Community-led initiative for control of anemia among children 6 to 35 months of age and unmarried adolescent girls in rural Wardha, India.
Study Goal
To evaluate the effect of a community-led initiative involving iron supplementation and nutritional education on reducing nutritional anemia in children and adolescent girls.
Results Summary
The initiative significantly reduced anemia prevalence from 73.8% to 54.6% in adolescent girls and from 78.2% to 64.2% in children, while improving awareness of iron-rich foods and perceived health benefits.
Population
Children aged 6-35 months and unmarried rural adolescent girls aged 12-19 years in Maharashtra, India.
Effective Dosage
Weekly iron-folic acid tablets for adolescent girls; daily liquid iron prophylaxis for children for 100 days/year.
Duration
Approximately 4-5 months (February/March to June/July 2008).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
weekly iron-folic acid tablets | decrease | nutritional anemia | adolescent girls | from 73.8% to 54.6% | significant reduction in the prevalence of | #1 |
daily liquid iron prophylaxis for 100 days in a year | decrease | nutritional anemia | children 6 to 35 months of age | from 78.2% to 64.2% | significant reduction in the prevalence of | #2 |
nutritional education | increase | iron-rich food items | adolescent girls and the mothers of the children | - | improvement in awareness of | #3 |
weekly iron supplementation | increase | appetite | girls | - | increase in | #4 |
weekly iron supplementation | decrease | scanty menses | girls | - | reduction in | #5 |
weekly iron supplementation | decrease | tiredness | girls | - | reduction in | #6 |
weekly iron supplementation | decrease | weakness | girls | - | reduction in | #7 |
iron syrup | increase | appetite | children | - | increase in | #8 |
iron syrup | increase | weight | children | - | weight gain | #9 |
iron syrup | decrease | irritability | children | - | reduction in | #10 |
iron syrup | decrease | mud-eating behavior | children | - | reduction in | #11 |
community-led initiative for once-weekly iron supplementation for adolescent girls and iron prophylaxis for children, in addition to nutritional education | increase | hemoglobin status | children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age | - | improved | #12 |
BACKGROUND: Studies in India have reported a high prevalence of nutritional anemia among children and adolescent girls. Nutritional anemia is associated with impaired mental, physical, and cognitive performance in children and is a significant risk factor for maternal mortality. OBJECTIVE: To evaluate the effect of a community-led initiative for control of nutritional anemia among children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age. METHODS: This Participatory Action Research was done in 23 villages of the Primary Health Centre, Anji, in Wardha District of Maharashtra. In February and March 2008, needs assessment was undertaken by interviewing the mothers of 261 children and 260 adolescent girls. Hemoglobin levels of adolescent girls and children were measured with the use of the hemoglobin color scale. The girls were given weekly iron-folic acid tablets, and the children were given daily liquid iron prophylaxis for 100 days in a year through community participation. The adolescent girls and the mothers of the children and adolescent girls were also given nutritional education on the benefits and side effects of iron supplementation. In June and July 2008, follow-up assessment was performed by survey and force field analysis. RESULTS: There was a significant reduction in the prevalence of nutritional anemia from 73.8% to 54.6% among the adolescent girls and from 78.2% to 64.2% among the children. There was improvement in awareness of iron-rich food items among the adolescent girls and the mothers of the children. The benefits to girls, such as increase in appetite and reduction in scanty menses, tiredness, and weakness, acted as positive factors leading to better compliance with weekly iron supplementation. The benefits to children perceived by the mothers, such as increase in appetite, weight gain, reduction in irritability, and reduction in mud-eating behavior, acted as a dominant positive force and generated demand for iron syrup. CONCLUSIONS: The community-led initiative for once-weekly iron supplementation for adolescent girls and iron prophylaxis for children, in addition to nutritional education, improved the hemoglobin status of children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age.