1. Child Anemia Feasibility Study: Approaches and Lessons Learnt S R Nagar – Uttar Pradesh Presentation at XIII Annual Conference of Indian Association of Preventive & Social Medicine UP & Uttarakhand Chapter Dehradun – Uttarakhand 31st October, 2010 Prof Prakash V Kotecha Country Representative, A2Z, the USAID Micronutrient Project, New Delhi, India Ex Professor and Head, PSM Dept, Medical College, Baroda, Gujarat pkotecha@aed.org/pvkotecha@gmail.com
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5. Anemia in Children Anemia failed to decrease…and at present highest ever Dr. Prakash V. Kotecha
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8. Dr. Prakash V. Kotecha Source: http://pariwarkalyan.up.nic.in/mch-intro.htm 17/09/2010
15. Study area Dr. Prakash V. Kotecha District State S. R. Nagar, UP Block Gyanpur Total population 2,65,678 No. of Sub-centers 32 No. of ANM 29 No. of AWC 187 Children 6-23 14000 Control block Handia, Allahabad district
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18. Scenario at the Start of the Feasibility Study in Gyanpur Block Dr. Prakash V. Kotecha
19. Anemia Prevalence at the starting of the Feasibility Study (6-23 m) Dr. Prakash V. Kotecha Source: NFHS III & A2Z study 2007-08
20. Helminthes Study Children in UP N=472 (Gyanpur Block) Source: Awasthi et al, 2008 Dr. Prakash V. Kotecha
21. IFA Consumption at the starting time 2008 Baseline study Dr. Prakash V. Kotecha Source: A2Z study 2007-08
39. On going Monitoring LQAS Dr. Prakash V. Kotecha FOCUS LQAS I (Sept. 08) LQAS II (Feb. 09) LQAS III (Aug. 09) Advice on Anemia 46 34 75 IFA syrup Received 66 45 73 Benefits Explained 44 33 65 IFA consumed in last 7 days 59 15 50 Complementary Feeding Advice 28 51 Complementary Feeding Practice 14 11 Anemia Prevalence 95 87 86
41. End Line Study Children Dr. Prakash V. Kotecha District Block Number of mothers of children aged 6-23 months (total sectors) Sant Ravi Das Nagar Gyanpur 304 Allahabad Handia 331 Total 635
42. Religion & Caste of children studied Dr. Prakash V. Kotecha Characteristics Project Block (Gyanpur) Comparison Block (Handia) Religion Endline Baseline Endline Baseline Hindu 93.4 93.8 93.4 94.2 Muslim 6.3 6.2 6.3 5.8 Scheduled caste 24.3 30.8 24.3 22.6 Scheduled tribe 2.6 0.0 2.6 1.3 Other backward caste 44.7 41.6 44.7 55.5 Total N 304 305 331 310
43. Standard of living & Literacy Dr. Prakash V. Kotecha Standard of living Percent Households Project Block (Gyanpur) Comparison Block (Handia) Low 80.6 25.7 Medium 14.8 33.5 High 4.6 40.8 Illiteracy Illiterate 54.3 37.8 Total N 304 331
52. Deworming Medicine Received by the Children Dr. Prakash V. Kotecha 87% children & 73% of mothers consumed the medicine
53. Benefits explained by ASHA Dr. Prakash V. Kotecha “ Child becomes weak and pale due to lack of blood in the body. It is advisable to take iron rich diet and other iron preparation to prevent anemia. Iron increases blood and help fight infection.”