Health facility-based data
The facility must carry out routine screening of haemoglobin levels for all women and not just those at risk. There are potential problems with unrepresentativeness of samples and incomplete record keeping.
Special population surveys can be conducted to assess the anaemia rate pre-and post-intervention with, for example, iron supplementation. Specific groups could include schoolgirls and mothers of children below 24 months of age (pregnant, nonpregnant, lactating, non-lactating).
The gold standard for assessing haemoglobin concentration is the direct cyanmethaemoglobin method (1). This method depends on the conditions under which the blood was collected, however, and also on access to proper laboratory facilities, which are not available or affordable in many settings. Others, such as the indirect cyanmethaemoglobin or the HemoCue methods, can be used in the field for large surveys in remote areas to analyse blood collected in a microcuvette (1,2). Nevertheless, in most antenatal clinics in developing countries where resources are lacking, anaemia screening is based on clinical examination (3). For these settings, WHO has developed a haemoglobin colour 41
scale, which compares the colour shade of blood with defined hues of red (4,5).
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