Counselling Cards : Help Pregnant Women Understand Anaemia

State and Development Partner

Madhya Pradesh

Centre for Social and Behaviour Change, Ashoka University, Clinton Health Access Initiative

Problem

Anaemia affects 53% women in the age group of 15-49 in India as per the NFHS-4 (2015- 16). Even though IFA consumption can alleviate the problem, adherence among pregnant women is low. This is because the messaging on IFA pills is not streamlined and women often receive different information from different sources on the pills' side- effects. This lack of consistency in messapinp affects uptake as the fears around side effects are not being adequately alleviated by FLWs.

Conventional Solution

Door-to-door counselling by FLWs has not proven effective as the dangers of anaemia are not clear to women. Handing pills to women and checking compliance only in monthly meetings has not worked as women get discouraged from taking the pills when they experience side effects. FLWs strupple to convince women that the temporary discomfort of side effects outweighs the lonp-term benefits of takinp the pill regularly.

Behavioural Insights Based Solution

The counselling card was designed as an aid for FLWs who are responsible for counselling pregnant women to take IFA supplementation. The counselling card aided FLWs in explaining the importance of taking the IFA pill as well as ways to cope with the side effects for lonp-term benefits. The visuals in the card not only made the point more salient for the women but made it easier for them to correctly recall the proposed strategy to cope with the side effects. The counselling card also shows the food equivalent of IFA pills which increases value perception amonp women. Earlier, FLWs would not mention the side effects as they did not want to scare women but this lack of information was one of the causes of lack of adherence. The counselling card made side effects easy to understand resulting in increased compliance to taking the pills. The card also mentions the time to take the pills, i.e. before sleeping, makinp habit formation and remembering to take the pill easy. It is also a great aid for the FLW as it explains difficult concepts to rural women more vividly and hence makes it more memorable and actionable.

Impact

The counselling card shows how visual aid ensures that the message has increased retention, which is required to improve adherence.

"I had stopped taking the iron pills but after speaking with the health worker who showed me the card, I started them . I would get dizzy bu that stopped. My delivery went very smoothly and i delivered a healthy baby." Rammurthy, resident of Papriyaghat Village, Madhya Pradesh

Source : Stories of Change from India's Aspirational districts - NITI Aayog publication