Expanding the Response to Maternal Anemia: Bringing in the Agriculture Sector

Abstract

Objectives: Maternal anemia remains an important public health problem contributing to maternal mortality and constraining women's ability to reach their productive potential. Consumption of iron-rich foods, taking the minimum 90+ IFA tablets required, and other behaviors related to maternal anemia prevention and control are low. Controlling maternal anemia has long been considered the purview of the health sector. Our objective was to construct a framework that would help the health and agriculture sectors to address maternal anemia as a public health problem AND an agro-economy problem, with sector-specific as well as cross-sectoral interventions.  Methods: Literature reviews, formative research, and a consideration of integrated nutrition program interventions in three Feed the Future countries led to adding agriculture-specific interventions to the health sector critical pathways.  Results: The resulting framework helps the agriculture and health sectors identify their respective roles in maternal anemia prevention and control and areas for strategic collaboration. The agriculture sector pathways lead to interventions supporting increased iron intake: for example, promotion of low-input technologies for growing, raising, preserving and storing iron-rich foods (IRF) including animal source foods. In addition, agriculture extension can support maternal anemia reduction and control by reducing exposure to helminth infections and malaria. BCC interventions meanwhile promote family dialogue and joint decision-making on use of household income to buy IRF. Conclusions: The integrated pathways framework can assist countries to 1) adapt the framework to their own contexts; 2) engage key stakeholders across sectors to find the most critical actions to address the causes of the country's maternal anemia problem.