Neeli Goli Khayi Kya? : Kondagaon District Administration's resolute battle against Anaemia

It was a typical afternoon at Government High School in Bharripara, a rural village near Keshkal. The students were immersed in their studies when suddenly the air filled with an electric anticipation. The sound of the lunch bell was about to ring, and everyone was excitedly waiting for it. As the bell finally tolled, there was a palpable energy in the room, and the noise level increased as students began to rise from their desks and shuffle towards the door. But, there was something else that was causing a buzz among the students, the blue Iron-Folic Acid tablets. As they chatted amongst themselves, they asked, "Neeli goli khayi kya ?" These IFA tablets were essential in preventing anemia among the female students.

According to the National Family Health Survey 5 (2019-2021), a staggering 79.7% of all women and girls aged 15-49 in the Kondagaon district are anemic. To address this daunting challenge, it is of paramount importance that school and college-going girls are educated about this health condition. To this end, the district administration, in collaboration with the Health department, Women and Child Development department and Panchayat department, has launched a public health initiative called "Anemia Mukt Kondagaon". This initiative targets all adolescent girls and women aged 15-25 years, and pregnant women aged 18-49 years and follows a "Test, Treat, Tell" model. Regular testing of girls' hemoglobin levels is conducted to identify anemic girls, who are then treated according to their hemoglobin levels. The "Tell" module employs various methods to raise awareness among the people at the grassroots. The initiative involves three surveys: the baseline survey to assess the students' condition prior to the program, the midline survey to track progress in the students' hemoglobin levels post treatment, and the endline survey to evaluate the final results of the program spanning over six months. Other types of survey include school, college, and open surveys have been conducted under which in total of 43226 females . Among these were 10740 preganent and lectating women.

H.S Maali, the Principal of Government High School Bharripara, is dedicated to ensuring that his students maintain optimal health and well-being. With regular testing of students' hemoglobin levels, anemia is detected early on, and students are divided into categories of mild, moderate, and severe cases. Those with severe anemia are referred directly to the nearest primary health center where they receive Iron-sucrose injections to address their condition. Through the use of a mobile application, real-time data is generated and provided to medical suppliers, who are then able to ensure the school has the necessary supply of Iron-Folic Acid (IFA) tablets. Nodal teachers are responsible for monitoring the dosage of IFA tablets and conducting periodic check-ups of students' Hb levels. In addition, a booklet is provided to students containing a diet chart that identifies locally available sources of iron and vitamins. This allows students to decrease their dependency on IFA tablets over time, while also enabling anemic students to track their tablet consumption.

Innovative approaches are being employed to raise awareness about the importance of good health among students. One such approach is the "Bal Sansad," or child parliament, where the health minister is tasked with the responsibility of ensuring that students take their "neeli goli," or IFA tablets, regularly and informing the nodal teacher of their progress. This initiative has yielded encouraging results, with students who have recovered from anemia and shown significant increases in their Hb levels being recognized during morning assemblies to inspire others to adopt similar changes to their habits. By leveraging a combination of cutting-edge technology, traditional methods, and community involvement, this school like many others in the district is working towards ensuring that all students are healthy and equipped to achieve their full potential.

Mrs. Sulochana Markam and Fuleshwari Markam are two dedicated volunteers working in a garden near the school playground in Kondagaon, Chhattisgarh. They are part of a larger volunteer-based organization called "Yuvodaya Kondanaar Champs" that is focused on raising awareness about health and education among the citizens of Kondagaon. One of the initiatives of this organization is the "Poshan Vatika" or nutrition garden, which is a horticultural field where iron-rich vegetables such as spinach, peas, and other locally available substitutes are grown to be used in the mid-day meal of students. The "Poshan Vatika" is a creative and successful strategy for encouraging pupils to develop good eating habits. It acts as a motivator for the pupils to include these iron-rich veggies in their daily meals by acting as a nudging unit., encouraging the students to incorporate these iron-rich vegetables into their regular diets at home. This is especially important in a district like Kondagaon, where iron deficiency is a prevalent problem among women and children.Ashok Pandey, the district coordinator of the "Yuvodaya Kondanaar Champs" program, shared that they have successfully built 12 such nutrition gardens across the district, which are regularly maintained by volunteers. The organization plans to expand this initiative to the panchayat levels as well, with the goal of promoting healthy eating habits among more people in the district.

In addition to the nutrition gardens, the volunteers of the program conduct regular meetings with the gram panchayats to encourage citizens to test the HB levels of women and adolescent girls. The organization provides IFA tablets to all anemic women, and it has become crucial for pregnant women to have regular Hb checkups. They are trying to make pregnant women mindful to have a vaccination every Tuesday and Friday so that thier Hb levels can also be checked regularly through it, making it easier to detect anemia. Adolescent girls who have dropped out of school are also encouraged to have their Hb levels checked up. The volunteers use various methods, such as wall writings and awareness rallies, to nudge behavioral changes towards anemia. "Yuvodaya Kondanaar Champs" program is doing remarkable work towards raising awareness that they are promoting healthy eating habits among the citizens of the district, and the volunteers are making a significant difference in the lives of many women and children.

When asked about the challenges faced by the administration, Dr. R.K Singh CMHO (Chief Medical and Health officer) said the biggest adversity faced is the lack of awareness and casual approach of villagers towards this condition. They don't fathom that this condition not only puts the life of these girls but also the life of the future babies at stake, the long-term implications it can have to their bodies as well as the health of their babies is sometimes irreversible, Anemia in pregnant women increases their risk of premature birth, low-weight baby, and severe increase in infant mortality rat. Teenage girls and women regularly have an absence of milk and other green vegetables in their diet which increases this problem manifold. When teenage girls drop out of school or do not continue their studies further, it becomes necessary that they adopt good eating habits from the school itself and go for regular health checkups in primary health centers.

The importance of educating villagers, especially parents and caretakers, on the impact of this condition cannot be overstated. Dr. Singh stressed that it is essential to raise awareness about the need for a balanced and nutritious diet, particularly among adolescent girls and women. It is crucial to encourage them to make informed choices about their health and wellbeing, which can help them prevent this condition and mitigate its harmful effects. Only by working together as a community and investing in preventive measures can we hope to overcome this significant health challenge.

Mr. Deepak Soni, the Collector and District Magistrate of Kondagaon, is determined to eradicate a major health condition from the district. Anemia, a common problem in the district, affects a large number of women and children. However, Mr Soni's vision is to completely eliminate anemia from the region through a sustained effort to bring about a social change among the common people. According to Mr. Soni, the solution to the problem is not just dependent upon the distribution of IFA tablets but also requires dietary and behavioral changes. To achieve this goal, district administration is working relentlessly to create awareness among the people about the importance of a healthy diet and lifestyle.

positive changes are already visible in the district, with every female between the ages of 15-25 being tested and treated as per the procedure. This proactive approach has been instrumental in identifying and treating anemia early on, preventing its progression to a severe condition. Mr.Soni remains optimistic about the future of the district and is confident that the sustained efforts being made to eliminate anemia will soon bear fruit. He believes that with continued awareness campaigns and proactive measures, the district will eventually get rid of this debilitating condition.The efforts being made by district administration in collaboration with various organizations are truly commendable. The district has a bright future ahead, and it is heartening to see that the authorities are taking proactive steps to address the health concerns of the people. With continued support and effort, anemia can be eradicated from Kondagaon, paving the way for a healthier and more prosperous future.