BEYOND HEMOGLOBIN: RISK-BASED AND NONINVASIVE SCREENING TO ENHANCE EARLY DETECTION OF IRON DEFICIENCY AMONG CHILDREN IN INDONESIA

Abstract

Background: Iron deficiency anemia (IDA) remains the most common micronutrient deficiency globally and continues to represent a major public health concern among children younger than five years, particularly in low- and middle-income countries. Early identification of children at risk is essential to prevent adverse effects on growth, neurodevelopment, and long-term health outcomes. Methods: A narrative review was undertaken to synthesize evidence from observational studies indexed in Scopus and published between 2019 and 2026. The review focused on studies evaluating screening approaches beyond conventional hemoglobin measurement, with particular emphasis on risk-based and non-invasive strategies for improving the early detection of IDA among Indonesian children. Results: The available evidence indicates that, in settings where access to invasive laboratory investigations is constrained, validated risk-based screening instruments and non-invasive assessment methods may improve the identification of children at risk for IDA. These approaches contribute not only to more accurate estimation of disease burden but also to a broader understanding of the cognitive implications and nutritional determinants of iron deficiency, extending beyond reliance on biomarker-defined diagnostic thresholds. Conclusion: Incorporating a practical risk-based IDA screening tool into routine child growth monitoring has the potential to enhance the early identification of vulnerable children, facilitate appropriate referral for confirmatory testing and timely intervention, and support the integration of anemia prevention within Indonesia's existing child nutrition and growth promotion programs.