Child Anemia Training Module

Conducted by Government of UP/Jharkhand

Supported technically by A2Z Micronutrient Project

Participants
Supervisors LHV, Mukhya Sevikas
ANM, AWW, ASHA, Sahiyas

Prepared by
Professor Prakash V Kotecha
Senior Technical Advisor,
A2Z, the USAID Micronutrient Project
AED India
 How does this training differ from other training courses?

In this training, there are no teaching sessions!

What we will be doing would be discussion, experience sharing and skill

development to be able to effectively communicate and counsel the clients
(mothers or care givers and their young children) for improving their health
and adequately seek the medical care as and when required. We will also
deliberate on how the young children need to be breastfed, fed after the
age of six months and how to ensure that the food they get is sufficient in
quantity and quality.
Other important thing we will do in this module is to ensure that we will be
able to communicate effectively to frontline workers how will they
communicate and counsel mothers such that mothers understand, grasp,
raise questions to them and get satisfied to initiate and/or continue desired
behavior for the good of the child and for herself.

How shall we do this?

We will have counseling material that has been field tested with ANM and
by ANM with mothers in YOUR community. We are going to take the help of
these counseling materials and have discussion on these materials
initially. After we have been satisfied with them, we are going to do role
play for how to use the counseling material in the field and ensure that
what we want to communicate has been actually grasped by the
mothers/caregivers.

Once we are confident that this is doable and easy, we are going to use
them in the field to ensure that these easy and simple guide helps to
discuss and negotiate with mothers to achieve what we want them to
achieve for the good of their children.
 Objectives of the Training

Broad Objective

The training for three day will provide basic information to front line workers
about child and maternal anemia in India and UP/Jharkhand and the program in
place for anemia control in UP/Jharkhand with its importance and the program
contents. The important focused component of the training is then to build
the capacity of the front line workers to effectively deliver the service
components including counseling to the clients and their family members
that will facilitate the clients to use the services and demand for the available
services.

Specific Objectives are as under:

By the end of the training participants will know

I. What is anemia and why it is important to treat anemia in women and in

children. What are the benefits to the child and how her/his growth and cognitive
function would improve when adequately protected from iron deficiency. What is
the anemia control program under the government and what is its current
situation in the country, state and district area where they are working.

II. What exact activities they need to do for child anemia control program.

They include:
1. To identify children 6-23 months and get a list of them by name, age and
gender and under which AWW and ANM they will be covered
2. Identify who will deliver IFA syrup with Counseling and demonstration of
how to give IFA, how long and how to manage side effects
a. Discuss side effects if any and seek timely help
b. Make sure that over dose is not given
c. Store IFA bottle safe in a dark and dry place out of reach for
children
 d. One person in the house is responsible for dosing the child every
time
3. How the mother should be encouraged to feed the child as required. This
calls for actual demonstration or explanation after talking to her and
finding out which of the desired behavior mother is doing and which the
mother is not currently following and then advising only on those that she
has not been doing after appreciating that she has been able to do.
4. Reinforce to visit for biannual rounds for deworming regularly
5. Encourage pregnant mothers for
a. IFA tablet collection and consumption timely
b. Discuss side effects if any and seek timely help
c. Take one or two extra food during pregnancy
d. Take nutritious food (one glass milk and more of dal, vegetables,
egg, meat)
6. Monitor coverage regularly
7. Assist in survey for coverage done by supervisors

Material Required for the Training

Handouts, Counseling Cards, Posters, Number of flip charts, pen, pencils,
calculators, Plain papers, Erasers, color cards (VIPP cards)
Prior Information Required
AWW, ANM may be requested to bring with them their centers basic information
that will include population and village/s covered by them, beneficiaries
registered and the copy of the last monthly report sent.
Day I
 Training Content

Session I: Welcome and Introduction:

It is desired that every participant and facilitator put in large bold letter name tag
and attach it to their dress so that every one can interact with each other by
name.

Session II Objectives of the training

This session will briefly guide the participants what would they be looking for in
these 3 days interactive sessions of discussion and learning.

Senior government official present (or as appropriate) welcomes participants and

mentions briefly the objectives of the training (as mentioned above) highlighting
the skill development aimed in the training and requests participants to actively
participate

Coordinator then requests every participant to introduce themselves: they may

give their name, place of working, designation and if they have seen a case of
anemia, one or two symptoms that they noticed. Introduction needs to be short.
This is the time pretest questionnaire needs to be introduced and shared for 10
minutes. Participants need not identify them selves. Encourage them to be
honest in answering as this is not THEIR examination but is a to guide training
content
Session III: What is Anemia 50 minutes

Objective of session III: Participants will know what is anemia, its dangers
and why it more common in children and in pregnant women, how
widespread it is and how to control it

Facilitator: Medical Person Available or Anemia Coordinator (knows the

time limit and also the contents keeping in mind the front line workers level
of understanding, a briefing is required)

What is Anemia and how widespread is it? (10 minutes)

(Share with participants hand outs in local language and in big bold letters with
pictures preferably, main points as below).
Iron deficiency is the most common form of malnutrition in the world, affecting
more than 2 billion people globally. Iron deficiency anemia (inadequate amount of
red blood cells caused by lack of iron) is highly prevalent in less-developed
countries but also remains a problem in developed countries where other forms
of malnutrition have already been virtually eliminated. Iron deficiency is not the
only cause of anemia, but where anemia is prevalent; iron deficiency is usually
the most common cause. The prevalence of anemia is defined by low
hemoglobin. (Less than 12 g/dL is anemic for non pregnant and less than 11 g/dL
for pregnant woman is criteria to diagnose a woman to be anemic, anemia for
children is defined as hemoglobin value of less than 11 g/dL)
Recent studies have shown that in India anemia is very common and
UP/Jharkhand is having of anemia higher than national average. (Please put
state specific data here). Ethical committee presentations with each state is
available and detailed data state specific are available in them

Iron deficiency generally develops slowly and is not clinically apparent until
anemia is severe even though functional consequences already exist. Where iron
deficiency anemia is prevalent, effective control programs may yield benefits to
human health.
Consequences of Anemia children (10 minutes)
1. Child with anemia may be born with low birth weight
2. When anemia continues or develops early in life, child maynot grow
adequately and his physical and mental capacity will remain lower as
compared to healthy children.
3. Child is more likely to develop infection and does not have good appetite.

Consequences of Anemia mothers

4. Increased chance of death during delivery: Overall, about 20 percent of

maternal and perinatal mortality in developing countries can be attributed
to anemia. Recent work has shown that most of this impact is in the mild
and moderate grades of anemia, rather than being limited to severe
anemia.

5. Low birth weight babies born: Anemia in pregnant women results in lower
birth-weight babies who have a higher risk of death.

Mild and moderate anemia also are detrimental to health and contributes to
larger proportion of total ill effects due to anemia

Session IV:
Session Objectives

How to control Anemia? (10 minutes) (USE the TIN Plate that we have
developed or appropriate IEC)

Mothers Level

1. Register as soon pregnancy is noticed.

2. Take one tablets of IFA tablet every day at night before going to sleep
after dinner from fourth month onwards
3. Need to increase amount of food consumed in pregnancy, one or two
extra meals during pregnancy besides normal food
 4. Deworming dose, one course of six tablets (one if albendazole) after four
months of pregnancy.
5. Malaria prevention (bednets) and immediate treatment for fever.
6. Counseling at the place and time that is suitable to mothers

Child Level (Anemia control and Malnutrition Control)

1. IFA syrup twice weekly (Wednesday and Saturday or RI days) 1 ml after

at least one katori full food
2. Counseling for food: BF to continue + 3 half katori semisolid food for 6-8
months, 3 katori solid food 9-11 months and 4 katori solid food for 12-23
months old children. Avoid bottle feeding.
3. Mother to wash hands with soap and water before feeding the child and
after defecation and also make child wash hands with soap and water
before feeding and after defecation.
4. Deworming dose at 12-18-24 months (if mebendazole 1 tab three days, if
albendazole, one tablet)
5. Protection from malaria in form of advising to get fever investigated and
ensure that mosquito breeding does not take place by keeping
surrounding clean and avoid water collection and mosquito breeding. Use
bednets to prevent mosquito bites
6. Counseling at the place and time that is suitable to mothers for their
children

Session V: Introducing MAAYA Strategy

Current Scenario of Anemia/Malnutrition Control in Your Area (30 minutes)

This should be converted in to group work after a quick question of concern that
what actions are required to control anemia and to control malnutrition. Put one
by one their replies on a flip chart such that the actions required by health care
providers are written down on lower
side and by community on upper side.
Put them in to four areas from
pregnancy, 0-6 months, 6-12 months
and above one year of age. What
would emerge from their discussion is
final strategy proposed as mentioned
here. This will help us in then
proposing the MAAYA Strategy as their own suggested strategy rather than our
imposing idea on them.

Session VI
Group work for identifying problems and suggested ways to resolve them

Objective: This is the time where participants will share their experience and
concerns. They may have been able to do some of the work well while at other
fronts face problems. They either know why the problem and how to solve them
but may not have resources or capacity to solve them. Or they know but are not
in position to solve them. In this group work participants will list and suggest
action points and possible problems and their suggested actions to resolve them.

Assignments:
TOR: The participants will be divided in four groups; one for pregnancy group
and for 0-6 months; 6-12 months and 12-23 months and each of these four
groups work with following format and enlist all the activities required as
perceived by them and what problems may be faced and how to resolve them.
They will also come up with who can be considered responsible to bring about
desired changes or can be made accountable
They should have a chair person and a reporter and should be provided with flip
charts, pen, pencil and material as requested. The chairperson will ensure active
participation from every member and will ensure healthy group dynamics
Services for Problems and Possible solutions Who would be
reducing Issues in providing or suggestions to responsible for
malnutrition and these services solve/resolve this solution?
anemia issues (Accountable)

Session VII
Presentation of Group work and discussions facilitation by staff from
Government (ICDS or Health)
Day II
Session 2.1

Recap of the day 1

This can be done either by requesting one participant who is confident and wants
to do it. Better option is to covert this in to a fun game where by rotation each
participant is asked a question from the previous day. It is necessary in this part
to skip to the next person if some participant is not able to answer and s/he
should not be made uncomfortable for not knowing. However a follow up if
required ensuring all the benefit of the learning exercise is clear to him/her.

Session 2.2

Group work

Terms of Reference for Group Work

The group would work to identify in their area, how many young children in the
age group of 6-23 will be there and how many pregnant women will be there.
They will, then work on how they would identify them and how would they
register all the beneficiaries.

They know the exact population they are covering.

STEP:
Objectives: participants will know how identify ALL PW in their area; how to
deliver a package of anemia interventions to them through AWC and special
arrangements for left-outs; and how to counsel mothers
Part I: How to identify all pregnant mothers?

Step I a: Identify Gap: Mothers

This part of the training is a self learning exercise. Participants are asked to refer
to their records and register the population served and number of pregnant
mothers registered for the service. We then request them to apply birthrate
(when not available; the thumb rule of 3% of birthrate and about 10% of
pregnancy wastage so 3.3% will be pregnancy rate). This is the number of total
pregnant women in one year who would deliver. At any given point of time
referring to only second and third trimester, about half of total women likely to be
pregnant in one year will be in second and third trimester and they need to be
registered with them at any given point of time.

Area covers 1000 population: Expected birth is 30. Expected pregnancy 33

Expected number of pregnant women in second and third trimester in any one
month will be 33/2 equivalent to 16-17 pregnant women who should be
registered. Any number shorter than this is a gap suggesting they have not been
able to reach.
Total population served= 1000 X
Total pregnancy expected= 33 X
Total pregnancy in any month in second and third trimester= 17 X(approximately)
Total registered pregnant women=Y
Gap =17 X – Y (if 17X>Y)

Concept needs to be simplified for the understanding.

Step I b: Identify Gap: Children

Number of children will be 4.5% of total population.

Population = 1000 X
Children will be 45 X
If they have registered children as Y
45X-Y = GAP if 45X >Y

Step II: How to reach out to those women and children who are not
registered?
Having identified the missing women and children, find out why are they not
registering? Specific community, specific area, caste/religion groups? How best
to reach out to them and motivate and convenience them to come forward?
Alternatively how to reach out to them for minimum package of services? What
will be the role of ASHA/Sahiya? Who else can help to reach out and provide
services and counseling? Transfer these names to ANM for possible depot
holder in out reach area that can provide IFA, deworming medicine to these left
out groups.
Step III: How to counsel the mothers for them and for their children?
Counseling does not mean sharing information. It means to be able to
understand the need of the client and provide and assist her with what she really
needs. Helping her in taking decision for action. Basic steps of counseling
include
• Greet: Mothers should be greeted and felt welcomed and made comfortable.
• Ask: Make sure you ask relevant questions in simple, short sentences that mother
understands and feels comfortable in answering
• Listen: It is very important to listen carefully what she has to say, and her
concerns. It is necessary when advice is given; it is given based on her needs and
is not generic. To do this it is important to listen to what mother has to say.
• Praise: To make her follow what advice is given, it is important she has trust in
you and in the system. This is best obtained by genuine praise for points which is
praise worthy. The fact that she is in the counseling session is bear minimum
positive point for praise. If she comes for counseling or for ANC regularly, you
can appreciate that or her diet or her weight gain
• Advise: Package for anemia control to mothers needs to be advised but keeping
what she is following already. What she follows need to be appreciated and what
she needs to be following now onwards need to be explained with reasons
• Check understanding: This is important step for effective communication. We
have advised mothers for steps and counseled but has she understood correctly?
This needs to be checked by asking appropriate questions. E.g. How many iron
tablets you will take? What part of the day will you take table iron tablets?
Questions should not be asked in leading format where answer can emerge as
“yes” or “no” as we will not be able to ensure the understanding when she says
“yes”, whether she has really understood what is being conveyed.
Session 2.3: Interventions 20 minutes

Objective of Session2.3: Participants will be able to understand and act on

what are the components of intervention for reducing child anemia and
malnutrition.

Facilitator: This is interactive and participatory sessions and monotony and

lecturing should be avoided here. Hand outs can be shared and then discussion
held.

Ask participants to say what they are doing at present for pregnant mothers for

1. IFA,
2. Deworming,
3. Extra food for pregnant mothers, (ICDS and otherwise)
4. Malaria

Ensure participations and encourage talking by everyone turn by turn without

repetition of activities. Encourage them to say everything that they do at the
clinic, during field visit and at RI sessions. Find out what messages are being
given along with above services and note down. Do not at this stage criticize.

Also then ask what are they doing to young children for reducing anemia and
malnutrition?

IFA syrup
Deworming medicine
Food advice
Prevention of malaria
ICDS services

SERVICE PACKAGE FOR ANEMIA CONTROL for Mothers:

1. Advice for one or two extra meal during pregnancy: Woman will in
normal case increase weight of about 8-12 kg during pregnancy; this goes
towards weight increase due to growing foetus; increased size of uterus,
placenta and increased amount of blood volume plus preparation for breast
feeding. Not all weight is for growing foetus; but it is important to gain minimum of
8 kg weight during pregnancy and for that extra food is required.
2. IFA Supplementation: One IFA tablet daily to be taken from 4th month of
pregnancy. It is preferable to take this tablet after food and preferably (not
necessarily) at night. This advice is to avoid likely side effects. Following
components need to be stressed:

1. How many IFA tablets to take? One a day after 4 months or pregnancy:
minimum 100 tablets.
2. When to be taken? It should be taken after food to avoid side effects and
to avoid those sensation it is better taken at night; so the woman goes to
sleep after that and would not have side effects perceived
3. Why it should be taken? We need to explain the mother that it is good
for her health and for her child’s physical and mental health. Child is likely
to be clever and would have better capacity to fight against diseases if
mother takes ALL IFA tablets during pregnancy.
4. Side Effects: Possible side effects like nausea and black color stool should
be explained to the mother with assurance that these are not serious side
effects and nausea would decline on continuation of taking tablets. Black
color stool will continue but is harmless. Any persistent side effect for long
time, doctor should be consulted.
5. The tablets should be kept away from the children to avoid accidental
consumption of tablets by the children
6. Advice to use IFA regularly also needs to be shared with the family
members who could then support the regular IFA consumption.
Particularly with husband and mother in law.
3. Deworming medicine one dose after 3 month of pregnancy:
Mothers need to be advised for one course of deworming medicine after three
months or pregnancy is over any time. The one full course of deworming
medicine dose consisting of 6 tablets of mebandazole (one tablet to be taken
twice a day for three days) needs to be provided.
4. Protection form Malaria
Mothers if develop fever, it is possible that fever is due to malaria. So she should
get herself examined for blood smear and if she has malaria, treatment should be
taken for the same. Even ASHA/Sahiya kits have medicines. To avoid getting
malaria, she should sleep under mosquito net preferably insecticide impregnated
mosquito nets.
5. Food from ICDS
If the woman is eligible to get ICDS THR, she should regularly get it and
consume it herself without sharing it with any other members.

SERVICE PACKAGE FOR MALNUTRITION CONTROL FOR CHILDREN

Children at this age of 6 months onwards are most vulnerable to malnutrition and
so package of services to prevent malnutrition is required.
1. Continue Breast Feeding
Up to 6 Months of
Mothers must continue breast feeding the child as Age
many times as possible as the child wants. Mothers
• Breastfeed as often as the
should not discontinue breast feeding during sickness. child wants, day and night,
at least 8 times in 24 hours.
2. Complementary Feeding:
• Do not give any other foods
Child needs energy much more than as a proportion to or fluids not even water
its weight as compared to adults. So besides breast Remember:
• Continue breastfeeding if
milk, after six months of age child will need extra food the
child is sick
and that should be fed to the child with active efforts by
the mother/family members. To make it rich in energy
adding ghee/oil is very useful. This is because child has small stomach and
cannot eat more. So what ever child eats need to be rich in energy.
For this reason child should get food appropriate to its requirement
 Feeding should be done to the child by
mother with active efforts to ensure
that the child consumes all the food
offered. It is going to take some extra
efforts by the mother to make sure that
child completes all food that is offered
to him. Mother must make sure that
child gets food that s/he likes. Before
feeding the child, mother must wash
hands with soap and water.
Quantity and foods are depicted in the
boxes:
6-8 months child must have three
6 Months up to 8 Months
(BF+3 half katori full semisolid food)
Breastfeed as often as the child wants.
• Give at least one katori serving* at a time :
- Mashed roti/ rice /bread/biscuit mixed in
sweetened undiluted milk OR
- Mashed roti/rice/bread mixed in thick dal with
added ghee/oil or khichri with added oil/ghee.
Add cooked vegetables also in the servings
OR
- Sevian/dalia/halwa/kheer prepared in milk or
any cereal porridge cooked in milk OR
- Mashed boiled/fried potatoes
______________________________________
*3 times per day if breastfed; 4 times if not breast fed
Remember:
• Wash your own and child’s hands with soap
and water every time before feeding
• Keep the child in your lap and feed with your
own hands/spoon
9 Months up to 11 Months
(BF+3 full katori full semisolid food)
Breastfeed as often as the child wants.
• Give at least one katori serving* at a time :
- Mashed roti/ rice /bread/biscuit mixed in
sweetened undiluted milk OR
- Mashed roti/rice/bread mixed in thick dal
with
added ghee/oil or khichri with added
oil/ghee.
Add cooked vegetables also in the
servings
OR
- Sevian/dalia/halwa/kheer prepared in milk
or
any cereal porridge cooked in milk OR
- Mashed boiled/fried potatoes
_____________________________________
_
*3 times per day if breastfed; 5 times if not
breast fed
Remember:
• Wash your own and child’s hands
with soap and water every time
katori of semisolid food at least during
the day; 9-11 months should have
energy rich food at least 3 katori full
during the day. Child above one year of
age should consume food by
himself/herself observed and promoted
by the mother/parent to ensure that
child finishes all the food given. At least
four full katori of energy rich food is
what child needs to consume.
3. Iron Syrup
Child should get one ml of IFA syrup (to be taken from bottle using dropper that
will take one ml of syrup when filled up to the top). Child should be fed first and
on full stomach only child should get one ml of IFA syrup on two days of the
12 Months up to 2 Years week (Wednesday and
(BF+4 full katori full solid food) Saturday preferably or as
suitable to mother/family).
•Breastfeed as often as the child wants.
• Offer food from the family pot One member of the family
• Give at least 11/2 katori serving* at a time of :
- Mashed roti/rice/bread mixed in thick dal with added should be responsible for
ghee/oil or khichri with added oil/ghee. Add cooked
vegetables also in the servings OR IFA syrup administration.
- Mashed roti/ rice /bread/biscuit mixed in
sweetened undiluted milk OR Over dose should be
- Sevian/dalia/halwa/kheer prepared in milk or any
cereal avoided. IFA syrup should
porridge cooked in milk OR
- Mashed boiled/fried potatoes be stored at a cool and dry
____________________________________
* 4-5 times per day. place and away from the
Remember:
• Wash your child’s hands with soap and water rich of the children.
every time before feeding
• Sit by the side of child and help him to finish the
serving

4. Deworming Medicine
Dose of deworming medicine to be given to all children after their fist birthday.
One course would mean 3 tablets (one tablet daily for 3 days) of mebendazole.
5. Protection from Fever/Malaria
Child should be protected from malaria by advising them to sleep under mosquito
net and get them selves investigated when they have fever. Surrounding to keep
clean to avoid mosquito breeding
Monitoring and support to weak performing area
Objective: Participants will know how to carry out supporting actions for
delivering services to pregnant women. From the reports available, they
will be able to assess their own performance. Over 70% coverage will be
assessed as good, 50-70% will be assessed as average and below 50%
coverage may be considered poor. This will be based on the ANC coverage
(any ANC). For child counseling for anemia and for nutrition counseling on
feeding same norms can be applied and revised based on the performance
of all workers as required.

Supply: Participants ANM (form 6) and AWW (MPR) is aware of their format.
These formats give their covered area’s actual population size. Using that
population and applying the area specific birth rate, it is possible to calculate
expected number of women who should have been registered. Applying
principles as in earlier sessions, they will be able to derive their performance
level. This level then can be discussed with Medical Officers and Facilitators and
possible reasons for their good, average and poor performance may be
discussed. From the learning of peers and guidance of the resource person,
strategy to improve for poor and average performance may be planned out.
Similar exercise can be done for IFA supply position and also for IFA distribution.
IFA supply: Target is to have at least minimum two months quota with the sub
health center and this has been possible to calculate based on the total
requirements. A formula for total requirement is based on pregnancy rate at
3.3%. So total number of IFA required for sub health center will be 3.3*total
population. Two month quota for sub health center will be 3.3/6 *total population
served. When IFA stock fall below this number, they MUST request for additional
supply and also follow up for their requirement in next block level meetings and
request MOIC who in turn should procure it from district authorities if he does not
have supply available with him. Similarly at MO PHC level at least one month
supply should be available as buffer supply when any sub health center requests.
Self Assessment Form: (Enclosed)
To further strengthen the capacity building, based on what the participants are
expected to do after they return to their service units, a self assessment form is
devised. It is important that participants understand the purpose of this form and
how to use this form. By rotation each of the participants can read question by
question this form, discuss whether questions raised here are relevant and would
help them to monitor them selves or not, taking their feed back in the process,
final self monitoring format can be evolved. This self monitoring format they
would then carry with them. Medical Officer in charge be then motivated to
supply these forms to each participants in the subsequent block meeting and
discuss the completed forms that participants will be encouraged to bring in the
block level meeting. In the block level meeting, this works as monitoring the
activities and also for identifying areas that call for special efforts to improve and
other problem solving approaches.
Day 3
Practice for Counseling:
This is important step for capacity building. Every participant will get an
opportunity to do a supervised counseling to the mother for child anemia
reduction and malnutrition control. Supervisor would observe the counseling
without any interruption and encourage the participant to complete counseling
based on the learning. After the counseling is over, supervisor would give feed
back to the participants from counseling skills point of view as well as contents
point of view. These would include principles of counseling observed as
discussed above and the package of services discussed as above. In doing so,
supervisor would also follow counseling skills steps and encourage the
participants first of the correct actions and then constructively put forward the
observations that needed to improve. (Check list enclosed)
This is the important step for capacity building and should not be rushed.
Adequate provision for timings and providing opportunity for the counseling be
important and integral part of the training.

Tools and Job Aids:

Counseling Material: For counseling simple tools in form of flip chart and poster
or tin plate are made available or will be made available soon. Till the final tools
are made available, please use that we have developed till date. For this
program 8-9 slides maximum should be used 4 for maternal anemia and 5 for
child anemia and IYCF. These may be further reduced as we finally develop.

It is necessary to have these tools with health workers. The training involves
educating and orienting participants how to use these tools. At what stage of
counseling these charts and poster need to be referred to and how best to use
them. Pictures are area specific and culture specific and messages are short and
simple in the language that community understands and in the local language to
facilitate the community members to grasp the message easily and with interest.
Self Assessment Form: It is proposed that a simple self assessment form
based on the job description of AWW/ANM be shared with participants. This form
is primarily to remind all health care providers as the check list for what task they
are to accomplish to achieve effective intervention for anemia control and
nutrition during pregnancy. If motivated to use properly and the training will cover
this part, this tool will work effectively to discuss areas and level of performance
by health care provider at the cluster/sector meetings and block level meeting.
Collected and compiled properly, this format will also work as monitoring
activities for the job functions of health workers.

Microplans

Objective: participants will develop micro plans to reach ALL women

through RI/NHD and other special outreach activities for non-AWC listed
women: (format for this I would shortly email )
Now that what is the intervention required for effectively control child anemia and
malnutrition is shared and participants are empowered with the contents for
anemia control package and methodology of how to approach and counsel the
clients, this session will be devoted to make micro plans and details of action and
time line to be able to effectively implement in future.
Medical Officers and CDPO should be resource persons and should be present
when the work plans are shared by the participants in plenary sessions and
assure the participants support as required.
Post training questionnaire can be shared here if planned and available

Training session ends by MOIC / Health / ICDS senior staff thanking

participants for work plans and assuring the support for the task.