Recent World Health Organization (WHO)/United Nations Children's Fund estimates suggest that the number of children with iron-deficiency anaemia (IDA) is greater than 750 million . Iron deficiency is the most common preventable nutritional problem despite continued global goals for its control. Historically, the problem of IDA in children largely disappeared in North America when foods fortified with iron and other micronutrients became available for children. In this group, the prevalence of IDA has fallen from 21% in 1974 to 13% in 1994 . Although pockets of infants and children remain at risk, generally, the eradication of iron deficiency in developed countries is recognized as a successful public health accomplishment. This solution has not worked in developing countries where commercially purchased fortified foods are not available or are not used.
In the developing world, there are three major approaches available to address iron deficiency: dietary diversification so as to include foods rich in absorbable iron, fortification of staple food items (such as wheat flour), and the provision of iron supplements. When dietary or fortification strategies are not logistically or economically feasible, supplementation of individuals and groups at risk is an alternative strategy. For the past 150 years or more, oral ferrous sulphate syrups have been the primary strategy to control IDA in infants and young children . However, adherence to the syrups is often limited owing to a combination of their unpleasant metallic aftertaste, the dark stain they leave on the child's teeth, and abdominal discomfort . Thus, despite the ongoing work of the United Nations Standing SubCommittee on Nutrition and others to solve the problem of poor adherence in infants and young children, all interventions to date have been universally unsuccessful [1,5]. In this article, we describe our efforts, stage by stage, towards achieving the goal of controlling IDA.