Student Dissertation

Agency : ASHAs Knowledge; National Iron Plan; Anemia

Objective : To assess the knowledge level of the National Iron plus Initiative Program among Accredited Social Health Activist in Narmada district of Gujarat.

Background : Anaemia, a manifestation of undernutrition and poor dietary intake of iron is a serious public health problem among pregnant women, infants, young children, and adolescents. NFHS 4 data reflect a higher prevalence of anaemia (among children and women in reproductive age) in our country. Taking cognizance of ground realities discussed above, the Ministry of Health and Family Welfare (GOI) took a policy decision to develop the National Iron+ initiative. This initiative will bring together the existing program (IFA supplementation for pregnant and lactating women and children in the age group of 6- 60 months) and introduce new age groups. Thus, the National Iron+ Initiative will reach the following age groups for supplementation or preventive programming through a Life Cycle Approach: • Bi-weekly iron supplementation for pre-school children 6 months to 5 years. • Weekly supplementation for children from 1st to 5th grade in Govt & Govt Aided schools • Weekly supplementation for out of school children (5-10 years) at Anganwadi Centers • Weekly supplementation for adolescents (10-19 years) • Pregnant and lactating women • Weekly supplementation for women in reproductive age An anemia supplementation program across the life cycle is proposed in which beneficiaries will receive iron and folic acid supplementation irrespective of their iron/hemoglobin status. The age-specific interventions are based on WHO recommendations, synthesis of global evidence on IFA supplementation and the recommendation of national experts. [2]

Methodology : Study design: The study Design is a cross-sectional descriptive study (Non-Experimental Observational Study) design to assess the existing Knowledge among Accredited Social Health Activist on National Iron plus Initiative Program. Study setting This study was conducted in all the blocks (Nandod, Tilakwada, sagbhara, Dadiapada, and Garudeshwar) of Narmada District Gujarat. Study population: The entire Accredited Social Health Activist (ASHAs) of Narmada District Gujarat. Duration of study’s Three months Duration from 5th February 2018 to 6th May 2018. Sampling: Sampling technique: Purposive Sampling. Sample size: Total 672 ASHA’s are currently working in all blocks of Narmada District. From each block randomly 10% ASHAs selected from these in each block Nandod, Tilakwada, sagbhara, Dadiapada and Garudeshwar respectively 14,21,11,12 and 12total 70 ASHAs selected as sample size. Research Instrument: Source of data collection: The source of data collected was primary in nature. For this purpose, a structured schedule was used. Data collection Technique: Face to Face interview was conducted for data collection. Data collection Tool: A structured Schedule was used as a tool for data collection. It had two parts: Basic information and Knowledge of ASHA’s regarding NIPI. Procedure: First, from all blocks of Narmada 70, ASHA’s were selected. Then data was collected personally by making personal visits to Anganwadi centers. For ensuring proper implementation of the program, registers were also checked. Data Analysis: After the collection of data, it was compiled in Microsoft Excel. Most of the data analysis was done on Microsoft Excel

Findings : The Narmada is one of the high priority Tribal districts in Gujarat. And now at the grass root level, RCH is majorly dependent on ASHA. NIPI is an important program for reducing anaemia for all as per life cycle and continuum of care. As per the result in the Narmada, NIPI implements in the whole district. But when we got an overall result of NIPI still 81 percent has knowledge regarding basic of NIPI. And if we talk about medicines/IFA used in NIPI 61 percent ASHA has knowledge. So, from here it clearly indicates that if in Narmada district wants to implement in a better way of NIPI needs to give training as refresher training in some duration of time in a year. In the next dosage of medicines again more than 51 percent have knowledge. And in a regime of dosage of IFA, it was 49 percent. About the where they can avail the medicines more 49percent knows but there are 51percent of ASHA those who don’t know anything about these. One of the major disappointing results in side effects only 16 percent of ASHA know about side effects and what they need to do during complications and side effects. Again, in the counseling part, only 30 percent have knowledge regarding counseling. In recording and reporting result is quite good as compare to other indicators 81 percent have knowledge means they have a responsibility regarding this.

Recommendations : The overall knowledge of ASHA regarding NIPI program is Good in Narmada district as result shown, However, Majority of the ASHA have satisfactory knowledge in IFA medicines and their dosage and regime, but they need to improve about side effects from IFA and what needs to do during side effects and complications. Counseling part also has to improve. They have good knowledge of recording and reporting. Training is a need in a period of time for refreshing the knowledge. NIPI is an important program for reducing anaemia as a life cycle.


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