No proper mechanism to conduct haemoglobin testing
IN her 20s, Savitha used to find it extremely difficult doing simple household chores.
A farm labourer from PG Palya village, Kollegal taluk of Chamarajanagar district, Savitha was in her second trimester of pregnancy and would often feel lethargic and weak.
Instead of gaining weight, she was losing it. The reason: Lack of proper nutrition had made Savitha severely anaemic.
Although, she was put on Iron Folic Acid (IFA) tablets – the medicines given by the government free of cost to anaemic women in villages – buying nutritious food was unaffordable for her.
Savitha’s case is one of the common and widespread issues concerning pregnant women in the State. Anaemia is one of the major causes related to indirect maternal mortality in the country. The State government data indicates 53 maternal deaths due to anaemia in the period from April 2010 to October 2010.
To bring down the number of pregnant anaemic women in the State, the National Rural Health Mission tied up with Myrada, an NGO that works for rural development, to conduct a pilot anaemia project in three taluks – Aurad (Bidar), Kollegal (Chamarajanagar) and Molkalmuru (Chitradurga) – last year. The three-year project aims at screening pregnant women, intervention, tracking and creating awareness about diet habits among pregnant women. While the National Health Family Survey (NHFS) III reported 63 per cent pregnant women having anaemia (an increase from NHFS II data), Myrada’s baseline survey in the three taluks showed nearly 73 per cent of the pregnant women to be anaemic.
“When we found the data, we were horrified,” said Dr Maya Mascarenhas of Myrada.
Although the government anaemia programme is 45 years old in the country, it hasn’t made much impact. Some of the biggest loopholes that they found in the government programme were poor follow-ups once the tablets were given and the missing education component. Only three fourths of the women received the IFA tablets and only 39 per cent bothered to consume at least 90 tablets during pregnancy, Mascarenhas said.
Delay and loss of data in the government system, anaemic women not getting double the dose of IFA tablets than normal women, the twice a month check up not being done and deworming tablets not being provided were other gaps highlighted in the survey.
“Iron tablets are only a temporary solution. The government should involve the community,” she said. Many women discontinued taking IFA tablets due to side effects. If the women were educated properly about when to take the pill and with what kind of food items, the anaemia rate would come down.
Mascarenhas said the baseline survey found there was no proper system to check the drug stock availability. As a result, there was a shortage of IFA tablets. Although the requirement of IFA tablets in the baseline survey was 3,48,900, sufficient tablets were not received.
Even the haemoglobin (Hb) testing equipment were either missing in many primary health centres (PHCs) or were outdated. So, only 40 per cent of the women underwent Hb testing. In all the three taluks, the NGO was using imported Hb (haemoglobin) testing kits for accurate reading.
“The NRHM has the budget and even the planning is done properly. But complete implementation has not taken place,” she said.
(Published in Deccan Herald on 12th March, 2011)