Addressing severe acute malnutrition and anemia in charnia, Haryana, India

Program/Project Purpose: Severe acute malnutrition and anemia (SAMA) are major causes of maternal and infant mortality in rural India. India’s health system faces challenges in tackling the rapidly escalating burden of SAMA due to limited access to healthcare facilities, pervasive poverty, and inadequate infrastructure to effectively treat the population. Upon conducting extensive needs assessments and hemoglobin testing in Charnia, Haryana, India, we found anemia and malnutrition prevalence to be high with over 80% of children and 100% of pregnant women tested in Charnia having hemoglobin levels indicative of anemia. Thus, our primary focus was to analyze the methods of sustainably mitigating anemia rates in rural Charnia, Haryana, India through a community health worker (or health promoter) program. Structure/Method/Design: We performed baseline hemoglobin testing and distributed IFA and Albendazole (deworming) to women and children. The mean hemoglobin level of the 113 individuals tested was 10.08 g/dL, and the prevalence of anemia was 78.8%. Accordingly, we trained health promoters for the experimental group. These individuals were expected to encourage anemia awareness and IFA compliance in their communities. Furthermore, Charnians have a very plain diet consisting primarily of rice, lentils, and potatoes. Lack of a varied diet and general malnutrition only compounds the anemia issue in Charnia. This short-term anemia intervention was assessed in August, 2014. Of the original 113 participants, only 12 remained in the community. Due to the migratory population, tracking and follow up with the study participants was difficult, and the remaining 12 participants’ hemoglobin levels were not tested. Outcomes & Evaluation: The results of the intervention demonstrated that: the government’s delivery system must be improved for community participation; increased oversight of the health promoters is necessary; and an IFA intervention must be combined with longterm food-based approaches to promote sustainability. However, to target long-term behavior change interventions in Charnia, we conducted focus group sessions with community health workers(ASHAs) serving the Charnia area to better understand barriers facing ASHAs and develop tools to assist ASHAs. Through the focus groups, we found the ASHAs to be open to additional trainings, novel approaches to treating SAMA, and open to implementing mobile health tools in their workflow. Going Forward: Moving forward, we are collaborating with the George Institute for Global Health to develop a smart phone tool that will train healthcare workers in Charnia to assess, refer, and/or treat individuals with anemia and malnutrition. (Unpublished Data, Northwestern Project RISHI, Rural India Social Health Improvement). Funding: International Program Development, Northwestern University and Center for Leadership, Northwestern University. Abstract #: 01NCD030