Publication:

Effectiveness of an integrated 4T intervention test, treat, talk and track in mitigating anemia among tribal communities in Telangana, India

Background Anaemia affects over 1.6 billion people worldwide, with India bearing a disproportionate burden despite five decades of national programming. Telangana’s 70% prevalence exceeds the 67.1% national average, with tribal districts like Bhadradri Kothagudem suffering from poor dietary diversity, limited healthcare access, and socioeconomic disadvantages. This study evaluated whether an integrated "4T" intervention- Test, Treat, Talk, and Track - could reduce Anaemia in this vulnerable population.

Methods A community-based longitudinal study was conducted in Laxmidevipally Mandal, Bhadradri Kothagudem, covering 1,228 households across 16 villages with a baseline population of 5,291. Haemoglobin levels were screened using the non-invasive EzeCheck device. Anaemic participants received targeted medical treatment, Behaviour Change Communication (BCC), and Nutri-kits for home kitchen gardens.

Results Following quarterly follow-ups and matched endline analysis, overall anaemia prevalence dropped significantly from 64.59% to 53.75% (p<0.001), representing a 10.84 percentage point reduction, with the largest reduction occurring among adolescent girls. Severe anaemia fell by 63% (from 9.8% to 3.6%), and mean haemoglobin levels rose from 11.0 to 11.6 g/dl. Among baseline severe cases, 24.4% recovered to normal or mild status, though 51.7% of the total cohort remained persistently anaemic. Furthermore, a notable knowledge-practice gap remained, while 96% of participants recognized green leafy vegetables as essential, only 56% had consumed them in the past 24 hours.

Conclusions The 4T model successfully yielded measurable health gains. However, high residual Anaemia and behavioural gaps underscore the need for extended, region-specific interventions, consistent Iron Folic Acid (IFA) supply chains, and sustained community communication.