Tj anemia mukta balika program

1. Anemia Mukta Balika
Program

2. The problem
 Approx. 10% adolescent females of the world live in India.
 1/2 Adolescent Girls in India are Anemic (Global Nutrition Report 2017)
Adolesce
nt Girls
in India,
10
In Rest
of the
world, 90
Adolescent Girl
Population
5050
Anemic Adolescent Girls in India

3. Anemia and SDGs
Anemia is a leading
indicator of target 2.2
According to target 2.2
in Global Goal 2 on Zero
Hunger, the stated aim
is to eradicate “all forms
of malnutrition” and it
mentions specific
population subgroups
including children under
5, adolescent girls,
pregnant and lactating
women, as well as older
people. (Hemocue,
2016)
Target 3.12 is
focused on capacity
building to reduce
health risks to all
groups
SDG 3’s, target 13:
Strengthen the
capacity of all
countries, in particular
developing countries,
for early warning, risk
reduction and
management of
national and global
health risks.
Since Anemia impairs sexual
and reproductive health, it is
an essential focus area to
foster gender equality as
expressed in target 5.6
Ensure universal access to
sexual and reproductive health
and reproductive rights as
agreed in accordance with the
Programme of Action of the
International Conference on
Population and Development
and the Beijing Platform for
Action and the outcome
documents of their review
conferences.

4. 3
strategies

5. 3.5 Decades, 3
Ministries, 5
Missions/Policies

6. NATIONAL
IRON PLUS
INITIATIVE
FOR ANAEMIA
CONTROL
Iron Folic Acid (IFA) Supplementation: Lifelong supplementation of Iron from the age of 6 month
onwards

7. WIFS Structure

8. Ministry of Health and
Family Welfare / State
Directorate of Health
and Family Welfare

9. Lack of success of the WIFS Program
Govt. of India 12th Five
Year Plan targeted to
reduce anemia among
women and girls by 50%
(28% by 2017).

10. Potential Challenge Areas and Who can
do What(?)
Diagnostic infrastructure
Training to
teachers and
Anganwadi
workers
Reporting, monitoring, and
review
Compliance
to medication

11. Potential Challenge Areas and Who can
do What(?)
Diagnostic infrastructure
Training
teachers and
Anganwadi
workers
Reporting, monitoring, and
review
Compliance
to medication
Jagruthi + IMA + FOGSI
Jagruthi Volunteers
Nodal Officer + Jagruthi
Volunteers
Govt. Primary Health Centres +
Private diagnostic centres

12. Telangana Jagruthi’s Anemia Mukta Balika Program
(Nizamabad)

13. Program Overview
 Objective: To bring down the level of anemia in adolescent girls to 28% (as envisioned in the 12th
Annual Plan) or below.
 Treatment group: Adolescent girls in and out of schools of age 12 to 21.
 Duration: Telangana Jagruthi’s intervention will engage adolescent girls for a period of 7 years or
her turning 21 years of age.

14. Approach
Educate
• Conduct
workshops on:
• Menstrual
hygiene and
health
• Food and
nutrition
• Social and
legal rights
• 3 Workshops in
each government
school in the
district every year
Support
• Support
government
agencies in
screening and
diagnosis of
anemia
• Support nodal
officers in
schools and
Anganwadi
centres to plan
& build capacity
(Diagnostic
infrastructure
etc.)
Monitor
• Monitor
compliance to
IFA medication
(bi-weekly
volunteer visit)
• Monitor stock
supply and
availability of
IFA and de-
worming
medication
• Monitor
compliance to
awareness
programs
Evaluate
• Conduct pre-
post anemia
screening tests
in randomly
selected govt.
schools
• Evaluate other
parameters such
as age of
marriage,
educational
outcomes,
attendance
rates, dropout
rates
• Partner with
UNICEF, Indian
Medical
Association,
FOGSI, and the
private sector
• Counselling
support (on
call/in-person)
• Mentorship
pairs (big
sister/akka
program) – tech
enabled
Participate

15. Expected Outcomes
 Expected Outcomes for Nizamabad:
 Cases of anemia in adolescent girls age (12 to 17) reduced to less than 28%
 Zero cases of severe anemia (HB levels under 7) in adolescent girls after 1 year of
program take-up
 Improved educational outcomes for girls undergoing the program
 Improved overall health outcomes for girls undergoing the program

16. Program TImelines
Engage
Engagement period if take up is at age 17
Engagement period if take up is at age 16
Engagement period if take up is at age 15
Engagement period if take up is at age 14
Engagement period if take up is at age 13
Engagement period if take up is at age 12
Age 12 13 14 15 16 17 18 19 20 21
Educate
Menstural hygeine and health
Through Anganwadi Centres/Open School
Workshops
Food and nutrition
Through Anganwadi Centres/Open School
Workshops
Social justice and legal rights of women
Through Anganwadi Centres/Open School
Workshops
Monitor
Monitor HB levels
Self reporting
through
Anganwadi
support
Monitor Deworming interventions
Supplement need assessment and supply chain monitoring (Montly)
Participate
Counselling support (on call/in person)
Develop capacity and knowledge sharing partnerships with IMA, FOGSI,
Private sector etc.
Mentorship pairs (Big sister/akka initiative) [5 year gap] Mentors Mentors Mentors Mentors Mentors Mentors
Support: Continuous
Evaluate (June to September for each district)

17. A Pilot in Nizamabad

18. Phase 1: Screening (June to September)
 Telangana Jagruthi conducted a
comprehensive screening of 280
government schools in the
Nizamabad district of Telangana
and found 79% of the girls to be
affected by anemia.
 Out of the 18000 girls screened,
approximately 14, 600 girls were
found to be anemic.
A clear indication of a lack of
implementation/effectiveness of
the WIFS Program

19. Nizamabad’s Anemia Profile for Adolescent
Girls
 In the survey conducted from June to
September 2018 in Nizamabad, out of the
18000 girls in government schools of the
district:
 32% suffered from mild anemia (HB levels
between 10 and 11), approximately
 32% had moderate levels of anemia (HB levels
7 to 10), and approximately
 15% had severe anemia (HB levels less than
7) !!
A clear indication of a lack of
implementation/effectiveness of
the WIFS Program

20. TJ teams coordinate with other agencies
and facilitate on ground support
Knowledge Partnerships + Infrastructural Facilitation
Phase 2: Partnerships for Capacity Building (Oct to May)

21. TJ teams track health and wellbeing of a girl until the age of 21
from Jun 2018 onward (already started) on an annual basis
(depending on data availability for the parameter)
HB levels Age of marriage Dropout rates
Admission into
higher education
Attendance rates
Phase 3: Evaluate (June to September) each year

22. Thank You