Anemia levels in adolescent girls of Telangana dropped by 15 percent without a single visit to hospital, ICMR study

An ICMR-backed trial in 14 villages of Telangana’s Medchal-Malkajgiri district found that doorstep screening and treatment reduced anaemia prevalence among adolescent girls from 56 per cent to 40.7 per cent. The intervention also increased haemoglobin levels by 1.03 g/dL

Hyderabad: In Telangana, based on a clutch of surveys, anemia prevalence among all women of reproductive age is between 55 percent and 57 percent. While the sobering statistic has remained stubborn for a long time, recently, a group of researchers have demonstrated that anemia levels can be brought down drastically in Telangana.

In fact, they showcased that anemia prevalence among adolescent girls in Telangana can be brought down by 15 percent, that too without a single visit to a hospital.

The landmark cluster-randomized trial evaluating the ICMR-backed ‘Screen and Treat for Anaemia Reduction’ (STAR) strategy, which was conducted in 14 villages of Medchal-Malkajgiri district, covering primary health centers located at Narapally, Shamirpet, and Srirangavaram, demonstrated that such initiatives should be pin-pointed rather than implementing them broadly.

The STAR study indicated a modest overall population increase in hemoglobin levels. However, the most vulnerable cluster, adolescent girls in the study, experienced a 1.03 g/dL (grams per decilitre) boost in hemoglobin. The improvement in hemoglobin levels translated to a significant 15.3 percentage point drop in anemia prevalence, falling from 56 percent to 40.7 percent.

Till now, the general approach of implementing an anemia reduction initiative, employed by the union Health Ministry in collaboration with the State health department, is blanket distribution of prophylactic iron-folic acid (IFA) supplements from the local health care centre.

For rural women, especially young girls, who face deep-seated barriers, regular visits to the local government hospital are not possible. As a result, anemia prevalence continued to persist, despite multiple attempts at improving the hemoglobin levels of women.

The STAR trial demonstrated that instead of making women visit the local PHC, the researchers conducted diagnostic tests for hemoglobin and distributed status-based therapeutic or prophylactic IFA doses and deworming treatments via a door-to-door delivery model for three months.

According to researchers, the success of the STAR trial among adolescent girls highlights a vital lesson for public health planners, which is that generic campaigns fail because baseline vulnerabilities are not distributed evenly.

Before the STAR intervention, adolescent girls in the study area suffered from staggering baseline anaemia rates exceeding 40 percent to 56 percent. A combination of diagnostic screening to find anemia levels and immediate distribution of medicines at the doorstep enabled a reduction in overall anemia levels among young women, the researchers said.

Very important points:

• Anaemia prevalence among all women of reproductive age in Telangana is between 55 per cent and 57 per cent.
• CMR-backed trial successfully cut anaemia among rural adolescent girls in the State by 15.3 percentage points.
• Study showed that anaemia prevalence in 14 villages of Medchal-Malkajgiri district can be reduced from 56 per cent to 40.7 per cent.
• The landmark study demonstrated that door-to-door screening and treatment can help target vulnerable populations.
• Young girls did not have to visit the local hospital, as they were diagnosed and medicines were provided at their doorstep.
• Young girls in the study experienced a notable 1.03 g/dL increase in haemoglobin levels.
• Trial showed that blanket implementation of iron supplementation is not efficient in addressing anaemia among vulnerable groups.
• Project bypassed last-mile delivery bottlenecks through doorstep diagnostic auto-analysers.
• The three-month intervention involved haemoglobin screening, status-based therapeutic or prophylactic IFA doses and deworming treatment.
• The findings highlighted the importance of targeting anaemia interventions according to the vulnerability of specific population groups.