What works in improving consumption of IFA among out of school adolescent girls: Learning from a field experiment in Madhya Pradesh, India

Background/Objectives

As per the National Family Health Survey (NFHS) (2005-06), around 70% girls in the age group of 12-17 years were anaemic. The prevalence is even higher among girls in rural areas. To address this challenge, in 2013, Government of India launched the Weekly Iron and Folic Acid Supplementation program. However, NFHS (2015-16), also shown very prevalence of anemia (55%+) among the 15-49 years women. In order to improve the consumption of IFA tablets among the out of adolescent girls, an intervention was undertaken in Mandla district of Madhya Pradesh, India.

Description Of Intervention And/or Methods/Design

9 villages were randomly selected for the study and in these villages, out of school adolescent girls were identified and tested for Hb level. Total 247 anaemic girls in the age group of 10-19 years were identified. Adolescent girls groups were formed and 3 Peer Educators were selected in each village. A curriculum was developed and training of community health workers & PEs were conducted. Fortnightly meeting of these groups were conducted. Besides that, each peer educator was given responsibility to follow-up with 8-10 girls, on weekly basis to ensure consumption of IFA tablets, given at Aganwadi Centre by health department. Also, meeting with parents of the girls were conducted to create enabling environment. The intervention was carried on for 12 months and after that Hb level of the girls were again tested & interview with girls were also conducted to assess their knowledge on the curriculum.

Results/Lessons Learned

92% of the planned meetings were conducted during the period. 83% girls participated in more than 50% of the meetings. 88% of the girls were able to tell the causes & treatment of anaemia. 82% girls shown improvement in their Hb level and 57% were girls were not found to be anaemic. 61% girls also shared that they started consuming more nutritious food. 68% girls shared that their parents became more concerned about the need of nutritious food for the girls. 73% girls also share that they feel healthier and more energetic. 89% Peer educators also shared that they feel more empowered and respected because of their role as peer educator.

Discussion/Implications For The Field

It was observed that though prevalence of anaemia is quite high in rural areas but combination of behaviour change communication in form of well-designed curriculum along with Peer pressure in form of follow-up by peer educator can significantly address this challenge. Advocacy with parents of girls also helped in creating enabling environment and better understanding of need of nutritious food for the girls.

Abstract submitted by: 

Rajnish Prasad

Shrutika Badgujar

Shweta Bhardwaj