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Anemia Prevention and Control: Programmatic Guidance Decision Tree

Asia and Middle East Regional Nutrition Meeting May 3, 2012; Dhaka, Bangladesh
Rae Galloway, Technical Lead in Nutrition, MCHIP
Photo: Gabe Bienczycki /PATH

What do we know about anemia prevention & control programs?


Any successful program maximizes supply and demand for an intervention What do we know about consumer demand? Is it just consumer demand we should be worrying about? What about the behaviors of all the stakeholders needed to make programs successful? What do we know about supplies and logistics?
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What do we know about anemia prevention & control programs?


Do we have the right anemia prevention and control packagei.e., are we addressing all the causes of anemia? How is the package being deliveredare we using the right channels? Are there key decisions in implementing programs that make a difference to delivery? A schematic may help to address some of these questions and make key decisions
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Establish National and Regional Anemia Prevalence in Pregnant Women

Establish National and Regional Anemia Prevalence in Pregnant Women

For Any Prevalence

Provide an Integrated Package for Anemia Prevention and Control (APC) to All Pregnant Women

Provide an Integrated Package for Anemia Prevention and Control (APC) to All Pregnant Women

Improve Diet in all Pregnant Women

Provide Adequate IronFolic Acid to all Pregnant Women

If Hookworm Infection is Prevalent

If Malaria is Prevalent

Promote Family Planning

If Prevalence is 40%
Provide 3 Months Iron-Folic Acid (IFA) Postpartum

Deworm

Give IPT/Promote ITNs

Improve Diet in all Pregnant Women

Provide Adequate IronFolic Acid to all Pregnant Women


Provide 3 Months Iron-Folic Acid (IFA) Postpartum

Provide an Integrated Package for Anemia Prevention and Control (APC) to All Pregnant Women

If Hookworm Infection is Prevalent


Deworm

If Malaria is Prevalent

Promote Family Planning

Give IPT/Promote ITNs

Has Formative Consumer Research Been Conducted?

Yes
Refine Product; Develop Communication and Advocacy Strategy; Identify Delivery Channels

No

Conduct Consumer Formative Research

Improve Form (taste, color, size, packaging) Supplies, and Logistics

Provide an Integrated Package for Anemia Prevention and Control (APC) to All Pregnant Women

Advocate, Ensure Sustainability

Work With Key Influencers, Champions

Refine Product; Develop Communication and Advocacy Strategy; Identify Delivery Channels

Refine Product; Develop Communication and Advocacy Strategy; Identify Delivery Channels

Decide on Channels of Delivery

If Antenatal Care (ANC) Coverage is 80%

If Antenatal Care (ANC) Coverage is <80%

Deliver APC Through ANC

Deliver APC Through Community Based Distribution

Deliver APC Through ANC

Deliver APC Through Community Based Distribution

Create Cadre of Community Distributors

Utilize Private Sector Suppliers When Available

Conduct Training (Pre-service, In-service)

Revise, Adjust

Conduct Training (Pre-service, In-service)

Revise, Adjust

Conduct Ongoing Supervision, Monitoring for Uptake of APC


On the Job Training
Health Workers
Women and Community

Community Workers, Private Sector Supplies

On the Job Training

Reinforce Training
Identify Barriers and Facilitating Factors to Uptake

Reinforce Training

Refine Product; Develop Communication and Advocacy Strategy; Identify Delivery Channels

Decide on Channels of Delivery

Utilize Other Channels (e.g. Multi-Media, Mobile Phones, Social Mobilization and Campaigns)

Adjust Messages, Materials, and Channels as Needed


Address Barriers Through MultiSector Approaches

Identify Barriers and Facilitating Factors to Uptake

Evaluate for Anemia Prevalence and Coverage Every 3-5 Years

Report on Progress; Reassess and Make Program Adjustments

What can we conclude?


Anemia prevalence remains high Addressing all the causes of anemia may help us meet our goal Decide on a delivery system which best reaches women Attend to both supply and demand barriers in program design and monitor and address barriers throughout implementation
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How similar are calcium supplementation and anemia control?


These comparisons will be made in panel 2.

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Thank you!

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