TPS MCH Final
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Final Presentation - TPS MCH Team on July 21, 2011 in Chennai on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.
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TPS MCH Final
- 1. Maternal & Child Health: Healthy Families Initiative Eprise Armstrong, Dessa Shuckerow & Audra Tafoya July 21, 2011
- 2. Overview The 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).
- 4. Background
- 5. 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 anaemic3 Sources: NHFS-3, NHFS-2, ICTPH Epidemiological Baseline Survey
- 6. Burden of Disease Anaemia costs an estimated 6% of India’s GDP4 $320 in GDP/capita 5 153 million deaths world-wide6 16.152 million Daily Adjusted Life Years (DALYs) worldwide 7
- 7. Main Determinants Health System - Diagnostics - Education Population - Lack of access to Vitamin B/Iron rich foods Household - Worm infestations - Diet
- 8. Intervention
- 10. Intervention Strategies Preparation Education & Training Procurement & Distribution Diagnostics
- 11. Strategy 1: Preparation Formative Research - Knowledge, Attitudes, and Practices (KAPS) - Acceptability of UN Multiple Micronutrient International Preparation (UNIMAP) - Development of education & marketing materials
- 12. Strategy 2: Education & Training Educate SVGs/CHWs - Anaemia - Early Pregnancy Detection - UNIMAP/MMS - Incentives Program - Diagnostics Educate women & families in their homes
- 13. Strategy 3: Procurement & Distribution RMHC (by nurses/staff) - Diagnostics - Photo calendar making equipment - UNIMAP/MMS - Container/Scoop Household (by SVGs/CHWs) - Pregnancy tests - Educational materials - Photo calendar
- 14. Strategy 4: Diagnostics Early detection of pregnancy with in-home pregnancy tests Peripheral Blood Smears to identify specific micronutrient deficiency Antenatal diagnostics in 1st trimester Woman is educated and given a copy of her diagnostics to take to PHC
- 15. Prospective Cohort Evaluation Phase I: includes intervention strategies occurring prior to a woman giving birth Phase II: includes follow up for the purposes of continued education, training, and evaluation.
- 16. Primary Impact Objective Lower prevalence of maternal nutrition related anaemia by end of 2nd trimester of pregnancy - Measure: HGL and Peripheral Blood Smear Test
- 17. 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
- 18. Process Objectives Improved KAPs regarding early pregnancy detection and MMS More complete antenatal diagnostics More complete picture of anaemia prevalence and causes
- 19. Acknowledgements ICTPH Staff Vani Priya, Sangeetha Lakshmanan, Subhalakshmi Ganguly, Deepak Rajanna, Sabyasachi Das, Selva Swetha, and Dr. Zeena Johar SVGs and RMHC Staff Residents of Karambayam
- 20. Contact Information Eprise Armstrong, MSW earmstrong@wustl.edu Dessa Shuckerow, MPH/MSW shucked@wustl.edu Audra Tafoya, MPH audratafoya@wustl.edu Washington University in Saint Louis George Warren Brown School of Social Work One Brookings Drive - Saint Louis, MO 63130
- 21. References 1. 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)00070-2 5. 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.pdf 7. Ibid.
- 22. Thank you