ABSTRACT
Objectives: In India, 79% of children less than three years are anemic. Intermittent iron supplementation, home-fortification with multiple micronutrient powders (MMP), and delayed cord clamping are scientifically recommended interventions to prevent pediatric anemia. Little is known about the extent to which these interventions are integrated into programs in India. Examine to what extent anemia control programs in India incorporate scientific recommendations and analyze their operational evidence-base. Methodology: We critically reviewed published (2000-2012) and grey literature, and government and non-government program documentation. Results: Published literature on interventions to reduce pediatric anemia in India is scant; there are six efficacy studies (1-delayed cord clamping; 1-use of MMP; 3- iron supplementation; 1- fortified milk) and no effectiveness studies. Intermittent iron supplementation delivered by frontline workers is the only intervention included in government programs. Only 2 of the 22 NGO programs reviewed provided iron supplements. Little is known about the operational successes and challenges on the demand and supply-side of the programs and of effectiveness of these programs. Neither national nor NGO programs include newer interventions such as MNPs or delayed cord-clamping. Conclusions: A poor evidence base on challenges and solutions to delivering iron supplementation in India precludes from strengthening operational strategies for iron supplementation. Lack of evidence on the efficacy and effectiveness of other recommended interventions prevents identification of alternate strategies for addressing pediatric anemia in India. A research agenda that focuses on closing these operational and effectiveness knowledge gaps is essential to make progress towards reducing the burden of anemia in India.