Maternal & Child Health: Healthy Families InitiativeEprise Armstrong, Dessa Shuckerow & Audra Tafoya July 21, 2011
OverviewThe Healthy Family Initiative (HFI) is designed to lower the prevalence of maternal nutrition- related anaemia through social marketing and the early introduction of a maternal micronutrient supplement (MMS).
Maternal Anaemia Tamil Nadu Statewide - 53% maternal anaemia1 ICTPH Catchment Area - 59.3% of pregnant women were anaemic 2 - 50.3% of non-pregnant women were anaemic3Sources: NHFS-3, NHFS-2, ICTPH Epidemiological Baseline Survey
Burden of DiseaseAnaemia costs an estimated 6% of India’s GDP4$320 in GDP/capita 5153 million deaths world-wide616.152 million Daily Adjusted Life Years (DALYs) worldwide 7
Main DeterminantsHealth System- Diagnostics- EducationPopulation- Lack of access to Vitamin B/Iron rich foodsHousehold- Worm infestations- Diet
Strategy 1: PreparationFormative Research- Knowledge, Attitudes, and Practices (KAPS)- Acceptability of UN Multiple Micronutrient International Preparation (UNIMAP)- Development of education & marketing materials
Strategy 2: Education & TrainingEducate SVGs/CHWs- Anaemia- Early Pregnancy Detection- UNIMAP/MMS- Incentives Program- DiagnosticsEducate women & families in their homes
Strategy 4: DiagnosticsEarly detection of pregnancy with in-home pregnancy testsPeripheral Blood Smears to identify specific micronutrient deficiencyAntenatal diagnostics in 1st trimesterWoman is educated and given a copy of her diagnostics to take to PHC
Prospective Cohort EvaluationPhase I: includes intervention strategies occurring prior toa woman giving birthPhase II: includes follow up for the purposes of continuededucation, training, and evaluation.
Primary Impact ObjectiveLower prevalence of maternal nutrition related anaemia by end of 2nd trimester of pregnancy- Measure: HGL and Peripheral Blood Smear Test
Secondary Client Outcomes and Indicators Outcomes Indicators Infant birthweight Weight at birth (self- report)Maternal weight gain Weight at monthly check- ups Infant malnutrition Height, weight, arm- circumference Preterm delivery Earlier than-expected delivery Infant anaemia HGL Levels
Process ObjectivesImproved KAPs regarding early pregnancy detection and MMSMore complete antenatal diagnosticsMore complete picture of anaemia prevalence and causes
AcknowledgementsICTPH StaffVani Priya, Sangeetha Lakshmanan,Subhalakshmi Ganguly, Deepak Rajanna,Sabyasachi Das, Selva Swetha, and Dr. ZeenaJoharSVGs and RMHC StaffResidents of Karambayam
Contact Information Eprise Armstrong, MSW email@example.com Dessa Shuckerow, MPH/MSW firstname.lastname@example.org Audra Tafoya, MPH email@example.com Washington University in Saint LouisGeorge Warren Brown School of Social WorkOne Brookings Drive - Saint Louis, MO 63130
References1. National Family Health Survey 2005-2006 (NHFS-3: Tamil Nadu State Report). (2008). Mumbai: International Institute for Population Sciences (IIPS) and Macro International.2. ICTPH Epidemiological and Needs Assessment Census Survey in three villages of Rural Tamil Nadu. (2010-2011).3. Ibid.4. Horton, S. (2003). The Economics of Iron Deficiency. Food Policy, 28(1), 51-75. doi: 10.1016/s0306- 9192(02)00070-25. Ibid.6. The World Health Organization. (2004). WHO Annex A: Death and DALYs 2004. Annex Tables. Accessed on 6/15/2011: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf7. Ibid.