In areas involving healthcare, individual efforts, and government initiatives can give people some helpful nudges.
Anaemia Mukt Bharat is one such nutrition awareness programme to bring about behaviour change in people towards healthy living. It also aims to reduce the prevalence of anaemia by three percentage points per year among children, adolescents and women of reproductive age from 15 to 49 years by 2022.
Consider the landscape of anaemia in India: according to the 2015-16 National Family Health Survey (NFHS-4), 50 per cent pregnant women in the country are anaemic along with 53 per cent women who are not. For women, the normal range of haemoglobin (Hb) is 12-15.5 grams per decilitre. Despite the government mandate of consumption of iron-folic acid tablets for 100 days during pregnancy, only 30 per cent, or three in every ten, pregnant Indian women consume iron-folic acid tablets for at least 100 days (NFHS-4).
Pregnant women with anaemia are at higher risk of preterm deliveries, increased bleeding during and after delivery, stillbirth, and low birth-weight babies. Anaemia can also lead to the death of the mother. Women in India face multiple challenges, including poor health, multiple pregnancies, and low social status. Interventions are much-needed to improve their health status, especially of pregnant women.
There is overwhelming evidence that morbidity and mortality risks associated with anaemia call for an urgent and effective strategy to address this public health problem. Hence, in March 2018, the Government of India launched Anemia Mukt Bharat, a flagship programme of the Ministry of Health and Family Welfare (MoHFW) under the POSHAN Abhiyaan, a strategy focusing on reducing the burden of maternal anaemia.
Through a life-cycle approach, the strategy targets pregnant women, along with lactating mothers, women of reproductive age group, adolescents, under-five children and school-going children. Private health sectors, NGOs, and the public need to come forward and support the government in the success of this initiative.
In September 2019, during the nutrition month (Poshan Maah) T3 camps were held in Government schools, colleges, and institutions across India. It was flagged off by the Union Health Minister Dr Harshvardhan, who inaugurated and addressed the camp organised at the Health Ministry premises in Nirman Bhawan, Delhi.
A typical T3 Camp is a key strategy to generate demand and mobilise people on anaemia. And it works in three steps:
Test: with the help of a digital haemoglobinometer
Treat: with iron-folic acid tablets (IFA) and referral
Talk: counselling beneficiaries on healthy lifestyle measures, to increase iron levels in the body and on foods rich in iron, protein and vitamin C.
The T3 Camp at Nirman Bhavan, New Moti Bagh, and Shashtri Bhavan played out over four days, two days and three days, respectively.
On average, 500 beneficiaries were covered, irrespective of any specific group, every day. In total, over 3,000 beneficiaries benefited from this event.
I, along with my team from the National Centre of Excellence and Advanced Research on Diets (NCEARD), participated in the T3 camp, to cater to the third step of “Talk”.
Our work focused on promoting nutrition messages on healthy diets, which includes foods rich in iron, protein and vitamin C; demonstration of iron-rich food recipes; do’s and don’ts for anaemia; and also, distributing iron-rich snacks and recipe books.
People with normal Hb levels got photographed holding placards with messages: “I am anemia free,” “I eat vitamin C-rich foods” at the selfie booths, to create awareness.
This initiative is a good idea of choice architecture, to influence people toward making healthy choices. It involves helping people to improve their ability to select positive lifestyle options.
One easier way to do this is to give comprehensive information about various options for healthy diet. If you are preparing any food, it only takes adding iron, protein, and vitamin C rich ingredients to improve your diet.
The Government, through the Anemia Mukt Bharat initiative has made a very effective programme that needs to reach every individual in India. It was a matter of immense pleasure for me to be a part of a great effort to empower people at the grassroots level.