Micronutrient Supplementation Programmes in India
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Direct answer
National micronutrient supplementation programmes in India deliver vitamin A, iron folic acid, zinc and calcium to prevent night blindness, anaemia and childhood diarrhoea. The examinable doses are one lakh IU of vitamin A at nine months and two lakh IU every six months from one to five years, and 20 mg of zinc daily for 14 days in children above six months.
What you must remember
- Vitamin A prophylaxis: one lakh IU at nine months, given with the measles vaccine, then two lakh IU every six months from about 16 to 18 months up to five years (often stated as one to five years).
- Vitamin A deficiency signs: night blindness, Bitot spots and xerophthalmia, with corneal ulceration in advanced cases.
- Weekly IFA: 100 mg elemental iron with 500 µg folic acid once weekly for adolescents aged 10 to 19 years.
- Antenatal IFA: daily iron folic acid in pregnancy, with 100 mg elemental iron and 500 µg folic acid, continued for about 180 days.
- Zinc in diarrhoea: 20 mg daily for 14 days for children above six months, and 10 mg daily for infants under six months.
- Anaemia cut-off: haemoglobin below 11 g/dL defines anaemia in children aged 6 to 59 months, per WHO criteria.
- Calcium in pregnancy: WHO advises calcium supplementation where dietary intake is low, to reduce the risk of pre-eclampsia.
A schedule-based approach across the life cycle
Micronutrient programmes follow the child from infancy through adolescence and pregnancy, and each stage has its own target. The steps below group the doses by life stage, so the dose can be recalled from the patient's age.
- Infancy and toddlerhood: give vitamin A at nine months and then every six months until five years, pairing the dose with routine immunisation contacts.
- Adolescence: provide weekly iron folic acid to girls and boys aged 10 to 19 years, because iron needs rise at puberty and menstruation begins.
- Pregnancy and postpartum: give daily iron folic acid throughout pregnancy, and a postpartum vitamin A dose to the mother within the early weeks after delivery.
- Childhood diarrhoea: add zinc to oral rehydration salts, using 10 mg for infants under six months and 20 mg for older children, for 14 days.
- Monitoring: check haemoglobin against age-specific cut-offs, and use the results to target districts under the Anaemia Mukt Bharat strategy.
These steps show that a dose is always linked to a group, not to a drug name alone.
Where the exam tries to catch you
Micronutrient questions reward careful reading of the age in the stem. Each trap below comes from applying the right dose to the wrong group.
- Trap: giving one lakh IU of vitamin A to a child aged two years. Correct: the one to five year dose is two lakh IU every six months, while one lakh IU is the nine-month infant dose.
- Trap: prescribing 20 mg of zinc to a five-month-old with diarrhoea. Correct: infants under six months receive 10 mg daily for 14 days, and 20 mg is for children above six months.
- Trap: calling a haemoglobin of 11.2 g/dL in a three-year-old anaemic. Correct: the WHO cut-off for children aged 6 to 59 months is below 11 g/dL, so this child is not anaemic by that definition.
Frequently asked questions
What is the vitamin A prophylaxis schedule for children under five in India?
Infants receive one lakh IU of vitamin A at nine months, given alongside the measles vaccine. Children aged one to five years receive two lakh IU every six months. Mothers also receive a postpartum dose in the weeks after delivery.
Which iron folic acid regimen does the weekly programme use for adolescents?
The weekly iron folic acid supplementation programme gives adolescents aged 10 to 19 years 100 mg of elemental iron with 500 µg of folic acid once a week. Its aim is to prevent iron deficiency anaemia in a group with rising needs at puberty. Distribution is through schools and community settings.
What is the zinc dose for acute diarrhoea in children?
Children above six months with acute diarrhoea receive 20 mg of zinc daily for 14 days. Infants under six months receive 10 mg daily for the same 14 days. Zinc is given alongside oral rehydration salts, because it shortens the illness and reduces recurrence.
What is the haemoglobin cut-off for anaemia in children aged 6 to 59 months?
WHO defines anaemia in children aged 6 to 59 months as haemoglobin below 11 g/dL. Cut-offs differ for older children and for pregnant women, so the age group must always be stated. Using the correct cut-off prevents both missed anaemia and over-diagnosis.
Why is calcium supplementation given in pregnancy?
WHO recommends calcium supplementation in pregnancy for populations with low dietary calcium intake, to reduce the risk of pre-eclampsia. Calcium is not a universal programme for every pregnant woman. The dose and programme use follow current national guidance.