Ferric Carboxy Maltose Utilization

Problem Statement

Despite impressive socio-economic growth, anaemia is still a major public health concern in Gujarat. Maternal mortality and morbidity due to anaemia in pregnant women continues to be cause for concern.

Programme Description

According to National Family Health Survey IV, 51.3 percent pregnant women suffered from Hb less than 11 gm/dl, while severe anaemia prevalence was 1.5 percent. Hence, specific interventions aimed at reducing maternal mortality due to anaemia but also improve pregnancy outcomes was necessary.

Challenges faced

Lack of evidence-based research studies/guidelines for large-scale implementation of injection Ferric Carboxymaltose (FCM) in pregnancies:

• Scarcity of documented practices on effective use of FCM for pregnant women in public health systems.

Process followed

The pilot project for FCM was started in Vadodara Corporation in 2017-18, and was subsequently rolled-out in districts like. Sabarkantha, Dahod, Mahisagar, Vadodara, Vadodara Corporation etc. after training of Medical Officers by Dr Vinit Mishra and the IKDRC team. FCM was also added in EDL to ensure accessibility of the medicine to treat severe iron deficiency in pregnant women in public health care institutions.

The targeted population: 13.5 lakh pregnant women, 12.3 lakh women in labour and 12 lakh infants are directly affected by the intervention. It will also lead to achieving one of the three Goals of Universal Health Coverage of Quality of Care.

The innovative aspects of the project

Capacity building, monitoring guidelines and inter-personal communication trainings of Medical Officers to encourage utilization of FCM.

Inclusion of injection FCM in Essential Drug List of the state Health department.

Scalability

A significant improvement in haemoglobin levels over a period of three weeks: from mean haemoglobin of 9.07±1.15 to 11.17±2.34.

Effective large-scale use of injection FCM in the state led to incorporation of injection FCM in Government of India guidelines for Anaemia Mukta Bharat and Intensified National Iron Plus Initiative.

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019