Anaemia, a condition caused by low iron levels, affects nearly half of India’s women and adolescents, leading to fatigue, poor concentration, and even pregnancy complications. Although India’s Anaemia Mukt Bharat programme focuses on routine supplementation, many remain unreached because testing is mostly clinic-based. The STAR study set out to test whether a proactive, community-level strategy could bridge this gap more effectively.
Researchers carried out the cluster-randomised trial in 14 villages of Telangana, screening individuals aged 6 months to 50 years for anaemia. Screening sites were set up within 200 metres of people’s homes, equipped with portable auto-analysers powered by 3KVA systems. ASHA workers and local leaders mobilised residents, while haemoglobin levels were checked through pooled capillary blood samples. Those found to be anaemic received therapeutic iron-folic acid (IFA) doses, while non-anaemic participants received preventive supplements as per national guidelines.
The results were striking: anaemia prevalence dropped from 32.5% to 29.6% in intervention areas. Among adolescent girls aged 10–19 years, rates declined by 15.3%, and average haemoglobin levels rose by 0.73 g/dL. Women of reproductive age also saw meaningful improvements, with a 4.4% decline in anaemia and a haemoglobin gain of 0.39 g/dL.
However, adherence to IFA supplementation remained a challenge-just 32% of those prescribed therapeutic doses and 47.5% on preventive doses complied fully. The researchers stressed that stronger counselling, follow-up, and community engagement are needed to sustain progress.
By integrating systematic screening and treatment into national health programmes, experts believe the STAR model could help India make faster strides toward reducing anaemia, ultimately improving energy, productivity, and long-term health outcomes for millions.
REFERENCE: Pullakhandam R, Augustine LF, Banjara SK, Dasi T, Palika R, Majumder R, et al. Impact evaluation of a population-based ‘Screen and Treat for Anaemia Reduction (STAR)’ strategy: a cluster randomised trial in rural Telangana, India. BMJ Global Health. 2025;10:e020633. https://doi.org/10.1136/bmjgh-2025-020633
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