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13th May 2005. Kotecha. 2. Iron Deficiency. Iron deficiency is the most common nutritional disorder in the world. 4-5 billion people (66-80%) of the global population is iron deficit.2 Billion anemic people (30% of global population) in the world are anemicID affects more people than any other con
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1. Anemia as a public health problemAdolescent Girls’ Anemia Control ProgramBaroda Experience and Scaling up For Nutrition Workshop
Prakash V Kotecha
Department of Preventive Social Medicine
Medical College Vadodara, Gujarat, India
Technical Support : UNICEF Gujarat
2. 13th May 2005 Kotecha 2 Iron Deficiency Iron deficiency is the most common nutritional disorder in the world. 4-5 billion people (66-80%) of the global population is iron deficit.
2 Billion anemic people (30% of global population) in the world are anemic
ID affects more people than any other condition in the world.. And remains silent despite severe consequences than other common conditions…
3. 13th May 2005 Kotecha 3 Population, anemia prevalence in risk groups, and death and disability attributable to iron-deficiency anemia in the world and in selected developing regions of the world
4. 13th May 2005 Kotecha 4 Prevalence of Anemia in Children NFHS II
5. 13th May 2005 Kotecha 5 Prevalence of Anemia in Women ICMR Mutli Centric Districts Study
6. 13th May 2005 Kotecha 6 Anemia Control strategy Position Magnitude of the problem and its effects are well appreciated in the programs…..!
#Tenth five year plan 2002-2007 goal
To reduce prevalence of anemia by 25% and moderate and severe anemia by 50% in children, pregnant and lactating women and adolescents!
Screening of children for anemia whenever required and appropriate treatment of those found anemic!
Universal screening of pregnant women for anemia and appropriate treatment!
7. 13th May 2005 Kotecha 7 So what should we do? Not just know anemia but UNDERSTAND anemia, its wide spread consequences in the field much beyond health
Effectively communicate that to those who DECIDE POLICY AND ALLOCATE RESOURCES
Come with technically sound, practically feasible and realistically targeted program
8. 13th May 2005 Kotecha 8 Why Anemia Control? Reduction of anemia means
More School attendance
Better Learning
More capacity to work and increased productivity
More income for individual and country
Less expenses and need for health care
Ability for care for self and others improved
Quality of life improves….
9. 13th May 2005 Kotecha 9 Why Anemia Control?
10. 13th May 2005 Kotecha 10 Gujarat Experience
11. 13th May 2005 Kotecha 11 Why Adolescent Girls?
Anemia in pregnancy has not been controlled ever….and anywhere….
Quality of life matters….
Adolescent age group is 1/6th of the total population and important one…
Half of them adolescent girls:
40% marriage by age of 18 years among all married women including young women (MICS 1999, 2001)
12. 13th May 2005 Kotecha 12 Background for the Project Baseline prevalence of anemia 75% in adolescent school girls
Similar among rural, tribal and urban areas
Readiness to take IFA tablets to 98% level
Technical and Administrative Assistance available
All 426 schools covered under the program
14. 13th May 2005 Kotecha 14 State Ministers Health, Education & UNICEF Chief Inaugurating
15. 13th May 2005 Kotecha 15 Project Inputs Once a week supervised IFA tablet
IEC for girls, teachers and parents
Training & Logistics –
Monitoring-
Individual,
Class (weekly),
School
SVS
District level
16. 13th May 2005 Kotecha 16 Prevalence of Anemia at Different Hb. Cut off Points Before and After Intervention
17. 13th May 2005 Kotecha 17 Positive Lessons Easy, doable and successful program. Replicable and effective to control anemia
Effective in reducing anemia by 20% with improvement in hemoglobin for 82% of girls in 17 months of the intervention period
Compliance for the schoolgirls to went up to 90%.... In 2003 in Vadodara district.
18. 13th May 2005 Kotecha 18 Progress based on Vadodara Project lessons Program extended to ALL 25 districts, owned by education and health department of Government of Gujarat jointly and supported by UNICEF (16 districts) and MI (9 districts)
Currently covers over one million adolescent girls in the schools
Internalized with education and health program with minimum extra input
19. 13th May 2005 Kotecha 19 Monitoring Education
Schools to
QDC and SVS
DEO
State
Health
Schools
PHC/SC
CDHO/RCHO
State
20. 13th May 2005 Kotecha 20 Vital Keys for Future Key for success is commitment and monitoring by District and State authorities (DDO can help tremendously here with their team members DEO and CDHO)
State Offices for Education and Health need to emphasize the importance of monitoring and request regular reports and a discussion and follow up on the monitoring
21. 13th May 2005 Kotecha 21 Key to success are District Authorities Please ensure monitoring
Please ensure joint review of monitoring reports and corrective actions for regularity and necessary feed back….
Health and education and WCD need to be partners at district level with strong linkages…
These linkages will come from whole hearted commitment and follow up at state level authorities…GO & NGO
22. 13th May 2005 Kotecha 22 Out of school girls… Out of school girls are about 70% of adolescent girls and they are not effectively covered…
Reach “Out of school girls” through ICDS, Panchayat, NGO etc.
Through ICDS AWW by involving them in urban area.
Over 10,000 girls covered under urban areas…staring in rural areas too..
KSY is ensuring larger coverage…
23. 13th May 2005 Kotecha 23