Figures & Tables
Figures
- FIGURE 1
Processes Involved in Computing IFA Coverage and AMB Index, India
Abbreviations: AMB, Anemia Mukt Bharat; HMIS, health management information system; IFA, iron and folic acid.
- FIGURE 2
Total Number of Individuals Covered Under the AMB Program, India, by Fiscal Year
Source: HMIS and AMB dashboard.
Abbreviations: AMB, Anemia Mukt Bharat; FY, fiscal year; HMIS, health management information system; IFA, iron and folic acid.
- FIGURE 3
IFA Supplementation Coverage Under the AMB Program, India, by Fiscal Year
Source: HMIS standard report.
Abbreviations: AMB, Anemia Mukt Bharat; FY, fiscal year; HMIS, health management information system; IFA, iron and folic acid.
- FIGURE 4
Boxplot of IFA Supplementation Coverage, India
Abbreviations: A and N, Andaman and Nicobar; IFA, iron and folic acid.
- FIGURE 5
AMB Index Value Distribution, by State, India, Fiscal Year 2022–2023a
Abbreviation: AMB, Anemia Mukt Bharat.
a Up to March 2023.
Tables
- TABLE 1.
AMB Program Guidelines for Prophylactic Doses and IFA Requirement for Different Groups, India
Groups Prophylactic Dose Regimen and Composition Total Drug Requirement, Yearly Children 6–59 months old Biweekly, 1 ml of IFA syrup 1 mL IFA syrup contains 20 mg elemental iron + 100 mcg FA 2 syrup bottles Children 5–9 years old Weekly, 1 IFA tablet 1 pinka sugar-coated tablet contains 45 mg elemental iron + 400 mcg FA 52 tablets Adolescents 10–19 years oldb Weekly, 1 IFA tablet 1 bluea sugar-coated tablet contains 60 mg elemental iron + 500 mcg FA 52 tablets Pregnant women Daily, 1 IFA tablet 1 reda sugar-coated tablet contains 60 mg elemental iron + 500 mcg FA 180 tablets Anemic pregnant women Daily, 2 IFA tablets 1 red sugar-coated tablet contains 60 mg elemental iron + 500 mcg FA 360 tablets Lactating mothers Daily, 1 IFA tablet 1 red sugar-coated tablet contains 60 mg elemental iron + 500 mcg FA 180 tablets Women of reproductive age 20–49 years old Weekly, 1 IFA tablet 1 red sugar-coated tablet contains 60 mg elemental iron + 500 mcg FA 52 tablets Abbreviations: AMB, Anemia Mukt Bharat; IFA, iron and folic acid; FA, folic acid.
a The pink, blue, or red coloring of the tablets is recommended by the Ministry of Health and Family Welfare for easy identification of the tablets for each group.
b Including both in-school boys and girls and out-of-school girls.
Source: AMB operational guidelines, 2018.22
Groupb HMIS Indicators Provided IFA (Numerator) AMB Target (Denominator) Children aged 6–59 months 9.9: Number of children aged 6–59 months provided 8–10 doses (1 mL) of IFA syrup (biweekly)
Number of children aged 6–59 months provided 8–10 doses (1 mL) of IFA syrup (biweekly) Total number of children aged 6–59 months (NIPI target) Children aged 5–9 years 23.1: Number of children covered under WIFS junior (5–9 years) provided 4–5 IFA tablets in schools23.3: Number of out-of-school children (5–9 years) given 4–5 IFA tablets at Anganwadi centers
Number of children covered under WIFS junior aged 5–9 years in school + number of out-of-school children (aged 5–9 years) provided 4–5 IFA tablets per month Total number of children aged 5–9 years (NIPI target) Adolescents aged 10–19 years 22.1.1.b: Number of boys (6th–12th class) provided 4 IFA tablets in schools
22.1.1.a: Number of girls (6th–12th class) provided 4 IFA tablets in schools
22.1.3: Number of out-of-school adolescent girls provided 4 IFA tablets at Anganwadi centers
Number of boys + girls in school + out-of-school girls aged 10–years provided 4 IFA tablets per month Total 10–19 years in-school girls + 10–19 years in-school boys + 10-19 years out-of-school adolescent girls (WIFS target) Pregnant women 1.2.4: Number of pregnant women provided full course 180 IFA tablets
1.1: Total number of pregnant women registered for ANC
Number of pregnant women provided full course 180 IFA tablets Total number of pregnant women registered for ANC Lactating mothers 6.3: Number of mothers provided full course of 180 IFA tablets after delivery
Number of mothers provided full course of 180 IFA tablets after delivery Lactating mothers (live births–midyear population × crude birth rate) Abbreviations: AMB, Anemia Mukt Bharat; ANC, antenatal care; HMIS, health management information system; IFA, iron and folic acid; FA, folic acid; NIPI, National Iron Plus Initiative; WIFS, Weekly Iron and Folic Acid Supplementation program.
↵a Indicators are per the HMIS before March 2023; some are updated in new HMIS from April 2023.
↵b Indicator for women of reproductive age under development.
Group Data Collection, Level and Person Responsible Data Compilation Performed, Level and Person Responsible Data Updated on HMIS Portal, Level and Person Responsible Children aged 6–59 months Subcenter, ANM PHC/CHC level, medical officer At block level by BPO Children aged 5–10 years and adolescents aged 10–19 years in school School, schoolteachers Education department at district level At district level by DPO (health) Children aged 5–10 years and adolescents aged 10–19 years out of school Anganwadi center, AWW Integrated child development services department, WCD At block level by BMO/BPO Pregnant women Subcenter, ANM PHC/CHC level, medical officer At block level by BPO Lactating mothers Subcenter, ANM PHC/CHC level, medical officer At block level by BPO Abbreviations: AMB, Anemia Mukt Bharat; ANM, auxiliary nurse-midwife; AWW, Anganwadi worker; BPO, block program officer; BMO, block medical officer; CHC, community health center; CDO, child development officer; DPO, district program officer; HMIS, health management information system; PHC, primary health center; WCD, women and child development.
Source: AMB training toolkit, 2019.
- TABLE 4.
Benefits and Limitations of Three Methods Used to Compute the Anemia Mukt Bharat Index
Method Benefits Limitations Composite index Normalizes coverage.
Reflects overall status/progress.
Allows for comparisons across different indicators.
Can produce a negative coverage index for nonreported states/districts.
Complex to interpret.
Can be sensitive to outliers.
Geometric mean Useful for calculating growth rates.
Less sensitive to outliers compared to the simple average method.
Can produce zero index value with zero coverage states.
May not be suitable for data with zero values.
Simple average Gives equal weightage to all groups.
Simple to understand and interpret.
Less sensitive to fluctuations in individual indicators.
May not be suitable for complex analyses.
Requires different weights for groups.
Can be influenced by outliers.
IFA Coverage, %a Children Aged 6–59 Months Children Aged 5–9 Years Adolescents Aged 10–19 Years Pregnant Women Lactating Mothers AMB Index,%b States Telangana 95.0 83.1 87.7 95.0 95.0 91.2 Tamil Nadu 72.1 95.0 95.0 95.0 92.3 89.9 Chhattisgarh 78.5 83.6 86.4 95.0 74.4 83.6 Andhra Pradesh 82.4 68.5 79.3 95.0 73.0 79.6 Madhya Pradesh 60.6 84.8 78.7 95.0 60.1 75.8 Odisha 57.2 55.0 73.6 94.8 65.7 69.3 Haryana 81.7 35.0 87.3 87.1 53.3 68.9 Maharashtra 59.8 41.2 40.1 95.0 76.2 62.5 Assam 31.0 49.2 61.8 95.0 75.2 62.4 Jharkhand 33.3 35.4 73.1 91.3 75.3 61.7 Gujarat 29.3 54.1 57.1 95.0 71.5 61.4 Rajasthan 61.9 19.3 42.2 95.0 71.9 58.1 Goa 7.5 23.3 78.9 83.5 83.2 55.3 Himachal Pradesh 34.4 47.6 45.5 80.9 62.8 54.2 Tripura 8.9 51.7 82.2 87.0 39.8 53.9 West Bengal 50.6 12.2 41.3 91.4 71.8 53.5 Karnataka 7.9 35.2 37.6 95.0 80.3 51.2 Punjab 18.1 34.2 71.8 72.7 55.9 50.5 Uttarakhand 9.4 43.4 38.0 89.6 71.3 50.3 Uttar Pradesh 1.1 51.9 51.9 95.0 44.0 48.8 Sikkim 5.8 5.3 20.2 87.4 95.0 42.7 Mizoram 0.4 29.8 70.5 73.3 31.1 41.0 Kerala 15.6 2.8 3.0 95.0 59.2 35.1 Bihar 3.4 7.0 18.8 81.1 44.6 31.0 Meghalaya 2.9 0.4 9.8 67.9 47.3 25.7 Arunachal Pradesh 0.2 0.5 0.6 74.1 51.6 25.4 Nagaland 0.0 0.6 7.3 60.7 36.4 21.0 Manipur 0.1 5.5 3.4 33.2 17.0 11.8 Union Territories Jammu and Kashmir 22.9 82.9 45.4 95.0 66.5 62.5 Puducherry 6.6 49.2 65.5 95.0 87.0 60.7 Dadra and Nagar Haveli and Daman and Diu 50.1 59.1 53.7 91.3 47.6 60.4 Chandigarh 1.2 18.0 88.9 95.0 95.0 59.6 Andaman and Nicobar Islands 43.9 57.9 42.7 63.6 61.8 54.0 NCT of Delhi 9.4 9.8 31.2 89.1 43.8 36.7 Ladakh 5.9 1.8 9.0 95.0 46.1 31.6 Lakshadweep 0.0 0.0 0.0 94.2 34.5 25.7 All India 33.1 39.6 51.0 95.0 69.1 57.6 Coefficient of variation 1.00 0.76 0.59 0.15 0.31 0.40 Abbreviations: AMB, Anemia Mukt Bharat; HMIS, health management information system; IFA, iron and folic acid.
↵a Indicators are per HMIS before March 2023; some are updated in the new HMIS from April 2023. IFA coverage calculated from key performance indicator numerators and denominators in Table 2.
b Simple mean of coverage values for 5 groups.
Source: Authors’ computation based on HMIS and AMB dashboard as on June 15, 2023.
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