Jain, ShashiNANDAL, URVASHI2020-09-162020-09-162019Nandal U. And Jain S.https://krishikosh.egranth.ac.in/handle/1/5810151376Development of a Model to Overcome Anaemia at Household LevelThe present study was undertaken on rural population of Kuraj village of Railmagra block of Rajsamand district of Rajasthan to develop a model to overcome anaemia at household level. The study was carried out in two phases. In the first phase, screening was done to identify anaemic households and judge anaemia prevalence. A screening proforma was developed to collect general family details from 469 members of 100 households about age, sex, educational status and haemoglobin level of each family member. From the 100 households, 30 anaemic families were selected based on maximum number of anaemic members in the households for intervention. The second phase of study was intervention on anaemia management. This included the preliminary survey of selected anaemic families, implementation of three fold intervention trial and its impact assessment and strategic model development. Well framed schedule was used for collecting general information, socio economic profile and dietary survey. Three folds intervention was implemented on 128 anaemic family members of 30 selected households for 100 days. These three folds were- food based iron supplementation to daily diet of anaemic members for faster recovery for 30 days by feeding iron rich lotus stem powder, group counseling to increase the awareness regarding overcoming anaemia for 90 days (7 times at 15 days interval) by visual e media and personal counseling to make necessary changes in diet and household environment for sustainability to prevent and overcome anaemia in the family for 100 days (11 times at 10 days interval). The results revealed that among 469 members in 100 households for screening about 40 per cent adults and family heads were illiterate. 70 per cent members were anaemic. Mean hemoglobin level of all age groups was less than their normal Hb level particularly in girls and adult females i.e. 13 per cent deviation from normal. Maximum subjects were moderately anaemic (36.25%) followed by mildly anaemic (27.72%) and very few severely anaemic (7.67%). The moderate form of anaemia was more prevalent among the study families. Anaemic members were commonly present irrespective of family sizes. Severely anaemic members were present in family size 4 and 5. Mild to moderate anaemia was prevalent in all family sizes. Three fold intervention programme was implemented on 30 anaemic families for 100 days considering household as one sample. About 60 per cent of adults were illiterate and majority (86.72%) subjects were vegetarian. There was improper environmental sanitation in the households and ill personal hygiene habits of subjects. About 90 per cent families belong to low socio economic class. Before intervention, all 128 members of 30 families were anaemic. Mean hemoglobin level of study group was ranging between 7.88 g per cent to 9.16 g per cent. About 30 per cent deviation from normal Hb level was observed in the members. Maximum were moderately anaemic (69.53%) followed by severely anaemic (28.13%) and very few mildly anaemic (2.34%). Adult females were most severely anaemic followed by children of 5-14 years and adult males. Dietary inadequacy was observed in all the food groups. Nutrient intake was lower than RDA at household level. Most specifically limiting nutrients were energy, Beta-carotene, vitamin C, vitamin B12 , Folic acid, iron and zinc. Statistically there was significant increase in the dietary intake at individual as well as per adult consumption unit at household level before and after 100 days intervention. At household level, there was a significant increase in the intake of macro and micro nutrients except β carotene, vitamin B12, folic acid and calcium. Improvement was evident in dietary intake in terms of quality as well as quantity at individual and household level after 100 days of intervention indicating impact of nutrition education by group and personal counseling on dietary practices and good personal hygiene and environmental sanitation habits. The mean haemoglobin level has improved in all age groups. Maximum per cent increase in Hb level before and after intervention was observed in children below 5 years (50%) followed by about 40 per cent increase in children 5-14 years and adult females and about 25 per cent increase in children of 15-17 years and adult males. After 100 days intervention, 20.31 per cent members were reported normal. Before intervention 28.13 per cent members were severely anaemic but after intervention about 80 per cent were having mild and moderate anaemia. There was no member having severe anaemia. Over all at household level 70 per cent moderate anaemia prevalence came down to about 40.00 per cent. Prevalence of mild anaemia was about 40.00 per cent at household level after 100 days intervention. About 20.00 per cent members became non anaemic after 100 days intervention. Hence, a shift of subjects was seen from severe to moderate, moderate to mild and mild to normal conditions. Anaemia prevalence also decreased in all age groups and 20 per cent decrease was observed at household level. Haemoglobin levels of subjects increased significantly by providing food based supplements alongwith imparting nutrition education through personal and group counseling at regular intervals for long time. So, the output of intervention was- Haemoglobin shifts towards normal, increase in nutrition knowledge, improvement in quality and quantity of diet and change in dietary pattern, anaemia prevalence, and lifestyle. The results of the study conclude with a three I model for overcoming the anaemia with an integrated approach which will be applicable at household level- intervention, information and intakeenThesis