Sustainability of integrated anaemia prevention activities implemented through non-government organizations and schools, and its effect on haemoglobin status of adolescent girls in urban slums of Pune, in Maharashtra, India.

Abstract

Programmes for the prevention of iron deficiency anaemia among adolescent girls need sustainable inputs for maximum benefits. To assess the interventions sustained for anaemia prevention implemented through NGOs and schools. An intervention study followed longitudinally in three phases. Phase I comprised (a) needs assessment of the community and (b) capacity assessment of service providers through a cross-sectional survey in nine slums, through six NGOs and three schools. Based on needs assessment, an integrated intervention for anaemia prevention was provided for adolescent girls (n = 384) in the community. To ensure sustainability the capacity of stakeholders (n = 67) was built by providing training in the components of the integrated intervention and establishing linkages with the public health system. Refresher training was conducted during phase II (n = 69) for reinforcing and strengthening of activities introduced in phase I. In phase II and III continuations of activities by the NGOs and schools that were initiated in phase I were monitored. Sustainability of activities was measured using an index that comprised technical, programmatic, social, and financial indicators. The impact of sustained interventions was assessed by comparing the mean rank haemoglobin concentrations of centres with varying levels of coverage. Scores of sustainability indicators decreased from phase II to phase III. Organizations that showed > 50% coverage showed significantly higher mean rank haemoglobin (p = < 0.05) during phases II and III. There is a need to identify and address barriers that prevent sustainable interventions for anaemia control.