Written by: Aashish Jain, CMGGA Faridabad 2023
In every classroom, the teacher’s familiar greeting, “How are you, students?” echoed, met with the usual chorus of “Yes, we’re good!” But beneath the surface, a different story lurked. Heads throbbed, fatigue drained energy, and insomnia painted restless nights.
➡ Why were students struggling despite their chirpy responses?
The answer surprised many. Anemia, an iron deficiency, was silently sapping their strength. Anemia is a condition in which the number of red cells or the hemoglobin concentration is lower than normal. Anemia is further classified into mild, moderate, and severe based on the hemoglobin levels of the individual. Anemia may present as poor growth, recurrent infections, fatigue, increased sleepiness, lack of stamina, inability to concentrate, poor scholastic performance, poor neurocognitive and behavioral development, poor athletic performance, etc. in school students. The causes of anemia are multifactorial. However, iron deficiency, primarily due to inadequate dietary iron intake, is considered the most common nutritional deficiency leading to anemia.
Due to menstrual blood loss and increased iron requirements during pregnancy, females are particularly susceptible to anemia. Its consequences include fatigue, weakness, impaired cognitive function, decreased work capacity, and compromised immune function. In pregnant women, anemia raises the risk of maternal and infant mortality, preterm birth, and low birth weight. Addressing anemia among girls and women is crucial for promoting their health, well-being, and socioeconomic empowerment. It also has an intergenerational impact on anemic girls having pregnancy-related complications like Postpartum hemorrhage (PPH), & preterm & low birth weight babies & eventually affecting the development of newborn babies & impacting (MMR) Maternal Mortality Rate & (IMR) Infant Mortality Rate.
As per the National Family Health Survey (NFHS) 5, the prevalence of anemia among adolescent boys & girls aged 15-19 years in India is 31% and 59% respectively & prevalence in Haryana is 30% in boys & 62% in girls.
Aware of this hidden epidemic, the district administration stepped in with an initiative: Anemia Mukt Faridabad. Launched in October 2023, it targeted a lakh of government school students, aged 5–19, from Class 1 to 12. This wasn’t just another campaign. It was a collaboration, a team effort with local health authorities and educational institutions. The program targeted school students, through awareness drives, nutritional supplementation, and health check-ups.
A multi-stage program tackled it:
Stage 1: Planning
– Detailed micro plans were made keeping in mind the available resources & the objective of the program.
– Extensive training sessions were organized by the District Administration, & health experts for the teachers, supervisors, and Anganwadi workers to enable them to correct usage of the TrueHb Meter.
– The roles & responsibilities of each department were clearly outlined with the District Administration acting as the Nodal authorities.
– Systematic algorithms and Standard of Procedures (SoP) were put in place.
Stage 2: Screening
– In 2 months 1 Lakh students from government schools were actively screened & treated for anemia.
– Of the 1 lakh students screened, 50% had normal iron levels, but nearly 50% were anemic, of which 24% were mild, 23% were moderate, and 2% were severe.
Stage 3: Treatment
– Mild and moderate cases received (IFA) Iron and Folic Acid tablets twice daily for two months (one in school after lunch/mid-day-meal and one at home after dinner).
– Anganwadi Workers monitored the second dose of (IFA) Iron and Folic Acid being administered at home & sensitized parents & society about anemia & its consequences.
– Over 250 severely anemic students received personalized treatment at the district hospital with transportation support.
Stage 4: Awareness
– Informative pamphlets highlighting anemia, its causes, symptoms, and prevention were designed and distributed.
– Special sessions such as Bal Sabha were organized during school assemblies to discuss anemia and health experts and/ or teachers-led discussions on the topic encouraging students to participate actively.
– Anemia-themed poster-making competitions were conducted among students.
– Officials from District Administration (Additional Deputy Commissioner, Sub-Divisional Magistrate), Medical Officers, and NGOs along with Anganwadi Workers were roped in to create awareness among parents & children by providing them with counseling sessions.
– Gram Sabhas were conducted through Sarpanchs to cover the rural areas and educate citizens on the causes, prevention & Impact of anemia.
Stage 5: Retesting
– After two months, retesting of 8781 anemic students showed a significant drop in anemia prevalence.
– Around 35% of these anemic students i.e., 3128 became non-anemic. Also, the % of Mild anemic was reduced by 26%, % of Moderate anemics reduced by 42%, and % of Severely anemic students was reduced by 45%.
Stage 6: Confirmation
– A third-party evaluation was conducted in January 2024 in collaboration with doctors from AIIMS, Delhi, to assess the impact of an intervention on anemia prevalence among schoolchildren.
– A total of 1009 students from different schools and classes were tested. The results showed that the intervention led to a 20% increase in the percentage of non-anemic students, a 6% decrease in the percentage of students with mild anemia, a 13% decrease in the percentage of students with moderate anemia, and a 1% decrease in the percentage of students with severe anemia.
– Overall 70% of students came out to be non-anemic. The team also corroborated and validated the retesting done by our health team in their reports.
The #AnemiaMuktFaridabad campaign wasn’t just about numbers or statistics. It was about unlocking the potential hidden within each student. With restored energy and focus, the students could finally shout a genuine “Yes!” the next time their teacher asked, “How are you?”
Soon, Phase 2 of Anemia Mukt Faridabad will reach out to colleges and private schools too.
As a Chief Minister’s Good Governance Associate (CMGGA) placed in Faridabad, I had the privilege to witness and be a part of the transformative power of grassroots action firsthand. Empowered by the administration’s mission, I embarked on a journey to combat anemia in Faridabad. With each community reached and each life touched, I saw the tangible impact of our efforts. The CMGGA program supported by the Ashoka University is a unique youth-led good governance initiative advancing the social delivery outcomes of the Government of Haryana. The program deploys young social development sector professionals, referred to as ‘associates’ across the districts to further the CM’s priority areas and support the state’s developmental goals. The associates’ roles are not just about volunteering; the program, with its unique design functions as a catalyst for change, empowering youth to support the government’s mission and drive impact at scale.