In the 6 tribal districts of Madhya Pradesh (Anuppur, Dindori, Mandala, Shahdol, Umaria, & Sidhi), the Sickle Cell Anemia Control Mission was started in August 2018 with funding support from the National Health Mission, Bhopal. Objectives are to sensitize the medical fraternity working in the area, to wake up the system and let them know that Sickle cell is a big problem in this area, and to build a system to comprehensively manage Sickle Cell Patients. In that, till now we have got success and identified new gaps which need to be done in the upcoming years. Following things happened due to our interventions in the previous 3.5 years:

• State-mandated Sickle cell screening & diagnosis of all pregnant women in these 6 districts through the public health system.
• Trained lab technicians in the system for the screening & diagnosis of SCD in the government system.
• Trained Specialists & Doctors in the 6 districts of the project area.
• Screening of 1,80,000+ persons including pregnant women, husbands of positives, family members of positive cases & school children. We identified 2000+ Sickle Cell Disease (SS) patients & 16000+ Sickle Cell Carriers (AS) in the 6 districts.
• Through our quality-focused community-based screening program we found that sickle cell positivity is 20%+ in the Anuppur & Dindori district.
• By seeing the load of SCD, the state developed a department of hemoglobinopathy (For Sickle Cell, Thalassemia, & Hemophilia) under state NHM.
• Madhya Pradesh state launched its own Sickle Cell Control Mission on 15th November 2021.
• We developed the standard treatment, diagnosis protocols, and Counseling booklets for patients.

Plan for next 3 years:

• Training of all Doctors in all these 6 districts. Currently I have trained 40% of them.
• Training of all Community health officers for screening of pregnant women & husbands of positive pregnant women, in the Health & Wellness Centers. 
• Refresher Training & supportive supervision of lab technicians in government health facilities.
• Management of identified Sickle Cell Patients through regular Patient Support group Meetings in 5 districts. Expansion of coverage area will be done in a gradual manner.
• Supportive Supervision of Stores of CMHO Office, CS Office, CHCs, & PHCs to ensure the continuous supply of needed drugs, reagents, equipment & consumables for SCD Screening & Management. 
• Awareness of SCD among ground health workers (ANM, ASHA, ASHA facilitators, CHOs).
• Publication of standard treatment, diagnosis protocols from National Health Mission.
• Facilitating disability certificate process to identified patients. 
• Will provide a unique patient card to all identified patients.
• Home visits of needy patients for their Counseling, drug supply to them if they are unable to visit hospitals.
• Continuing the Sickle patient helpline in 2 districts - In Anuppur for Anuppur, Shahdol, Umaria, Sidhi & in Dindori for Dindori & Mandala.
• Continuing the Patient Care Coordination of hospitalized patients in DH & CHCs by the counselors.

• Patient management through Peer support group meetings.
• We don’t leave trained staff after training, we do their supportive supervision for a longer time to ensure the implementation of trained staff.
• Door-to-Door (Village level, even in interior villages) screening of pregnant women, their husbands & family members of sickle-positive cases.
• JSS’s developed low-cost & good-quality Hb electrophoresis machine is being used for the confirmatory tests of Solubility Positive cases in the field.