tps mch final
DESCRIPTION
Final Presentation - TPS MCH Team on July 21, 2011 in Chennai on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.TRANSCRIPT
Maternal & Child Health:
Healthy Families Initiative
Eprise Armstrong, Dessa Shuckerow & Audra Tafoya
July 21, 2011
Overview
The Healthy Family Initiative (HFI) is designed
to lower the prevalence of maternal nutrition-
related anaemia through social marketing
and the early introduction of a maternal
micronutrient supplement (MMS).
Overview
Background
Intervention
Implementation
Evaluation
Background
Tamil Nadu Statewide
- 53% maternal anaemia1
ICTPH Catchment Area
- 59.3% of pregnant women were anaemic2
- 50.3% of non-pregnant women were
anaemic3
Maternal Anaemia
Sources: NHFS-3, NHFS-2, ICTPH Epidemiological Baseline Survey
Burden of Disease
Anaemia costs an estimated 6% of
India’s GDP4
$320 in GDP/capita5
153 million deaths world-wide6
16.152 million Daily Adjusted Life Years
(DALYs) worldwide7
Main Determinants
Health System
- Diagnostics
- Education
Population
- Lack of access to Vitamin B/Iron rich foods
Household
- Worm infestations
- Diet
Intervention
Intervention Strategies
Preparation
Education & Training
Procurement & Distribution
Diagnostics
Strategy 1: Preparation
Formative Research
- Knowledge, Attitudes, and Practices (KAPS)
- Acceptability of UN Multiple Micronutrient
International Preparation (UNIMAP)
- Development of education & marketing
materials
Strategy 2: Education & Training
Educate SVGs/CHWs
- Anaemia
- Early Pregnancy Detection
- UNIMAP/MMS
- Incentives Program
- Diagnostics
Educate women & families in their homes
Strategy 3: Procurement &
Distribution
RMHC (by nurses/staff)
- Diagnostics
- Photo calendar making equipment
- UNIMAP/MMS
- Container/Scoop
Household (by SVGs/CHWs)
- Pregnancy tests
- Educational materials
- Photo calendar
Strategy 4: Diagnostics
Early detection of pregnancy with in-home
pregnancy tests
Peripheral Blood Smears to identify specific
micronutrient deficiency
Antenatal diagnostics in 1st trimester
Woman is educated and given a copy of her
diagnostics to take to PHC
Prospective Cohort Evaluation
Phase I: includes intervention strategies occurring prior to
a woman giving birth
Phase II: includes follow up for the purposes of continued
education, training, and evaluation.
Primary Impact Objective
Lower prevalence of maternal nutrition
related anaemia by end of 2nd trimester
of pregnancy
- Measure: HGL and Peripheral Blood Smear
Test
Secondary Client Outcomes and
Indicators
Outcomes Indicators
Infant birthweight Weight at birth (self-
report)
Maternal weight gain Weight at monthly check-
ups
Infant malnutrition Height, weight, arm-
circumference
Preterm delivery Earlier than-expected
delivery
Infant anaemia HGL Levels
Process Objectives
Improved KAPs regarding early
pregnancy detection and MMS
More complete antenatal diagnostics
More complete picture of anaemia
prevalence and causes
Acknowledgements
ICTPH Staff
Vani Priya, Sangeetha Lakshmanan,
Subhalakshmi Ganguly, Deepak Rajanna,
Sabyasachi Das, Selva Swetha, and Dr. Zeena
Johar
SVGs and RMHC Staff
Residents of Karambayam
Contact Information
Eprise Armstrong, MSW
Dessa Shuckerow, MPH/MSW
Audra Tafoya, MPH
Washington University in Saint Louis
George Warren Brown School of Social Work
One Brookings Drive - Saint Louis, MO 63130
References
1. National Family Health Survey 2005-2006 (NHFS-3: Tamil Nadu State Report). (2008). Mumbai:
International Institute for Population Sciences (IIPS) and Macro International.
2. ICTPH Epidemiological and Needs Assessment Census Survey in three villages of Rural Tamil Nadu.
(2010-2011).
3. Ibid.
4. Horton, S. (2003). The Economics of Iron Deficiency. Food Policy, 28(1), 51-75. doi: 10.1016/s0306-
9192(02)00070-2
5. Ibid.
6. The World Health Organization. (2004). WHO Annex A: Death and DALYs 2004. Annex Tables. Accessed
on 6/15/2011:
http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf
7. Ibid.
Thank you