I also met community health workers in Purandhar Taluka, Pune district (Maharashtra) who were trained by the Foundation for Research in Community Health (FRCH): Pushpa, Kalpana, and Rajashree are all remarkable women, but Rajashree stood out for the epidemiological research she'd done.
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| Rajashree Tai (center, reading) at a meeting in Mandhar Hamlet |
Rajashree is an Arogya Tai in Mandhar hamlet (served by the Parinche Primary Health Center [PHC]). Many women in her hamlet used to report feeling tired and not having a healthy appetite. Suspecting anemia, Rajashree got the PHC to check the Hemoglobin level in about 50 women from her hamlet. Mandhar is a small hamlet in a mountainous region south of Pune, where people are dependent on rains for agriculture. She compared the Hemoglobin of women here to that of women from Khengrewadi, a village with access to year-round irrigation for agriculture.
Rajashree Tai found that the prevalence of anemia in Khengrewadi was far less than that in Mandhar, where 84% of the women tested were anemic. She referred people who were severely anemic to the PHC and got them Iron Folic Acid tablets-the PHC initially denied these tablets to anemic women saying they were only meant for pregnant women. However, Rajashree managed to lobby the PHC officials to provide IFA tablets to anemic women. She also counseled others in the village to eat leafy vegetables and use iron vessels to cook food in. She was able to reduce the prevalence of anemia by 50% in her village.
Rajashree had categorized her data, allowing her to make a fairly detailed comparison of Mandhar and Khengrewadi. For instance, there were a fair number of women with Hemoglobin levels between 6.1 and 7, 7.1 and 8, 8.1 and 9 in Mandhar, but none in these categories in Khengrewadi (everyone tested in Khengrewadi had a Hemoglobin level >9.0). I'm not going to reproduce all her data here, but they showed that the odds of a woman having anemia (with Hemoglobin <9.0) in Mandhar are about 50 times that in Khengrewadi.
It is interesting that in neither village did anyone tested have a hemoglobin level >12.0, which would be normal for adult women. There could be at least two reasons for this: 1. it could have something to do with the accuracy of the test in Parinche, or 2. it could be that people in this area have a depressed level of hemoglobin in general. If the second case is true, people with a healthy diet still have a Hemoglobin level <12.0. I wonder if this might warrant a rethink about the normal range of Hemoglobin for adult women in this area based on their diet?
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