Kushwaha, ArchanaJoshi, Deepa2019-02-042019-02-042018-08http://krishikosh.egranth.ac.in/handle/1/5810093462Adolescence (10-19 years) is a bridge between childhood and adulthood. India is a home to 253 million adolescents, out of which, one-third of boys and half of girls are anaemic. Low intake and poor absorption of iron and increased iron requirements for growth, blood losses in menstruation along with multitude of social beliefs and customs are causes of anaemia among adolescent girls in India. It is important to understand the epidemiology in order to plan effective interventions. It will also be helpful in drawing recommendations and rendering suggestions to evaluate and enhance the existing Anemia Control Programmes. There is a lack of up-to-date information on prevalence, correlates of anaemia and effective nutrition education programmes in district U.S. Nagar. A cross sectional study was conducted between March 2017-June 2018 among 880 adolescent girls (10-19 years) in 88 anganwadi (AWC) centers covering three blocks one each from rural, urban and tribal blocks of district U.S. Nagar. A pre-structured questionnaire was used to collect socio-demographic, dietary and menstrual health data on AGs along with their anthropometric and heamoglobin (Hb) measurements. Univariate logistic regression analysis was performed using R software between independent variables categorized under socio-demographic characteristics, anthropometric, menstrual health and dietary characters versus presence of anaemia. Independent variables which were found to be significantly associated with presence of anaemia, in univariate analysis were further analysed through multiple regression analysis to find predictors of anaemia. Knowledge, Attitude and Practices (KAP) of adolescent girls subject and ICDS functionaries pertaining to anaemia was assessed through questionnaire. On the basis of identified predictors and KAP status of adolescent girls, an IEC module was developed for improving the KAP of adolescent girls and its effectiveness was assessed through nutrition education intervention to a group of 27 adolescent girls(experimental group) compared against control group (n=28). The mean age of study population was 15.4 years. Prevalence of anaemia was found to be 83.18% among adolescent girls with mean Hb value of 10.62±1.5g/dl. Prevalence of anaemia was highest in tribal block (87.43 per cent). In univariate analysis, consumption of iron folic acid supplement (IFA), age, current school status, exposure to nutrition education on anaemia, mother’s literacy status, number of children in the family, abdominal, behaviour of skipping meals, number of meals per day, duration of menstrual flow and type of menstrual flow were significantly associated with anaemia in adolescent girls. While multiple regression analysis revealed that the strongest predictors of anaemia were non-exposure to nutrition education on anaemia OR (95%CI) 1.76 (1.36, 3.12); mother’s illiteracy OR (95%CI) 1.56(1.17,1.96) and long duration (>5 days) of menstrual flow OR (95%CI) 1.45(1.25, 1.65), and these were significantly associated with increased odds of nutritional anaemia while consumption of IFA OR(95%CI) 0.329(-0.04-0.71), scanty menstrual flow OR (95%CI) 0.692(-0.45,0.95) and late adolescent age OR (95%CI) 0.45(-0.03,0.94) showed a protective effect. About half of girls (52.04 per cent) were having low level of knowledge regarding anaemia, almost equal proportion of adolescent girls had negative (36.82 per cent), neutral (34.2 per cent) and positive (33.07 per cent) attitude towards anaemia, whereas 78.18 per cent of girls were following poor practices. Knowledge level on anaemia: definition, diagnosis, signs & symptom and preventive strategy at individual level, attitude of the adolescent girls towards perceived severity and susceptibility, preventive strategy, treatment of anaemia and dietary practices were found to be associated with presence of anaemia. About 39.7, 12.6 and 9.63 per cent increase in the knowledge, attitude and practices score, respectively was observed post nutrition education intervention in experimental group. Addressing the nutritional anaemia among adolescent girls will require attention to both nutrition education and iron supplementation programs targeting adolescent girls. Nutrition education as a long term strategy to bring desired behavioral changes among adolescents, recommended being a part of current education system and anaemia prophylaxis programmes.enThesis