Barriers to Implementation and Anemia Prevalence among Adolescents under the Anemia Mukt Bharat Abhiyan: A Cross-Sectional Study

Abstract

Anemia remains one of the foremost nutritional and public health challenges globally, especially in low- and middle-income countries such as India. Among adolescents, the burden of anemia adversely affects growth, cognition, school performance, and lifetime well-being. In response, the Government of India launched the Anemia Mukt Bharat Abhiyan (AMB or AMBA) in 2018 (as part of Poshan Abhiyaan), with a six-by-six strategic framework aiming to reduce anemia prevalence across age groups. However, field-level gaps in implementation may undermine its effectiveness. This cross-sectional study assessed anemia prevalence and examined barriers to AMB implementation among 300 school-going adolescents aged 10–19 years in Sarojini Nagar Lucknow. Hemoglobin reports and a semi-structured questionnaire (covering socio-demographics, dietary practices, awareness, and perceived programmatic challenges) were used. The overall anemia prevalence was 57%, with significantly higher prevalence in females (64%) than males (44%). Only 38% of adolescents were aware of AMB, and just 32% had received iron–folic acid (IFA) supplementation in the past six months. Major barriers cited included irregular IFA supply (47%), absence of health education sessions (42%), socio-cultural myths (29%), and limited parental awareness (41%). The findings underscore the persistent gap between policy and practice. To strengthen AMB’s impact, study recommend improvements in supply chain, monitoring mechanisms, school-based BCC (behaviour change communication), and community integration. Addressing systemic, operational, and socio-cultural obstacles is essential if India is to realize the vision of an “Anemia Mukt Bharat.”