Treatment and tracking algorithm for iron deficiency anaemia among children and adolescents— a policy informed evidence— based framework for India

Background and objectives The Anaemia Mukt Bharat (AMB) programme advocates for ‘test, treat and track’ strategy. However, limited coverage, poor adherence, workforce shortages and inconsistent follow up, affect implementation. Recent programme monitoring data indicate suboptimal coverage of biweekly iron and folic acid (IFA) supplementation among children aged 6–59 mo, underscoring the need for a standardised, treatment and tracking algorithm. This exercise aimed to develop evidence-based treatment and tracking algorithms for iron deficiency anaemia in children and adolescents (6 mo-18 y) to support clinical decision-making, improve adherence and follow up, and strengthen the AMB programme implementation. Methods National/International guidelines and consensus statements were reviewed. Methodological quality was appraised using AGREE II tool. Systematic literature searches were conducted to address specific questions related to diagnostic thresholds for serum ferritin and C-reactive protein (CRP); iron supplementation dosage and frequency; and dosing strategies. Findings were consolidated to develop anaemia management algorithms, refined through expert consultation. Results Two algorithms one each for ( i ) mild, and ( ii ) moderate—to severe—anaemia were developed. The algorithms included treatment initiation, follow up, response assessment, and guidance to subsequent steps. Measurement of haemoglobin is suggested as the first line test for identification of anaemia, and serum ferritin and CRP for non-responders. Interpretation and conclusions The proposed algorithms provide an evidence—based operational approach to strengthen anaemia management and follow up within AMB programme settings to improve continuity of care and reduce variability in practice. These algorithms need field validation in different settings.