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Anaemia is the most serious complication of iron deficiency and a significant cause of death. More than half of the pregnant women in developing countries suffer from anaemia. The accurate estimation of haemoglobin levels is an essential pre-requisite in a variety of other health issues, such as trauma care, selection of blood donors, epidemiological studies, and general primary health care. The measurement of haemoglobin in blood as an indicator of anaemia has traditionally relied on the services of a well-equipped clinical laboratory. In primary health care centers, when laboratory facilities are not available, anaemia is usually diagnosed from clinical signs (pallor of the conjunctiva, tongue, palms and nail beds, using anaemia recognition cards if available), although accurate interpretation of these signs depends a great deal on effective training. However, in rural areas where anaemia is common, an alternative method is needed to screen for anaemia easily and economically.

How does the Colour Scale for Haemoglobin work?

It is a simple and effective medical device for the accurate estimation of haemoglobin levels in blood. It comprises a small card with six shades of red that represent haemoglobin levels at 4, 6, 8, 10, 12 & 14 g/dl respectively.
The device is simple to use:
- Place a drop of blood on the test strip provided
- Wait about 30 seconds
- Match immediately the colour of the blood spot against one of the hues on the scale.
This will indicate whether the patient is anaemic and, if so, the severity of anaemia in clinical terms.

Sensitivity and specificity of the Scale to screen for anaemia

For severe anaemia, the Scale shows a sensitivity of 95% and a specificity of 99.6%. To distinguish normal from mild anaemia, the sensitivity and specificity are 98%. Using a photometer (Stat-Site M) as a reference, the Scale was compared with the copper sulphate specific gravity method that is traditionally used to screen blood donors for anaemia. The scale was accurate to 98% in distinguishing among 2,800 volunteer blood donors those with normal Hb from those rejected because of anaemia. The Scale was more reliable than copper sulphate, the tests giving 2.4% and 5.4% false readings respectively.

Sensitivity and specificity of the Scale to screen for anaemia

S.R No	Name of the instrument & description (Salient features)
A	Colour Scale for Haemoglobin (Starter Kit)
	Colour Scale for Haemoglobin shall be based on the principle of comparing the Colour of a drop of blood absorbed on a particular type of paper, against a printed scale of Colour corresponding to different levels of haemoglobin.
	The range of haemoglobin shall be 4-14 gm/dl. The technique shall be simple and inexpensive method for estimating haemoglobin. It shall not require any additional chemicals reagents, energy source etc. to perform the test. It shall be suitable for field test. It shall be suitable for field work.
	Components: 1. Colour scale as above. 2. Test strips - 200 strips 3. Printed Literature regarding method of use.
B	Haemoglobin test strips- Refill kit of 2000 strips Specification as above at "A"
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