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ADOLESCENT GIRLS

ANAEMIA CONTROL
PROGRAM
-Karunya Vinukonda
INDEX
Introduction
Anaemia & consequences
Statistics
Objective
Strategy
Initial phase, consolidation phase, expansion phase
Sample sheet
Lessons learnt
Conclusion
References



INTRODUCTION
Adolescence: transition phase
Rapid growth phase: 45% skeletal
growth- 15 to 25% adult height
achieved
Increase in lean body mass, expansion
of blood volume, onset of
menstruation- iron requirement

ADOLESCENT ANAEMIA
Affects growth and development
concentration
learning ability
appetite
irregular menstrual cycles
physical fitness
work productivity
lower pregnancy iron stores LBW,
Preterm new borns or still births.
STATISTICS
India 113 million adolescent girls
between ages 11 to 18 years
56% - anaemic [64 mn girls]


OBJECTIVE
Main objective
To reduce the prevalence and severity
of anaemia in school-going adolescent
girls using schools as delivery channels
and in out-of-school adolescent girls
using the community anganwadi centre
of Indias ICDS programme as the
delivery platform.
STRATEGY
Globally, 3 pronged strategy
1) Dietary diversification and
improvement
2) Food fortification with iron and other
essential micronutrients (vitamins and
minerals)
3)Regular consumption of IFA
supplements.
Relevance to India
PROGRAM STRATEGY
3 interventions
WIFS supplementation comprising
100 mg of elemental iron and 500g of
folic acid 52 weeks a year for the
prevention of nutritional anaemia

Why?

PROGRAM STRATEGY
Bi-annual deworming prophylaxis (400
g of albendazole) six months apart for
the prevention of helminth infestations
PROGRAM STRATEGY
Information, counselling and support to
adolescent girls on how to improve
their diets, especially iron intake, how
to prevent anaemia and how to
minimise the potential undesirable
effects of WIFS and deworming.
INITIAL PHASE (2000-2005)
Departments of Health and Family
Welfare, Women and Child
development, and Education played a
key role
How?
Innovative phase
INITIAL/INNOVATIVE PHASE
The initial phase of the programme was
launched in 2000-2001 across 20
districts in five states, namely Andhra
Pradesh, Bihar, Gujarat, Rajasthan and
Tamil Nadu.
In 2001-2002, six additional states
(Jharkhand, Madhya Pradesh,
Maharashtra, Odisha, Uttar Pradesh
and West Bengal) initiated the
programme in 12 districts.
INITIAL/INNOVATIVE PHASE
School-going girls:
The Department of Education was the
nodal department responsible for
expanding the coverage
Principals and teachers associations
parent-teacher associations
The district inspectors of the
Department of Education were
responsible for monitoring
INITIAL/INNOVATIVE PHASE
Out-of-school girls:
The Department of Women and Child
Development
A community-based approach was
adopted comprising supervised IFA
consumption at the anganwadi centre
using a girl-to-girl approach.
EVALUATION PHASE
Results
Evaluation in 7 states Andhra Pradesh,
Gujarat, Jharkhand, Madhya
Pradesh, Maharashtra, Uttar Pradesh
and West Bengal.
8.8 million adolescent girls were
reached during this phase.
Adherence
EVALUATION PHASE
Supervised WIFS consumption and
recording of programme adherence in
school registers anganwadi centre
registers and girls self-reporting cards
Enhancing overall awareness about the
programme by covering the launch of
the programme through radio and
television
Dispelling potential misconceptions
EVALUATION PHASE
Involvement
Use of IFA stock registers in schools
and reporting formats at different
levels
Designation of a nodal person at every
level for regular reporting and tracking
of girls adherence to the programme;
Capacity building of ICDS workers
EVALUATION PHASE
EVALUATION PHASE
EVALUATION PHASE
CONSOLIDATION PHASE
(2006-2010)
Garnering political commitment
Planning and convergence
Effective programme implementation
Strategic gap filling
Programme communication
Monitoring and evaluation

CONSOLIDATION/
REPLICATION PHASE
CONSOLIDATION/
REPLICATION PHASE
CONSOLIDATION/
REPLICATION PHASE
EXPANSION PHASE
(2011 & BEYOND)
2011 GOI- SABLA RG scheme for
empowerment of adolescent girls
Nutrition and non-nutrition services
ACP + Hot cooked meal + education &
counselling on reproductive and sexual
health+ FP + Prevention of early
pregnancy & HIV + menstrual hygiene
management
EXPANSION/
UNIVERSALISATION PHASE
STRATEGIES
SAMPLE
SAMPLE
LESSONS LEARNT
Evidence-based advocacy
Data on effectiveness and cost
Synergy among state departments
Involvement of stakeholders : at all
levels
Timely and quality communication
Timely availability of supplies
LESSONS LEARNT
An integrated package of interventions
Use existing delivery platforms: today
while creating new policies and
program opportunities for tomorrow
Girls are the best advocates :peer to
peer and girl to girl education
Figure 4: A continuum of care for the nutrition, development and
empowerment of adolescent
girls Adolescent Girls Anaemia Control Programme, India 2011 and
beyond
CONCLUSION
The lessons learnt suggest that the
AGACP has the potential to become an
important platform for intersectoral
convergence to empower adolescent
girls, reduce gender and social
inequities and break the inter-
generational cycle of undernutrition
and deprivation in India
REFERENCES
The Adolescent Girls' Anaemia Control Programme: a decade of
programming experience to break the inter-generational cycle
of malnutrition in India by guayo VM , Paintal K, Singh G.
Adolescent girls anaemia control programme, Gujarat, India by
P.V. Kotecha, S. Nirupam & P.D. Karkar
Anaemia Control Programme for Adolescent Girls (11 - 18
Years) in Orissa
Prevention of deficiency anaemia in adolescents: role of weekly
iron and folic acid supplementation. World Health Organization,
2011.
Weekly iron and folic acid supplementation programmes for
women of reproductive age: an analysis of best programme
practices. World Health Organization, 2011.
Adolescent Girls Anaemia control program by the UNICEF

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