Digital Monitoring of Anemia Control Measures in a District Using Anemia Mukt Bharat Health Management Information System Indicators.

Introduction: Anemia is a severe public health problem in India, affecting more than 50% of individuals across most age groups. The Anemia Mukt Bharat (AMB) program, with a target of a three-percentage point reduction in anemia prevalence per year, developed a monitoring mechanism based on a set of 18 indicators and six key performance indicators (KPIs) derived from routine reporting in the Health Management Information System (HMIS). The study's objective was to assess the status of anemia control measures in the district of Faridabad, Haryana, India, using AMB HMIS indicators from April 2018 to March 2019.

Methods: A cross-sectional study was conducted in the district of Faridabad, Haryana, from May 1 to June 15, 2019 (reference period: April 2018 to March 2019). The status of existing activities for anemia control was assessed by documentation of HMIS indicators identified by the AMB program for routine monitoring. Sources of data were HMIS, program reports, and district annual reports. Denominators provided by the AMB program were used for ascertaining proportions and the AMB index. A critical review of the generated data and a description of the collection and reporting process were done.

Results: Activities in place to control anemia were prophylactic iron and folic acid (IFA) supplementation and deworming to 6-59-month children, adolescents, and pregnant and lactating women. For children five to nine years of age, IFA was not provided in the district, but deworming was done. The coverage of IFA prophylaxis in children 6-59 months was 22.5% and 85.1% in adolescents. The 180-day IFA supplementation in pregnant women was 33.1%. The IFA stock status was not captured in the district. The AMB index for district Faridabad (April 2018 to March 2019) was 35.2. Gaps in understanding data elements and mismatches between AMB denominator data and census forecasts limited the data's accuracy.

Conclusions: Overall, the status of anemia control measures assessed by HMIS indicators was unsatisfactory in the study district. Number-based reporting and issues with data quality limited the use of data for decision-making. Periodic evaluations of anemia control measures at the district level may be required to achieve the targets set by the AMB program.