Addressing Anemia Among Pregnant Women in Meerut District

Anemia is a prevalent condition among pregnant women in Meerut, India. The Anemia Mukt Bharat program aims to reduce anemia rates by providing iron and folic acid supplements through ANC services. Data analysis shows progress in ANC registration and iron tablet consumption, highlighting the importance of early intervention and regular check-ups to combat anemia effectively.

• Anemia
• Pregnant women
• Meerut district
• Public health
• Iron deficiency

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1. REDUCING PREVALENCE OF ANAEMIA AMONG PREGNANT WOMEN IN DISTRICT, MEERUT Group 3 Dr Ashok Kumar Talyan , Dr Anurag Kr Varshney, Dr Kamlesh Kumar Yadav, Dr Sitaram Kanojiya, Dr Kaushlendra Singh , Dr Vikas Singh

2. Introduction In India, anemia is exceedingly common in all age groups including pregnant women. To address this widespread public health concern, the Anemia Mukt Bharat (AMB) program was launched in 2018, focusing on reducing anemia from 50% in 2016 to 32% by 2022

3. Anemia is a condition when the blood does not have enough red blood cells, which leads to a reduced flow of oxygen throughout the body, main cause of anemia is iron deficiency. Anemia in Pregnant Women It is a part of Ante-Natal Care (ANC) and all pregnant women are provided iron and folic acid tablets during their ante-natal visits through the existing network of sub- centres and primary health centres and other health facilities as well as through outreach activities at Village Health & Nutrition Days (VHNDs) and launched Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) to focus on conducting special ANC check up four times every month with the help of Medical officers to detect and treat cases of anemia. Meerut (45 lakhs Population) is the 15th largest district in the state of Uttar Pradesh, District Divided into 12 Blocks with 96750 Birth cohort District having Public Health Infrastructure of 1. 2 District level Hospital 2. 12 CHC equipped with (Iron Sucrose injection) 3. 3 FRU s (with Blood Storage Unit) 4. Blood Bank : 2 (at DH and Medical College)

4. NFHS Indicators Indicators India (%) Uttar Pradesh (%) Meerut (%) NFHS 4 2015-16 Meerut (%) NFHS 5 2019-20 ANC registered in first trimester 70 62.5 64.4 73.4 4 ANC Checkups 58 42.4 47.1 49.9 IFA Consumption (100 Tabs) 44 22.3 16.5 35.5 IFA Consumption (180 Tabs) 26 9.7 6.4 13.8 PW with Anemia 52 45.9 53.8 44.9 Above table shows that Anemia in pregnant women can be significantly reduced by early registration ,more antenatal checkups and adequate iron Folic acid Tablet consumption .

5. ANC Registration Meerut ANC Registration Meerut HIMS Data(Apr23 HIMS Data(Apr23- -Sept 23) Sept 23) 180 160 140 120 100 % ANC Reg. against Est. target 80 % ANC Reg. in 1st Trim. 60 40 20 0 Apr/23 May/23 Jun/23 Jul/23 Aug/23 Sep/23

6. Preg Preg. Women Detected Anemic in Meerut . Women Detected Anemic in Meerut HIMS Data(Apr23 HIMS Data(Apr23- -Sept 23) Sept 23) 35 30 25 20 %PW Hb < 11g/dl 15 %PW Hb <7 gm/dl 10 5 0 Apr/23 May/23 Jun/23 Jul/23 Aug/23 Sep/23

7. Nutrition Infrastructure Community awareness Less self & family awareness Inadequate supply of Tab IFA & ,Inj.Iron Sucrose Inadequate iron , Folic acid,Vit.B12,Vit.C in diet Lacking of spacing methods Poor Adolescent counseling Less follow diet schedule Multi gravida Non availability of Vit B12 ANEMIA AMONG PREGNANT WOMEN IN DISTRICT, MEERUT Less PMSMA (HRP )Days Worm Infestation Cultural behavior Malaria Literacy Inadequate no. of ANC visit Low socio economic status Tuberculosis Weak De worming program for ANC Poor Sanitation HemolyticDisorders Policy Diseases Sociodemographic factor

8. Gaps/Solutions Poor mobilization of pregnant women to attend Village Health and Nutrition Days(VHND) and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) Day. Promote regular antenatal check-ups for pregnant women to monitor their hemoglobin levels and overall health. This allows early detection and management of anemia. We can give JSY incentive in phased manner linked with ANC attendance . Less adherence in IFA consumption. Ensure that all pregnant women have access to iron and folic acid supplements . IFA Tablets should be provided in monthly dose and consumption should be monitored like NLEP program in which next dose is given after taking empty strips back. Less use of Iron sucrose at FRUs Building capacities and competencies of facility Medical Officers,staff-nurses & pharmacists in administering Iron Sucrose Inadequate consumption of Iron rich food by pregnant women Conduct awareness campaigns and educational programs with better inter-sectoral coordination (ASHA ,Aaganwadi & education) to inform adolescent girls ,pregnant women and their families about the importance of proper nutrition, iron-rich foods, and the risks associated with anemia during pregnancy.

9. Gaps/Solutions Social factors Counseling of pregnant women and her family members regarding importance of spacing method of family planning, safe drinking water and sanitation. Programmatic gaps Ensuring regular supplies of IFA &Iron Sucrose , quality training and monitoring and regular tracking of performance indicators of programs.

10. Way Forward Early registration and monitoring of every pregnancy at e-kavach portal. Payment of beneficiary/ASHA to be associated with ANC visit and e-kavach entry. Ensuring monthly intake of IFA tablet by PW through collection of empty blisters by Health Care Worker. It will also provide additional opportunity for follow up and interaction with beneficiary. Joint efforts of health and ICDS workers for better outcome.

11. Thanks For Patient Listening