Impact of market-based home fortification with micronutrient powder on childhood anemia in Bangladesh: a modified stepped wedge design

Anemia poses a significant public health problem, affecting 1.6 billion people and contributing to the loss of 68.4 million disability-adjusted life years. We assessed the impact of a market-based home fortification program with micronutrient powder (MNP) called Pushtikona-5 implemented by Banglades...

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Published in:Frontiers in nutrition (Lausanne) 2023, Vol.10, p.1271931-1271931
Main Authors: Sarma, Haribondhu, Rahman, Mahfuzur, Tariqujjaman, Md, Islam, Mohammad Ashraful, Mbuya, Mduduzi N N, Aaron, Grant J, Askari, Sufia, Harbour, Catherine, Khondker, Rudaba, Bipul, Moniruzzaman, Sultana, Sabiha, Rahman, Mohammad Ashikur, Shahin, Shaima Arzuman, Chowdhury, Morseda, Afsana, Kaosar, Ghosh, Samik, Banwell, Cathy, D'Este, Catherine, Salasibew, Mihretab, Neufeld, Lynnette M, Ahmed, Tahmeed
Format: Article
Language:English
Subjects:
anemia
Bangladesh
children
home fortification
market-based program
micronutrient powder
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Summary:Anemia poses a significant public health problem, affecting 1.6 billion people and contributing to the loss of 68.4 million disability-adjusted life years. We assessed the impact of a market-based home fortification program with micronutrient powder (MNP) called Pushtikona-5 implemented by Bangladesh Rural Advancement Committee (BRAC) on the prevalence of anemia among children aged 6-59 months in Bangladesh. We used a modified stepped wedged design and conducted three baseline, two midline, and three endline surveys to evaluate the Pushtikona-5 program implemented through three BRAC program platforms. We interviewed children's caregivers, and collected finger-prick blood samples from children to measure hemoglobin concentration. We also collected data on coverage of Pushtikona-5 and infant and young child feeding (IYCF) practices. We performed bivariate and multivariable analysis and calculated adjusted risk ratios (ARRs) to assess the effect of program outcomes. A total of 16,936 households were surveyed. The prevalence of anemia was 46.6% at baseline, dropping to 32.1% at midline and 31.2% at endline. These represented adjusted relative reductions of 34% at midline (RR 0.66, 95%CI 0.62 to 0.71, value of
ISSN:2296-861X
2296-861X
DOI:10.3389/fnut.2023.1271931