Doorstep Screening Shows Promise in Cutting Anaemia Among Girls and Women

Hyderabad: A population-wide strategy that screens people for anaemia at the community level and offers treatment can reduce anaemia more effectively than routine health services, a study by the city-based National Institute of Nutrition (NIN) has found.

The study, carried out across 14 villages in Telangana, tested a ‘screen and treat for anaemia reduction (STAR) approach that involved screening people aged 6 months to 50 years and providing iron-folic acid supplements at their doorstep based on haemoglobin levels. The findings were published in the ‘BMJ Global Health’ journal.

Under the STAR model, 6,131 participants were screened and treated, while 5,255 participants formed the control group receiving routine services under existing national programmes. The trial found that anaemia prevalence was lower in the intervention group at 29.6 per cent, compared with 32.5 per cent in the control group.

The strongest gains were seen among high-risk groups. Among adolescent girls aged 10-19 years, anaemia prevalence fell by 15.3 per cent, alongside a rise in mean haemoglobin levels by 0.73 grams per decilitre (g/dL). Among women of reproductive age, anaemia prevalence declined by 4.4 per cent.

“Under the Anaemia Mukt Bharat programme, India largely depends on prophylactic supplementation and facility-based screening, which has limited reach,” said Dr Bharati Kulkarni, director of ICMR–NIN. “A proactive, population-wide screen-and-treat approach had not been studied adequately until now.”

In intervention villages, haemoglobin testing was conducted close to homes using portable auto-analysers operated with the support of ASHA workers and community leaders. Anaemic individuals received therapeutic iron–folic acid doses, while non-anaemic participants were given preventive supplementation as per national guidelines.

Dr Raghu P., Scientist F and co-lead author, said the haemoglobin gains were most visible among adolescent girls and women. “Adjusted haemoglobin increases reached 1.03 g/dL in adolescent girls and 0.39 g/dL in reproductive-age women,” he said.

The study flagged challenges including compliance with supplementation remaining modest, at 32 per cent for therapeutic doses and 47.5 per cent for preventive doses, limiting the overall impact.

Dr Kulkarni said improving adherence through counselling and follow-up would be critical. Researchers added that integrating structured screening into existing programmes could speed up anaemia reduction and improve long-term health outcomes.