Effectiveness of community-based complementary food supplement (Yingyangbao) distribution in children aged 6-23 months in poor areas in China

Abstract

BackgroundPoor growth and micronutrient deficiency mainly attack older infants and young children. Some countries have adopted clinically effective measures to combat malnutrition, but the compliance and improvement in efficacy of intervention vehicles in national programs require evaluation.MethodsBaseline and follow-up cross-sectional surveys were conducted before and after a nutrition intervention program in 3 national poverty counties in China. Soybean-based complementary food supplements called Yingyangbao (YYB) in Chinese and training materials on child feeding were distributed to households with children aged 6–23 months for 18 months. Representative children were selected by probability proportional to size sampling methods to assess compliance of YYB and the intervention efficacy. A questionnaire was designed to collect data on basic characteristics of children, breastfeeding, 24-hour dietary intake, and consumption and appetite of YYB. Anthropometrics and hemoglobin were measured in the field, and anemia prevalence was evaluated. Venous blood was drawn from children aged 12–35 months to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children’s anemia.ResultsOf the children involved in the follow-up survey (n = 693), the P50 (P25, P75) intake of YYB was 6.7 (3.5, 7.0) sachets weekly, and 54.7% of the children liked the taste of YYB. Compared with the baseline situation (n = 823), the proportion of children fed a diverse diet and foods rich in iron or vitamin A increased (P < 0.01) in the follow-up study. The prevalence of stunting and underweight decreased (P < 0.05), the prevalence of anemia decreased from 28.0% to 19.9% (P < 0.01), and the prevalence of vitamin B12 deficiency decreased from 26.8% to 15.4% (P < 0.01). For children aged 12–23 months, those who liked YYB and consumed 6 or more sachets of YYB weekly were at lower risk for anemia (OR = 0.34, 95% CI 0.13–0.90, P < 0.05), but the risk of stunting was associated with a non-diverse diet (OR = 1.48, 95% CI 1.06–2.07, P < 0.05).ConclusionThe quality of diet and nutritional status of children aged 6–23 months are significantly improved by the intervention of YYB and nutrition education, and good compliance to YYB contributes to a low risk for anemia.Trial RegistrationChinese Clinical Trial Registry ChiCTR-OOC-16008846

Anemia prevalence, severity and associated factors among children aged 6–71 months in rural Hunan Province, China: a community-based cross-sectional study

“…The possible reason for the low anemia prevalence in this study area may be that the Chinese government has Many studies showed that Yingyangbao intervention and nutrition education could significantly improve the diet quality and nutritional status of children, and good compliance to Yingyangbao contributed to a low risk for childhood anemia [32,33]. In our study, the anemia severity was mainly mild, followed by moderate, which was in agreement with similar studies conducted in Ethiopia [34] and Haiti [35].…”

Prevalence and causes of anaemia in children aged 6–23 months in rural Qinghai, China: findings from a cross-sectional study

“…Although traditional delivery channels (mainly by village doctors) proved to be effective in our previous study, the key IYCF indicators were still low and the YYB compliance needed to be further improved47 to increase the effectiveness of the interventional programme. In addition, the sustainability of the YYB programme could also be an issue since the anaemia prevalence in Huzhu County went up from 47.8% in 2014 to 59.1% in 2018.…”

“…Nutrients supplements have been commonly accepted as effective interventions in reducing child anaemia worldwide 15 46–51. In China, a domestically produced multi-nutrient powders for infants and young children called YYB was developed, and a study conducted in Gansu Province from 2001 to 2004 to test the effectiveness of this complementary food supplement showed that the use of YYB could significantly reduce the anaemia prevalence 48…”

Anemia prevalence, severity and determinant factors among children aged 6-71 months in rural Hunan Province, China: a community-based cross-sectional study

“…The finding of this study showed that the overall anemia prevalence among children aged 6-71 months in rural Hunan Province was 9.7%, which was significantly lower than the preschool children in Yingyangbao contributed to a low risk for childhood anemia [28,29].…”