From time immemorial the human societies world over have been dominated by the Adam power of males. Consequently the other half of the society has always borne the brunt of their atrocities. As the society matured and equality resulted into the empowerment of women their ailments consequent to the inferior lifestyle also abetted in some parts of the world. But unfortunately in spite of prevalence of worship of Devis, the Indian society has not matured enough to treat the fairer part of it equally. This has been further complicated by the practices of gender discrimination, feticide, child marriage, human trafficking, lower wages and domestic violence. Being last person in the family to take the meals, she is deprived of many dishes which she prepares. All these natural, social, cultural and domestic circumstances lead to deficient diet and excessive stress. Nature had bestowed the women with motherhood. But the above mentioned factors converted this into a health hazard named Anaemia.
Before discussing about the programme of AFI let us first understand what Anaemia means.
Human blood is constituted by 50% liquid portion known as plasma and 50% cellular part. The cells in the blood are of three types –
First one is concerned with oxygen carriage; second one with immunity and third one are needed for clotting of blood.
RBCs have their red colour due to the presence of hemoglobin. They are very important for life as oxygen is essential to utilize glucose in the body for production of energy. Brain, heart and muscles are highly susceptible to its deficiency. While brain dies within 4 minutes in absence of oxygen, heart attack is the death of some part of it due to anoxia and muscle cramps are nothing but the pain experienced by them due to anoxia consequent of malnutrition or stress.
When Hb% goes below 12% mg in women and 14% mg in males the person is called to be Anaemic. According to the WHO standards the three category of anaemia in women is as below:-
- Severe Anaemia – below 7% mg
- Moderate Anaemia – 7% to 10% mg
- Mild Anaemia – 10% to 12% mg
Symptoms of Anaemia-
Fatigue, lack of concentration, breathlessness and higher susceptibility for any infection are the main symptoms. The deficiency is usually a part of general nutritional deficiency and other symptoms may be related to that.
Direction of the programme:-
After enumerating the aetiology of Anaemia in women it is evident that any project aiming to control the ailment will have to address all factors leading to it. Thus the aims of Anaemia control programme of Arogya Foundation of India are to:-
- Improve health of the women by medical care and addressing the social and cultural factors and reviving indigenous ways of balanced diet.
- Taking care of the children below 10 yrs. to improve health status of the future generation of the country.
It comprises of 3 steps.
- Implementation of Programme
- Follow up
To have a field experience the doctors and Karyakartas of AFI have been conducting medical camps, testing Hb% and administering medicines along with awareness programmes for last 3 years. Now the programme has taken a definite shape and the above mentioned steps have become our mainstay. They are conducted as follows:-
(1) Survey – One sanch comprising 30 villages is the project area for one programme.The Acharya with the help of Arogya Sanyojika of the village conduct survey of that village. In this survey all the families of the Ekal village are registered. Out of them the women of child bearing age and children between 2-10 years are also registered. BPL status of the family is also noted in the format.
Once the registration through survey is completed in 30 villages the data is compiled at Bhag Karyalaya.
For every five villages Arogya Sevika, who will be responsible for the heath of all the registered women and children, is selected. Thus in a sanch six such women are employed as Arogya Sevikas.
(2) Implementation of the programme:- After initial survey three pronged programme status:-
- Medical Camps –To provide treatment at doorsteps six medical camps each for five villages are conducted within six months.
- Monthly Abhyas Varg of Arogya Sevikas:-In these training cum feedback the Arogya Sevikas are trained to –
(a) Conduct Hb% testing of registered women.
(b) Deliver medicines to Anaemic women and wormicides to children below 10 years.
(c) Conduct awareness meeting in all the villages.
The data collected from the Sevikas is compiled and analyzed and recorded in the central office of AFI.
3) Medicine Distribution with Awareness
Arogya sevika visits every family and delivers medicine in the following way-
Tab albendazole to all the children between 2 to 10 yrs & all the females between 10 to 45 yrs also along with iron+folic acid
Awareness- Arogya Sevika personally convinces the women about the importance of green leafy vegetables and balanced diet. Once in a month she also organises a public meeting in the village to sensitize the whole public about the gender discrimination and other social evils. Sometimes doctors and other social persons of the area are also called to deliver the speech.
4) Follow up and evaluation:-
The programme goes on for six months as described above. After that again the Hb% of all the registered women are tested and another round of same programme in the sanch repeats itself.
The programme is conducted under the guidance of a team of experts comprising of doctors and senior kendriya toli members of Arogya Yojana of Ekal Abhiyan.
Reasons for Anemia and Method Followed to Control
1) Contributory Factor:- The following factors are mainly responsible for Anemia
a) Harder Life for Women
b) Cyclic Monthly Blood Loss
d) Child Rearing & Lactation
e) Lower Wages
f) Gender Discrimination
g) Female Foeticide
h) Crime Against Females
i) Domestic Crime
2) Result of above factors are: -
a) Iron Deficiency Anemia
b) Iron-deficiency anemia increases the risk for:-
(i) Preterm labour
(ii) Low birth weight
(iii) Infant mortality
(iv) Increased maternal death during pregnancy & delivery
(v) Reduced intellectual performance among school children
(vi) Exhaustion & low concentration among women
3) Complete eradication of anemia would require intervention at following level: -
4)Arogya Foundation of India Takes Care Of : -
c) Social Factors
5) The Methodology followed by us for controlling anemia are: -
b) Medicine Distribution with Awareness
c) Follow Up
a) Area of Survey – Sanch( 30 Villages)
b) Target – All the Families of Ekal Village (Average- 50 Families)
c) Family Divided Into –
a) Male & Female
b) Children Up to 10 Yrs & Adult Females ( 10 to 45 yrs)
7) Medicine Distribution with Awareness
a) Two Ways:-
(i) Medical Camps at Six Places Each Covering Five Villages – An Arogya Sevika is Nominated to Serve this much of area
(ii) Medicine Distribution at Doorsteps – Arogya Sevika visits every family and delivers medicine in the following way-
Tab Albendazole to all the Children between 2 to 10 yrs & all the females between 10 to 45 yrs along with IRON+FOLIC ACID.
8) Follow Up
a) Monthly Training of Arogya Sevikas with Feed Back
b) Fortnightly visit of each village by arogya sevika to observe :-
- The Diet Pattern
- Medicine Consumption
- Awareness talk – balanced diet & social impacts
- Major Illness
9) Follow Up –
Repeat Medical Camps After 6 Months
- Repetition of medical camps as before
- At the time of visit of Arogya Sevika all the target women are tested for estimation of Hb%
- All target children and women are delivered tab Albendazole(wormicide) again
- Only those women who are still anemic are given Iron+ Folic Acid