Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after
Abstract Background In 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005–2014) and its yield...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Israel Journal of Health Policy Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13584-021-00510-9 |
| _version_ | 1798034608142417920 |
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| author | Joseph Meyerovitch Doron Carmi Shraga Aviner Michael Sherf Doron Comaneshter Yoseph Laks Calanit Key Uri Gabbay Arnon D. Cohen |
| author_facet | Joseph Meyerovitch Doron Carmi Shraga Aviner Michael Sherf Doron Comaneshter Yoseph Laks Calanit Key Uri Gabbay Arnon D. Cohen |
| author_sort | Joseph Meyerovitch |
| collection | DOAJ |
| description | Abstract Background In 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005–2014) and its yield 5 years after it ended (2019). Methods The CHS database was retrospectively reviewed twice yearly from 2005 to 2014 for repetitive samples of children aged 9 to 18 months regarding the previous half-year interval, and a single sample in 2019. Data were collected on gender, ethnicity (Jewish/non-Jewish), socioeconomic class (SEC; low/intermediate/high), hemoglobin testing (yes/no), and hemoglobin level (if tested). Excluded were infants with documented or suspected hemoglobinopathy. Results At study initiation, the rate of performance of hemoglobin testing was 54.7%, and the IA prevalence rate was 7.8%. The performance rate was lower in the Jewish than the non-Jewish subpopulation. The low-SEC subpopulation had a similar hemoglobin testing rate to the high-SEC subpopulation but double the IA prevalence rate. Overall, by the end of the intervention (2014), the performance rate increased to 87.5%, and the AI prevalence rate decreased to 3.4%. In 2019, there was little change in the performance rate from the end of the intervention (88%) and the IA prevalence was further reduced to 2.7%. The non-Jewish and low-SEC subpopulations showed the most improvement which was maintained and even bettered 5 years after the intervention ended. Conclusions The 10-year IA intervention program introduced by CHS in 2005 led to a reduction in IA prevalence rate to about 3.5% in all sub-populations evaluated. By program end, the results in the weaker subpopulations, which had the highest prevalence of IA at baseline, were not inferior to those in the stronger subpopulations. We recommended to the Israel Ministry of Health to adopt the intervention countrywide, and we challenge other countries to consider similar interventions. |
| first_indexed | 2024-04-11T20:45:30Z |
| format | Article |
| id | doaj.art-b7fceb03a4c14f12900d57ac78f46768 |
| institution | Directory Open Access Journal |
| issn | 2045-4015 |
| language | English |
| last_indexed | 2024-04-11T20:45:30Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Israel Journal of Health Policy Research |
| spelling | doaj.art-b7fceb03a4c14f12900d57ac78f467682022-12-22T04:04:02ZengBMCIsrael Journal of Health Policy Research2045-40152022-01-011111810.1186/s13584-021-00510-9Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years afterJoseph Meyerovitch0Doron Carmi1Shraga Aviner2Michael Sherf3Doron Comaneshter4Yoseph Laks5Calanit Key6Uri Gabbay7Arnon D. Cohen8Medicine Wing, Community Division, Clalit Health ServicesShoham Ambulatory Center, Clalit Health ServicesDepartment of Pediatrics, Faculty of Health Sciences, Barzilai University Medical CenterClalit Health ServicesClalit Health ServicesPediatric Ambulatory Center, Clalit Health ServicesNursing Medicine Wing, Community Division, Clalit Health ServicesSackler Faculty of Medicine, Tel Aviv UniversityDepartment of Pediatrics, Faculty of Health Sciences, Barzilai University Medical CenterAbstract Background In 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005–2014) and its yield 5 years after it ended (2019). Methods The CHS database was retrospectively reviewed twice yearly from 2005 to 2014 for repetitive samples of children aged 9 to 18 months regarding the previous half-year interval, and a single sample in 2019. Data were collected on gender, ethnicity (Jewish/non-Jewish), socioeconomic class (SEC; low/intermediate/high), hemoglobin testing (yes/no), and hemoglobin level (if tested). Excluded were infants with documented or suspected hemoglobinopathy. Results At study initiation, the rate of performance of hemoglobin testing was 54.7%, and the IA prevalence rate was 7.8%. The performance rate was lower in the Jewish than the non-Jewish subpopulation. The low-SEC subpopulation had a similar hemoglobin testing rate to the high-SEC subpopulation but double the IA prevalence rate. Overall, by the end of the intervention (2014), the performance rate increased to 87.5%, and the AI prevalence rate decreased to 3.4%. In 2019, there was little change in the performance rate from the end of the intervention (88%) and the IA prevalence was further reduced to 2.7%. The non-Jewish and low-SEC subpopulations showed the most improvement which was maintained and even bettered 5 years after the intervention ended. Conclusions The 10-year IA intervention program introduced by CHS in 2005 led to a reduction in IA prevalence rate to about 3.5% in all sub-populations evaluated. By program end, the results in the weaker subpopulations, which had the highest prevalence of IA at baseline, were not inferior to those in the stronger subpopulations. We recommended to the Israel Ministry of Health to adopt the intervention countrywide, and we challenge other countries to consider similar interventions.https://doi.org/10.1186/s13584-021-00510-9Infantile anemia (IA)Intervention programProcessOutcomeYield |
| spellingShingle | Joseph Meyerovitch Doron Carmi Shraga Aviner Michael Sherf Doron Comaneshter Yoseph Laks Calanit Key Uri Gabbay Arnon D. Cohen Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after Israel Journal of Health Policy Research Infantile anemia (IA) Intervention program Process Outcome Yield |
| title | Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after |
| title_full | Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after |
| title_fullStr | Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after |
| title_full_unstemmed | Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after |
| title_short | Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after |
| title_sort | reducing infantile anemia insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10 year intervention program and 5 years after |
| topic | Infantile anemia (IA) Intervention program Process Outcome Yield |
| url | https://doi.org/10.1186/s13584-021-00510-9 |
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