India: Jharkhand

A2Z India: Jharkhand Map and Statistics

Jharkhand was part of Bihar until it came into existence as a separate state in November 2000. More than half of its population belongs to disadvantaged groups, and three-quarters of the population live in rural areas. Within this context A2Z is supporting vitamin A supplementation and anemia reduction packages.
Sustainable Vitamin A Supplementation
A2Z in partnership with the Micronutrient Initiative and UNICEF led efforts to institutionalize twice-yearly vitamin A rounds as part of mother and child health (MCH) and nutrition months. In February 2008 the Government of Jharkhand announced these twice-yearly months for the entire state. A package of MCH services is delivered during the rounds. The project has built state capacity in reviewing high and low performing districts, improved procurement of vitamin A supplements by the Health Department, developed urban and rural microplans, supported operational guidelines, and designed IEC materials. Program sustainability is being strengthened through improved supply procurement and distribution and the use of data from the health management information system for planning.

Scaling Up Maternal Anemia Reduction Packages
A2Z works through the maternal health component of the state MCH program to strengthen outreach services of auxiliary nurse-midwives in collaboration with the Integrated Child Development Services (ICDS). These services include provision of iron folic acid, deworming medication, and nutrition and health education on such topics as malaria control. A2Z activities also involve advocacy, capacity building of staff, behavior change communication, strengthening of supply systems, and use of data for planning and decision-making.
Developing Child Anemia Reduction Packages
A test is underway among children 6-24 months old in a population of 85,000 to determine the feasibility of implementing an intervention package to reduce child anemia through ICDS and health staff. The package includes iron supplements, improved feeding practices, links with malaria control efforts, deworming, and promotion of hand washing. The package is based on a comprehensive situational analysis involving a review of anemia prevalence data and the current status of ICDS and health program implementation, acceptability tests of different iron formulations, a worm prevalence study, key informant interviews, and formative research. As a result of A2Z advocacy, state policy is being revised to improve deworming activities, and pediatric iron formulations are now being procured for infants and young children for all districts. An ethical review panel was constituted for the first time ever in the state and is being used for all studies on human subjects.