Child-Owned Poultry Intervention Effects on Hemoglobin, Anemia, Concurrent Anemia and Stunting, and Morbidity Status of Young Children in Southern Ethiopia: A Cluster Randomized Controlled Community Trial

Abstract

Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6–18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28–0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24–0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21–0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low.

Ownership of small livestock species, but not aggregate livestock, is associated with an increased risk of anemia among children in Ethiopia: A propensity score matching analysis

“…Consistent with our findings, other studies (Custodio et al, 2008 ; Jankowska et al, 2012 ; Omer & Hailu, 2023 ; Osei et al, 2017 ) have also found that poultry provides a protective advantage against anemia in children. Perhaps, not all studies have showed beneficial effects, as there are also some observational and experimental studies showing a reverse association or effect (Olney et al, 2009 ).…”

“…Conversely, theoretical studies have also shown that livestock keeping may lead to infection (Cash‐Goldwasser et al, 2018 ; Raghunathan et al, 2005 ; Zerfu et al, 2022 ), and that infection and inflammation contribute to anemia (Hasyim et al, 2018 ; LaBeaud et al, 2015 ; Lambrecht et al, 2022 ). However, there is insufficient evidence to conclude whether livestock production improves, or remains unrelated to childhood anemia in LMIC settings (Lambrecht et al, 2019 ), including Ethiopia (Abdurahman & Id, 2021 ; Omer & Hailu, 2023 ; Passarelli et al, 2020 ). Furthermore, existing evidence on the relationship between livestock ownership and its health consequences is mainly based on observational studies that are short of causal‐effect association.…”