the older anaemia programme. The review found weak IFA supply, weak demand and weak monitoring. It also found slow progress, with a fall of less than 1% a year from 2005 to 2015.

1.3 What did AMB promise?

The strategy set a target of 3 percentage points less anaemia every year, from 2018 to 2022. It aimed to reach about 450 million people. A percentage point is one step on the percentage scale. A fall from 58% to 55% is a fall of 3 percentage points.

The guidelines gave a 2022 target for each group. The baseline was NFHS-4 (2015-16). Each target sits 18 points below its baseline.

AMB is a universal strategy. It reaches every village, block and district. It uses the existing delivery platforms of the National Iron Plus Initiative and the Weekly Iron Folic Acid Supplementation programme.

2.1 Which six groups were covered in 2018?

The 6x6x6 strategy means six age groups, six interventions and six institutional mechanisms. The six groups are:

• Children aged 6 to 59 months.
• Children aged 5 to 9 years.
• Adolescent girls and boys aged 10 to 19 years.
• Pregnant women.
• Lactating women.
• Women of reproductive age.

2.2 Why do some sources say 15-49 and others 20-49?

The 2019 PIB reply gives the reproductive age group as 15 to 49 years. The 2018 guidelines give the IFA dose for women aged 20 to 49 years who are not pregnant or lactating. The 2018 beneficiary count table lists women aged 20 to 24. The 2026 PIB reply also says 20 to 49 years. Adolescents aged 15 to 19 already sit in the 10 to 19 group. So read 20 to 49 as the current group.

PIB lists six interventions. They work like a chain. Give iron, remove worms, change habits, test and treat, fortify food and fix other causes.

• Prophylactic iron and folic acid (IFA) supplementation.
• Deworming.
• A year-round behaviour change campaign, including delayed cord clamping.
• Testing for anaemia by digital methods, with point of care treatment.
• Mandatory iron and folic acid fortified foods in government-funded programmes.
• Action on non-nutritional causes: malaria, haemoglobinopathies and fluorosis.

3.1 How much iron and folic acid does each group get?

Prophylactic means given to prevent a problem. Under AMB, IFA is given to children, adolescents, women of reproductive age and pregnant women whether or not they are anaemic. The dose changes with age. The tablet colour also changes.

Pregnant women start the daily tablet from the fourth month of pregnancy. They take at least 180 days of tablets in pregnancy. They continue for 180 days after delivery. The table says “biweekly” for the syrup. The guideline text explains this as twice a week. Do not read it as once in two weeks.

The IFA given is iron and folic acid. It is not calcium. This is the exact trap in the 2023 UPSC question in section 7.

3.2 What is deworming, and when is it done?

Worm infections are one cause of anaemia. The guidelines list helminth (worm) infections among the other important causes. India runs National Deworming Day twice a year, on 10 February and 10 August. Children and adolescents aged 1 to 19 years get an albendazole tablet.

Under-five children and out-of-school children get the tablet at Anganwadi centres. School-going children get it at school. Pregnant women get one dose after the first trimester, preferably in the second trimester.

3.3 What is the behaviour change campaign, and why delay the cord clamp?

The campaign is called “Solid Body, Smart Mind”. It runs all year. It targets four habits.

• Take IFA tablets and deworming doses.
• Feed infants and young children well.
• Eat more iron-rich food.
• Delay cord clamping after delivery.

Delayed cord clamping means the birth attendant waits before cutting the umbilical cord. The guidelines say wait at least 3 minutes, or until the cord stops pulsating. This builds up the baby’s iron stores for the first 6 months. Early breastfeeding within 1 hour of birth should follow.

3.4 How are people tested and treated?

The guidelines call for digital testing and point of care treatment. They give special focus to pregnant women and school-going adolescents. The older field method, Sahli’s method, is to be replaced by newer technology. In field settings, testing uses a digital invasive haemoglobinometer. A semi-auto analyzer is used at facilities from the PHC upwards.

For severe anaemia in pregnant women, PIB lists intravenous iron sucrose or a blood transfusion.

3.5 Which foods must be fortified?

Fortified food has extra nutrients added to it. The Government of India has mandated fortified salt, wheat flour and oil in food served under ICDS and the Mid-day Meal scheme. ICDS is the Integrated Child Development Services scheme.

3.6 What are the non-nutritional causes?

Not every case of anaemia comes from poor food. AMB addresses causes in endemic pockets. Endemic means common in a particular area. The focus is on three causes.

• Malaria, which is also one of the important causes of anaemia.
• Haemoglobinopathies, which are disorders of haemoglobin. Sickle cell disease and thalassaemia are examples.
• Fluorosis, caused by too much fluoride in food and water. It reduces the absorption of iron and folic acid.

The guidelines add a safety note. Iron by injection is contraindicated in sickle cell disease. Contraindicated means it should not be used.

The strategy has six institutional mechanisms. These are the bodies and tools that keep the work moving.

• Inter-ministerial coordination.
• The National Anemia Mukt Bharat Unit.
• The National Centre of Excellence and Advanced Research on Anemia Control (NCEAR-A).
• Convergence with other ministries.
• Strengthening supply chain and logistics.
• The AMB dashboard and digital portal.

4.1 Who leads at the national level?

The National Unit works under the Joint Secretary (RMNCH+A) in the Health Ministry. NCEAR-A is housed at AIIMS, New Delhi, in its Centre for Community Medicine. NCEAR-A gives technical inputs and addresses research needs.

4.2 Who delivers it on the ground?

Health is a State subject. States and Union Territories carry the main duty. The Centre gives money and technical help through the National Health Mission. At the district level, the District Programme Officer under the National Health Mission handles day-to-day work. By September 2018 a web portal, anemiamuktbharat.info, had been built to show survey data and quarterly programme coverage.

The survey data do not show a fall in anaemia after 2018. Three surveys tell the story. NFHS-3 was in 2005-06. NFHS-4 was in 2015-16. NFHS-5 was in 2019-21.

5.1 What happened before AMB?

Between NFHS-3 and NFHS-4, anaemia fell slowly. Among children aged 6 to 59 months it went from 69% to 58%. Among pregnant women it went from 58% to 50%. Among adolescent boys it fell only from 30% to 29%.

5.2 What did NFHS-5 show?

NFHS-5 (2019-21) found higher anaemia than NFHS-4 in every group that PIB listed.

NFHS-5 also found 25.0% anaemia among men aged 15 to 49 years. PIB said the Covid-19 pandemic “hampered AMB programme implementation”.

5.3 What about NFHS-6?

The NFHS-6 (2023-24) fact sheets came out on 29 May 2026. PIB’s 4 August 2026 reply says anaemia figures will come from a separate ICMR survey instead. The Health Ministry decided this. That survey uses the intravenous method of testing haemoglobin. So anaemia figures will come from ICMR, not from the NFHS-6 fact sheets.

In June 2026 the Government revised the strategy. It moved from 6x6x6 to 7x7x7. It also gave the programme a new name.

6.1 What was released, and by whom?

Union Health Minister J P Nadda released the Anemia Mukt Bharat Abhiyaan Operational Guidelines on 29 June 2026. He did so at the 16th meeting of the Central Council of Health and Family Welfare, in New Delhi. The release marked eight years of the programme. The programme is now called Anemia Mukt Bharat Abhiyaan.

6.2 What is 7x7x7?

The new framework adds one item to each list. The seventh beneficiary group is low birth weight (LBW) babies aged 0 to 6 months. The seventh intervention is “Eating Right”. The seventh mechanism is a digital framework for monitoring and evaluation.

The Rajya Sabha reply of 11 August 2026 lists the seven beneficiaries as:

• Children 6 to 59 months.
• Children 5 to 9 years.
• Adolescents 10 to 19 years.
• Pregnant women.
• Lactating mothers.
• Women in reproductive age (20 to 49 years).
• LBW babies aged 0 to 6 months.

The seven interventions in the same reply are:

• Prophylactic IFA supplementation.
• Testing of anaemia.
• Therapeutic management of anaemia.
• Deworming and delayed cord clamping.
• Jan Bhagidari, a communication strategy to improve compliance with IFA.
• Addressing non-nutritional causes.
• Eating Right, which promotes locally available iron-rich food.

The seven institutional mechanisms in the same reply are:

• Intra-ministerial coordination.
• NCEAR-A.
• The National AMB Abhiyaan Unit.
• Supply chain and logistics.
• Convergence with other ministries.
• The AMB Abhiyaan Portal.
• A digital framework for monitoring through the T4 approach.

6.3 What is T4?

The older approach was T3: Test, Treat, Talk. The new approach is T4. It adds a fourth T, Track. Tracking means following each beneficiary for treatment, referral and follow-up.

6.4 What else is new?

• The focus shifts from prophylactic care to therapeutic care. Therapeutic care means treating people who already have anaemia.
• For pregnant and lactating women who are severely anaemic or do not respond to tablets, intravenous iron therapy is included. The two drugs named are FCM and iron sucrose.
• Haemoglobin records flow into one AMB Abhiyaan Portal. Pregnant women are recorded on the JANANI portal. School children are recorded on RBSK. Children who come for vaccination are recorded on U-WIN.
• Anaemia is sorted as mild, moderate or severe, with care to match.
• Jan Bhagidari is a nationwide community drive. It aims to turn passive acceptance of anaemia into active ownership.

UPSC asked about AMB in Civil Services Preliminary 2023. The question is below in the official wording. Read the key before you read the notes.

7.1 UPSC CSP 2023, GS Paper I

UPSC CSP 2023, GS Paper I, Q52.
Consider the following statements in the context of interventions being undertaken under Anaemia Mukt Bharat Strategy :
1. It provides prophylactic calcium supplementation for pre-school children, adolescents and pregnant women.
2. It runs a campaign for delayed cord clamping at the time of child-birth.
3. It provides for periodic deworming to children and adolescents.
4. It addresses non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis.
How many of the statements given above are correct?
(a) Only one
(b) Only two
(c) Only three
(d) All four

Official paper: UPSC question paper. Official answer key (Series A): UPSC key. Key: (c).

The official Series A key gives (c) Only three. Statement 1 is wrong. AMB gives iron and folic acid, not calcium. Statements 2, 3 and 4 are right. Delayed cord clamping, deworming and non-nutritional causes are all AMB interventions.

7.2 What traps should I avoid?

• IFA is iron and folic acid. It is not calcium.
• The syrup for children 6 to 59 months is given twice a week. Older children, adolescents and non-pregnant women get a weekly tablet.
• Pregnant and lactating women take a daily tablet for 180 days each.
• NFHS-5 shows a rise in anaemia, not a fall.
• The 2026 update is 7x7x7 and T4. The 2018 design is 6x6x6 and T3.