Interventions for Dietary iron deficiency

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Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Advice to mothers on ensuring breastfeeding including early initiation, exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and young child nutrition including micronutrient dietary diversification and dietary modification Community engagement on Infant and Young Child Nutrition IYCN * Counselling on micronutrient supplementation -Vit. A Supplementation, antihelminth * Counselling on when to seek medical help at facility level. * Counselling on feeding the sick child Promote exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and nutrition including micronutrient dietary diversification and dietary modification	Vitamin A Supplementation Deworming * Indoor residual spraying * Healthy nutrition for infant and young children Timely and appropriate complementary feeding especially dietary diversification and frequency of feeding children 6-59 months. Community based MUAC and bilateral edema screening for early identification * Mothers Support Groups (MSGs) to prepare local micronutrient rich diversified complementary foods Iron-fortified cereals or bread Foods rich in iron Breast feeding Timely and appropriate complementary feeding especially dietary diversification and frequency of feeding Deworming * Integrated vector control measures (use of bed nets and indoor residual spraying) Mothers Support Groups (MSGs) to prepare local micronutrient rich diversified complementary foods	Recognition of dietary iron deficiency signs and symptoms	Early identification of anaemia symptoms and referral for diagnostic work up Treatment with anti-helminths Treatment with anti-malaria for symptomatic children * Follow Up of patients in community Ensure compliance of feeding and or drug uptake
Primary Care
Advice to mothers on ensuring breastfeeding including early initiation, exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and young child nutrition including micronutrient dietary diversification and dietary modification	• Routine prenatal supplementation of iron and folate • Multiple Micronutrient Supplements • Deworming • Perennial malaria chemoprevention (PMC) • Early detection and treatment of malaria	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Oral iron sulphate tablets Immediate transfer of severe anaemia to a higher-level health care facility
Referral Facility: General
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Treat underlying cause Oral iron sulphate Blood transfusion for severe anaemia
Referral Facility: Specialist
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Serum ferritin level Bone marrow	Treat underlying cause Oral iron sulphate Parenteral iron Blood transfusion for severe anaemia

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Promote appropriate and timely complementary feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Timely and appropriate complementary feeding especially dietary diversification and frequency of feeding Deworming * Integrated vector control measures (use of bed nets and indoor residual spraying) * Mothers Support Groups (MSGs) to prepare local micronutrient rich diversified complementary foods	Recognition of dietary iron deficiency signs and symptoms	Treatment with anti-helminths Treatment with anti-malaria Immediate transfer of severe symptoms to a higher-level health care facility
Primary Care
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Multiple Micronutrient Supplements Deworming * Perennial malaria chemoprevention (PMC) Early detection and treatment of malaria	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Daily iron suplate II supplementation +malaria chemoprophylaxis - Deltaprim Oral iron sulphate tablets Immediate transfer of severe anaemia to a higher-level health care facility
Referral Facility: General
Advice to parents on ensuring breastfeeding including early initiation, exclusive breastfeeding Counselling on appropriate and timely complementary feeding and healthy infant and young child nutrition including micronutrient dietary diversification and dietary modification Counselling on good hygiene practices including hand hygiene Community based MUAC and bilateral edema screening for early identification * Community engagement on Infant and Young Child Nutrition IYCN * Education on use of safe water and good compound practices * Counselling on when to seek medical help at facility level. * Promotion of food safety, appropriate and safe sanitation facilities, safely managed drinking source, water treatment, safe clean play areas * Promote safe blood donation Build capacity of CHWS * Counselling on feeding the sick child	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Treat underlying cause Oral iron sulphate Blood transfusion for severe anaemia
Referral Facility: Specialist
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Serum ferritin level Bone marrow	Treat underlying cause Oral iron sulphate Parenteral iron Blood transfusion for severe anaemia

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Promote balanced diet including micronutrient dietary diversification, dietary modification and fortification of staple foods with bioavailable iron	Deworming * Integrated vector control measures (use of bed nets and indoor residual spraying)	Recognition of dietary iron deficiency signs and symptoms	Treatment with anti-helminths Treatment with anti-malaria Immediate transfer of severe symptoms to a higher-level health care facility
Primary Care
Nutrition education to promote balanced diet including micronutrient dietary diversification and dietary modification	Supplementation of iron and folate	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT Secondary level	Oral iron sulphate tablets Immediate transfer of severe anaemia to a higher-level health care facility
Referral Facility: General
	Routine prenatal supplementation iron and folate plus daily food supplements. * Deworming * IPTp for the prevention of malaria	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Treat underlying cause Oral iron sulphate Blood transfusion for severe anaemia
Referral Facility: Specialist
Nutrition education to promote balanced diet including micronutrient dietary diversification and dietary modification	Supplementation of iron and folate	History Physical examination Haemoglobin Haematocrit Complete blood count Serum ferritin level Bone marrow	Treat underlying cause Oral iron sulphate Parenteral iron Blood transfusion for severe anaemia

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Promote appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Deworming Integrated vector control measures (use of bed nets and indoor residual spraying) Seasonal malaria chemoprevention (SMC)	Recognition signs and symptoms of dietary iron deficiency	Treatment with anti-helminths Treatment with anti-malaria Immediate transfer of severe symptoms to a higher-level health care facility
Primary Care
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Deworming * Seasonal malaria chemoprevention (SMC) Early detection and treatment of malaria	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Oral iron sulphate tablets Immediate transfer of severe anaemia to a higher-level health care facility
Referral Facility: General
Nutrition education to promote balanced diet including micronutrient dietary diversification and dietary modification	Supplementation of iron and folate	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Treat underlying cause Oral iron sulphate Blood transfusion for severe anaemia
Referral Facility: Specialist
Nutrition education to promote balanced diet including micronutrient dietary diversification and dietary modification	Supplementation of iron and folate	History Physical examination Haemoglobin Haematocrit Complete blood count Serum ferritin level Bone marrow	Treat underlying cause Oral iron sulphate Parenteral iron Blood transfusion for severe anaemia