Patna: A staggering 63.5 per cent of children aged six-59 months, 60.4 per cent of non-pregnant women aged 15-49 years, and 58.3 per cent of pregnant women aged 15-49 years are anaemic in Bihar, according to the 2015-16 National Family Health Survey 4 (NFHS4).

The survey, the fourth of its kind and the results of which were released early this year, for the first time provides district-level estimates for many important indicators.

In Patna district, 51.6 per cent of children aged 6-59 months are anaemic, as are 67.4 per cent of women aged 15-49 years.

People suffering from anaemia lack enough healthy red blood cells (RBC) to carry oxygen throughout the body. And fewer healthy RBC could mean less oxygen travelling to the brain and may result in cognitive decline. Those who do have anaemia symptoms may feel tired, become easily fatigued, appear pale, have a feeling of a racing heart, feel short of breath, and/or have worsening heart problems.

Anaemia can be caused by several conditions, including kidney disease, and nutritional deficiencies, especially of iron.

The government claims it is doing its bit.

"We are providing iron tablets free to all women, including those who are pregnant, from time to time," said Lokesh Kumar Singh, executive director cum secretary of the State Health Society.

However, the state government programme of providing free iron, vitamin and calcium tablets to children in schools and colleges by organising camps has been suspended for the last five months.

"Yes, the children are not being currently provided free iron tablets," Singh said. "The tender process for it is in the final stage. Once it is completed, free iron tablets would be provided to children too."

Experts say that while the government has started to recognise the problem of anaemia and under-nutrition in women, there are gaps in addressing the problem.

"Anaemia is a bigger challenge though we often speak of non-communicable diseases which need to be dealt with urgency," said Dr Ajay Kumar, senior vice-president of the Indian Medical Association's Bihar chapter.

"Only nutrition cannot address the problem," said Patna-based paediatrician Dr A.K. Thakur. "Poor hygiene is a major cause for anaemia because it prevents absorption of nutrition."

Low awareness, illiteracy and the practice of putting "family before self" when it comes to care are factors that often deter women in India from taking proper nutrition and care for themselves leading to anaemia, he said. "The impact can be severe at times, especially when it happens in the child-bearing age," he added.

Anaemia among women in the reproductive age often leads to health issues in the mother as well as the child. While such women are prone to infection and may need blood transfusion during pregnancy, their children often remain under-developed with poor immunity, said Ajay Kumar.