Breaking barriers and building health among rural adolescent girls through implementation of a sustainable multi-component intervention in an aspirational district of Karnataka, India

This study evaluated the sustainability and impact of a multi-component intervention on the nutritional status and service utilization of rural adolescent girls (10–19 years) in Raichur, Karnataka, using a community anchored, prospective pre and-post interventional design based on two independent cross-sectional surveys. The intervention included household visits, community activities, and mobile engagement focusing on Iron-Folic Acid supplementation, deworming, hygiene, and nutrition education. A total of 246 and 259 adolescents were enrolled during the pre- and post-intervention assessments, respectively. Among 10–14 years girls, significant increases occurred in food supplementation (44.79–62.35%), health check-ups (28.13–66.27%), IFA receipt (38.61–83.44%), and reduced anaemia (57.14–42.65%). However, stunting and thinness increased from 8.91 to 44.22% and 23.76 to 27.89%, respectively limiting interpretation of the intervention’s overall success. Among 15–19 years girls, Anganwadi utilization and IFA consumption (≥ 52 tablets) declined from 63.45 to 17.59% and 62.32 to 30.23%, respectively. The overall findings of the study indicate differential responses across age groups, highlighting the need for age-specific and out-of-school outreach strategies in resource-limited settings.