Ladies. Do you often have dizziness and headaches? Are you also feeling tired and becoming irritated easily? Do you think you look pale when you look at yourself in a mirror? If you answer ‘yes’ to these questions, you might be suffering from anemia, a condition that occurs when your body doesn’t have enough healthy red blood cells. When this happens, the blood cannot provide enough oxygen to the body.

The figures from the Health Data Center of the Ministry of Public Health in 2023 show that 37% of Thai women of reproductive age (15-49 years) who are not pregnant and have a screening test for anemia, suffer from the condition, while 31.2% of Thai pregnant women are anemic.

“Most healthy women get rosy cheeks naturally. They are able to have a healthy pregnancy and positive birth outcome for mother and child,” said Dr Suwannachai Wattanayingcharoenchai, director general of the Department of Health.

To help Thai women of reproductive age stay healthy and have a healthy pregnancy when they are ready, the Department of Health has launched the “Natural Rosy Cheeks” (or Saow Thai Kam Daeng in Thai) project. It also aims to raise awareness about maintaining good health under the Universal Health Scheme.

Under healthcare benefits managed by the National Health Security Office (NHSO), Thai infants aged between 6 months and five years are entitled to a liquid iron supplement, while children aged between 6 to 12 years are also provided with the supplement but in tablet form. Thai women of reproductive age are granted an iron supplement and folic acid in tablet form, while pregnant women are given access to iodine and iron supplements as well as folic acid until six months after they give birth.

Dr Suwannachai noted that the Ministry of Public Health has the policy to provide an iron nutrient for Thai people of different age groups to ensure that they get enough of it and stay healthy. It has also implemented nutritional improvement plans as an integral part of primary health care to reduce iron deficiency anemia.

“We have worked with a health network in an effort to control and prevent iron deficiency anemia among Thai people and prevent newborn babies from some certain birth defects that are caused by folic acid deficiency,” he said, adding that iron nutrition and folic acid are important for pregnancy as they can prevent some serious birth defects.

Anemia is a serious global public health problem that particularly affects young children and pregnant women. The World Health Organization (WHO) estimates that 42% of children under 5 years of age and 40% of pregnant women worldwide are anemic, while half a billion women of reproductive age worldwide are affected by the health condition.

The causes of anemia are variable. However, it’s estimated that half of all cases are due to iron deficiency, the WHO said.

The World Health Assembly is targeting a 50% reduction of anemia in women of reproductive age by 2025. Thailand, meanwhile, aims to reduce the number of women of reproductive age with anemia to 12.4% by 2030, Dr Montein Kanasawat, deputy director general of the Department of Health noted.

“We aim to ensure that women of reproductive age have a healthy balanced diet and get enough iron and folic acid. We have worked hard to promote the ‘Natural Red Cheeks’ project to the public through the media, particularly among women of reproductive age who are the project’s main target group,” he said.

To achieve the national goal, the Department of Health has worked hand in hand with 77 companies to promote the project in a pilot scheme that could be extended to other enterprises in the future.

“Women of reproductive age group are workers. That’s why we have to work with companies under this project,” said Dr Montein.

The companies chosen to take part in this project must have a policy or measures that support and prevent iron deficiency anemia, and/or have health promotion policies or measures in place. They initiate activities that promote eating healthy diets that are high in iron and folate. The companies’ workers who are of reproductive age receive the iron supplement and folic acid the government provides to take.  The companies must also encourage workers to have a hemoglobin blood test and anemia evaluation every year.

Improving access to supplements for anemia amongst women of reproductive age

Dr Montein noted that the Department of Health has speeded up its efforts to have talks with the NHSO to improve the services and access to supplements for anemia amongst women. The department plans to urge the NHSO to provide the iron supplement and folic acid to women aged 13-45.

“This could help them better maintain health so they can be productive at work and are able to have healthy pregnancy when they wish to do so. It’s important for them to be healthy,” he said.

He added that the department has also encouraged Thai women to eat foods including vegetables and fruits that are packed with iron. Good sources of iron, according to him, are red meats and liver.

Dr Krit Leethongin, advisor to the NHSO said that in 2023 the agency has allocated a certain amount of its budget for the supplements.

Thai women of reproductive age are granted to supplements that include 60 mg iron and 2,800 mcg folic acid tablets per week. They can receive the services from local hospitals and clinics, health care centers, public health centers near their community and pharmacies that have registered with the HNSO nationwide.

He added that the NHSO has held talks with the Comptroller General’s Department and the Social Security Office in an effort to draft a law that allows all Thai people under all the government’s health security funds to receive the services more conveniently.

“We believe that we will be able to provide better services in the future,” Dr Krit said.

Workers who are members of Social Security Fund are now required to receive the services at public health units under the Ministry of Public Health. The services are not provided at hospitals that offer the Social Security Scheme.

By Veena thoopkrajae