The Milken Institute School of Public Health was recently awarded a $4 million grant from the Bill & Melinda Gates Foundation for a project that aims to address iron deficiency and anemia in India, a serious public health problem.
More than 30 percent of the world’s population is anemic, about 2 billion people, according to the World Health Organization (WHO). Many of these cases are due to iron deficiency. More than half of all women of childbearing age in India are anemic, with rates in the eastern state of Odisha particularly high.
Rajiv Rimal, SPH professor and chair of the Department of Prevention and Community Health, will use the foundation support to design a social norms-based strategy aimed at reducing the high rates of iron deficiency and anemia in Odisha with the hope that the model can be used in other parts of the country or the world.
Severe anemia can cause dizziness, rapid heart rate, neurological issues and fatigue. It is especially risky for pregnant women and their developing babies.
“Iron-deficiency anemia can lead to a cycle of poor health, one that can affect women, their children and entire communities,” said Dr. Rimal, who serves as the principal investigator for the new project. “Our study aims to find an innovative solution for this important public health problem.”
The WHO recommends women of childbearing age take daily iron and folate acid supplements during pregnancy and during the post-partum period. Since iron deficiency is the most common cause of anemia, that step could go a long way toward solving this health problem. However, despite public health campaigns to get more women to take the supplements, the situation continues to remain dire.
Dr. Rimal and his team will first identify barriers that prevent women in Odisha from taking these supplements. For example, it is possible women do not get the social support they need from family members to take the pills. Women may not like the taste of the tablets or there may be other reasons why they are not taking these supplements.
Once the team has identified the barriers, they will design a study to see if they can promote changes in social norms and behavior, with the ultimate goal of reducing the risk of anemia. The research team will partner with IPE Global, a group already working on the problem of iron deficiency anemia in Odisha.
A small-scale intervention will be developed, tested and refined during the first year of the three-year study. The researchers then will launch a trial in which 2,000 women in one village will get the intervention and 2,000 women in a second village will serve as a control group. Data will be collected at the start of the trial, during the middle of the intervention and at the conclusion of the study.
Dr. Rimal and his colleagues hope to find a successful intervention that would spur women in Odisha to take the supplements and thus reduce high rates of anemia. If it is left unchecked, iron deficiency anemia can lower the work capacity of individuals and entire populations—leading to serious economic and health consequences.
The researchers also will see if the intervention can boost energy levels in the test population. Dr. Rimal says women often work in the fields around Odisha, which is a farming region. If they’re in peak condition, that translates to a benefit for their families and often the entire community, he said.