Developing a Strategy for Anemia Prevention and Control

This portion of the Toolkit draws heavily from a seminal document, which outlines the below steps for strategy development, which can be found here.

  1. Know the problem
  • Determine the prevalence of anemia and identify priority target groups (those with the highest anemia and who suffer most from the consequences of anemia); collect available information on the causes of anemia; and programs to prevent and control it.
  • Determine what people know about anemia and their experience with anemia prevention and control.

The Demographic and Health Surveys provide information on anemia prevalence in children 6-59 months and all reproductive age women 15-49 years of age which is disaggregated to pregnant women, breastfeeding women, and women who are not pregnant or breastfeeding. Surveys also may collect information on the coverage of IFA supplementation, deworming, IPTp, ITNs/LLINs, food intake, and other anemia-related programs. Click here to visit the DHS website. Click here to view the relevant information by country and indicator from DHS which was collated for this Toolkit. These tables will be updated periodically with new information as it becomes available.

  1. Raise awareness and develop partnerships
  • Raise awareness about the costs to individuals and countries of not addressing anemia and the integrated package to prevent and control anemia within health teams and across sectors: advocate and educate.
  • Build partnerships in health, agriculture, food, and pharmaceutical sectors among government ministries and agencies, nongovernmental organizations (NGO), donors, industry, and commerce.

Advocacy about the importance of addressing anemia could start with partners within health, particularly to talk about defining the integrated packaging and making its delivery a priority. Within health, people working on malaria, helminths, and nutrition need to be involved and family planning staff.  Within nutrition, micronutrient specialists need to work with infant and young child feeding specialists to ensure that optimal feeding practices are integrated into anemia control programming for young children. It also will be important to reach out to the funders of programs including the Ministry of Finance and donors to discuss the costs to individuals and national development and thecost of programs to address anemia. Click here for a brief that can be used or adapted on what policy makers can to do advocate for the importance of addressing anemia.

Click here for information on a useful tool, PROFILES, which has been used in many countries to assist in determining the costs of malnutrition, including anemia, to national development and in starting a national discussion about malnutrition.

Click here for information about the costs of nutrition programs.

Delivering an integrated package, in most countries, requires a multi-sectoral response by preventing and controlling anemia in certain groups through advocacy and partnership with the Public Health Service/Ministry of Health. Within the Public Health Services/Ministry of Health departments such as nutrition, maternal health, reproductive health, and infectious diseases will be important partners in defining and delivering the integrated package. Other ministries that can address anemia in the populations they serve include:

  • The Ministry of Education, which can include practical nutrition information in school curriculums, implement school health and nutrition programs, including giving iron, treating malaria and hookworm infections, and promoting the consumption of iron-rich foods to children in pre-school programs and children in primary and secondary school
  • The Ministry of Agriculture, which can assist with increasing the production and availability of iron-rich foods including introducing new micronutrient-rich varieties, and train extension workers to give nutrition messages;
  • The Ministry of Industry, which can support food fortification programs in the private food industry and make long-lasting, insecticide-treated nets (LLINs) available to private vendors and health sector workers; The Ministry of Finance, which can put anemia control into the budget of several ministries;
  • The Ministry of Women’s Affairs, which can advocate for addressing anemia through its network of community workers;
  • The Ministry of Water and Sanitation, which can improve hygiene and decrease transmission of helminth infections that cause anemia; and
  • The Ministry of Local Government, which can assist with coordinating anemia prevention and control programs at lower levels of administration.
  1. Develop interventions and implementation plans
  • Identify priorities, responsibilities, and timeframes.
  • Identify specific objectives.
  • Identify potential collaborating groups (universities, government agencies, NGOs, civic groups, commercial entities).
  • Review existing programs and determine and develop anemia prevention and control activities.
  • Determine and secure staffing, funding, and other resources for implementing activities.
  • Develop a monitoring and evaluation plan.

Formative research may be needed in the beginning to identify barriers to current programs and which behaviors of stakeholders need to change to move forward in improving anemia prevention and control programs. This research also could help define priorities and responsibilities of stakeholders. Strategies should be “strategic” and prioritize objectives and phase in others over time. Objectives should be time-bound and measurable to allow for monitoring and evaluation.

Resources