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Digital Monitoring of Anemia Control Measures in a District Using Anemia Mukt Bharat Health Management Information
Surabhi Puri1, Kapil Yadav1, Shashi Kant1
1Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Insights
Anemia control measures in Faridabad were unsatisfactory, with low IFA supplementation coverage and data quality issues hindering progress. Regular evaluations are needed to meet Anemia Mukt Bharat targets.
Area of Science:
- Public Health
- Nutrition Interventions
- Health Information Systems
Background:
- Anemia is a significant public health issue in India, impacting over 50% of the population.
- The Anemia Mukt Bharat (AMB) program aims to reduce anemia prevalence by 3% annually.
- AMB utilizes a monitoring system with 18 indicators and six KPIs from the Health Management Information System (HMIS).
Purpose of the Study:
- To assess the effectiveness of anemia control measures in Faridabad district, Haryana.
- To evaluate the status of anemia control using AMB HMIS indicators from April 2018 to March 2019.
Main Methods:
- A cross-sectional study was conducted in Faridabad from May to June 2019.
- Data were collected from HMIS, program reports, and district annual reports for the period April 2018 to March 2019.
- The AMB index was calculated using program-provided denominators, with a critical review of data quality.
Main Results:
- Iron and folic acid (IFA) supplementation was not provided to children aged 5-9 years.
- Coverage for IFA prophylaxis was 22.5% in children (6-59 months) and 33.1% in pregnant women.
- The AMB index was 35.2, with data accuracy limited by understanding gaps and denominator mismatches.
Conclusions:
- Anemia control measures in Faridabad were unsatisfactory based on HMIS indicators.
- Data quality issues and number-based reporting hampered effective decision-making.
- Periodic district-level evaluations are necessary to achieve AMB program targets.
Introduction:
Anemia is a severe public health problem in India, affecting more than 50% of individuals across most age groups. The Anemia Mukt Bharat (AMB) program, with a target of a three-percentage point reduction in anemia prevalence per year, developed a monitoring mechanism based on a set of 18 indicators and six key performance indicators (KPIs) derived from routine reporting in the Health Management Information System (HMIS). The study's objective was to assess the status of anemia control measures in the district of Faridabad, Haryana, India, using AMB HMIS indicators from April 2018 to March 2019.
Methods:
A cross-sectional study was conducted in the district of Faridabad, Haryana, from May 1 to June 15, 2019 (reference period: April 2018 to March 2019). The status of existing activities for anemia control was assessed by documentation of HMIS indicators identified by the AMB program for routine monitoring. Sources of data were HMIS, program reports, and district annual reports. Denominators provided by the AMB program were used for ascertaining proportions and the AMB index. A critical review of the generated data and a description of the collection and reporting process were done.
Results:
Activities in place to control anemia were prophylactic iron and folic acid (IFA) supplementation and deworming to 6-59-month children, adolescents, and pregnant and lactating women. For children five to nine years of age, IFA was not provided in the district, but deworming was done. The coverage of IFA prophylaxis in children 6-59 months was 22.5% and 85.1% in adolescents. The 180-day IFA supplementation in pregnant women was 33.1%. The IFA stock status was not captured in the district. The AMB index for district Faridabad (April 2018 to March 2019) was 35.2. Gaps in understanding data elements and mismatches between AMB denominator data and census forecasts limited the data's accuracy.
Conclusions:
Overall, the status of anemia control measures assessed by HMIS indicators was unsatisfactory in the study district. Number-based reporting and issues with data quality limited the use of data for decision-making. Periodic evaluations of anemia control measures at the district level may be required to achieve the targets set by the AMB program.
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