2021 Seed Grant Award Problem Statements 

Health and Wellbeing

Problem #2: Anemia affects a large proportion of the population in Myanmar, but reducing anemia rates effectively remains difficult without understanding the actual causes of anemia in country.

Country/Region of execution:  Myanmar
Collaborating Organization: World Concern Development Organization
World Concern, an international relief and development agency founded in 1955, focuses on the needs of the poorest and most vulnerable within society, providing capacity-building for partners, while having the flexibility to respond to disasters through relief and rehabilitation assistance. Currently World Concern is implementing roughly $30 million in programming in its 10 country offices located throughout Africa, Asia, and the Americas. Since 1991, WCDO has received, implemented and administered grants in excess of $59 million from USAID. WCDO headquarters is based in Seattle, WA, and the Myanmar country office is located in Yangon.
Problem Statement Description:  One of the key targets of SDG 2 (Zero Hunger) is Target 2.2: “By 2030, end all forms of malnutrition …”. In Myanmar, the proportion of people affected by anemia is larger than any other form of malnutrition. In Myanmar, anemia affects 35.6% of children under five, 29.8% of adolescent girls, 40% of pregnant women, and 35.4% of lactating women (The Myanmar National Micronutrient Survey, 2019) . The consequences of anemia during pregnancy, include increased risks of low birthweight, preterm birth, perinatal mortality, and neonatal mortality (Maternal anemia and risk of mortality: a call for action, March 2018, The Lancet), while it also places the mother at increased risk of death during and after childbirth. Anemia in children negatively impacts their cognitive and physical development, and reduces physical stamina and productivity in both adults and children.
Bottleneck: In line with global and national nutrition indicators, our organization included reduction of anemia in our nutrition programs. The bottleneck however is that an assessment on the causes of anemia in Myanmar is not available. As anemia can have a variety of causes, which can differ by location, it is difficult to effectively reduce anemia. Anemia interventions should include comprehensive strategies to address the locally identified causes to be most effective.
Key Constraints: Some key constraints to conduct such a survey include the costs and technical know-how to measure the wide variety of causes. Anemia can be caused by excessive red blood cell loss due to loss of blood (post-partum hemorrhage, menstrual loss, injury etc.) or due to increased destruction of red blood cells (due to helminths, malaria, or genetic conditions). Or, it may be caused by inadequate red blood cell production due to inadequate intake or absorption of micronutrients, or due to inflammation from chronic disease, infection or malaria.
Thus far, the main strategies to control anemia in Myanmar included iron supplementation, deworming and nutrition education. A nation-wide micronutrient survey was conducted in 2019 which measured the prevalence of anemia but did not look into causes of anemia. Discussions with the State Health Department of Kachin State showed their keen interest on supporting a study and/or program on anemia. Technical support to refine and review the anemia assessment design is requested, in particular to assess the variety of causes as well as to enable comparison of different groups (e.g. adolescent girls, women of reproductive age).