galloway_anemia prevention and control_programmatic guidance decision tree
TRANSCRIPT
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
Provide an Integrated Package for Anemia
Prevention and Control (APC) to All Pregnant Women
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
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 Hookworm Infection is Prevalent
If Malaria is Prevalent
Promote Family
Planning
Deworm Give
IPT/Promote
ITNs
Provide 3 Months Iron-Folic Acid
(IFA) Postpartum
Refine Product; Develop
Communication and Advocacy Strategy;
Identify Delivery Channels
Advocate, Ensure Sustainability
Work With Key Influencers, Champions
Improve Form (taste, color, size,
packaging) Supplies, and
Logistics
Provide an Integrated Package for Anemia
Prevention and Control (APC) to All Pregnant Women
Refine Product; Develop
Communication and Advocacy Strategy;
Identify Delivery Channels
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)
Refine Product; Develop
Communication and Advocacy Strategy;
Identify Delivery Channels
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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