Galloway_Anemia Prevention and Control_Programmatic Guidance Decision Tree

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?

2

What do we know about anemia

prevention & control programs?

Do we have the right anemia prevention and

control package—i.e., are we addressing all

the causes of anemia?

How is the package being delivered—are 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

3

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

Improve Diet in all Pregnant

Women

Provide Adequate Iron-Folic Acid to all Pregnant

Women

If Malaria is Prevalent

If Hookworm Infection is Prevalent

Give

IPT/Promote

ITNs

Provide 3 Months Iron-Folic Acid

(IFA) Postpartum

If Prevalence is ≥40% Deworm



Promote Family

Planning

Has Formative Consumer Research Been Conducted?

No

Conduct Consumer Formative Research

Yes

Refine Product; Develop

Communication and Advocacy Strategy;

Identify Delivery Channels



Improve Diet in all Pregnant

Women

Provide Adequate Iron-Folic Acid to all Pregnant

Women

If Hookworm Infection is Prevalent

If Malaria is Prevalent

Promote Family

Planning

Deworm Give

IPT/Promote

ITNs

Provide 3 Months Iron-Folic Acid

(IFA) Postpartum




Advocate, Ensure Sustainability

Work With Key Influencers, Champions

Improve Form (taste, color, size,

packaging) Supplies, and

Logistics






Decide on Channels of Delivery

If Antenatal Care (ANC) Coverage

is ≥80%

Deliver APC Through ANC

If Antenatal Care (ANC) Coverage

is <80%

Deliver APC Through Community Based

Distribution

Deliver APC Through Community Based

Distribution

Create Cadre of Community Distributors

Utilize Private Sector Suppliers When Available

Deliver APC Through ANC

Conduct Training (Pre-service, In-service)

Conduct Training (Pre-service, In-service)

Conduct Ongoing Supervision, Monitoring for Uptake of APC

Health WorkersWomen and Community

Community Workers, Private Sector Supplies

Identify Barriers and Facilitating Factors to Uptake

On the

Job

Training

On the

Job

Training

Revise,

Adjust

Revise,

Adjust

Reinforce

Training

Reinforce

Training

Identify Barriers and Facilitating Factors to Uptake

Address Barriers Through Multi-

Sector Approaches

Adjust Messages, Materials, and

Channels as Needed

Utilize Other Channels (e.g. Multi-Media, Mobile

Phones, Social Mobilization and Campaigns)




Decide on Channels of Delivery

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

14

How similar are calcium

supplementation and anemia control?

These comparisons will be made in panel 2.

15

Thank you!

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