Five-year follow-up of a food-based vitamin A intervention in Tanzania

Kidala, D; Greiner, Ted; Gebre‐Medhin, Mehari

doi:10.1017/s1368980000000495

Cited by 42 publications

(48 citation statements)

References 22 publications

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“…Such contamination has been described in other community-based studies 57,58 . We attempted to strike a balance between the control communities being sufficiently far away to prevent the spread of messages from the intervention households, yet remain comparable socio-economically and demographically 59 .…”

supporting

confidence: 73%

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

Yeudall

Gibson

Cullinan

et al. 2005

Public Health Nutr.

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Objective: To evaluate the efficacy of a community-based dietary intervention to reduce risk of micronutrient inadequacies in high-phytate maize-based Malawian diets. Design: Quasi-experimental post-test design with a non-equivalent control group. Setting: Four villages in Mangochi District, Southern Malawi. Participants: Households with children aged 3-7 years in two intervention (n ¼ 200) and two control (n ¼ 81) villages participated in a 6-month intervention employing dietary diversification, changes in food selection patterns, and modifications to food processing to reduce the phytate content of maize-based diets. Baseline comparability between the groups was confirmed via assessment of sociodemographic characteristics, anthropometry, knowledge and practices, morbidity, haemoglobin and hair zinc. After 12 months, knowledge and practices and dietary intakes were assessed by interactive 24-hour recalls, one during the food plenty and a second during the food shortage season. Nutrient adequacy for the two groups was compared via dietary quality indicators and predicted prevalence of inadequate intakes using the probability approach. Results: Intervention children had diets that were significantly more diverse and of a higher quality than those of controls. Median daily intakes of protein, calcium, zinc (total and available), haem iron, vitamin B 12 and animal foods (grams; % of total energy) were higher (P , 0.05) whereas phytate intakes, phytate/zinc and phytate/iron molar ratios were lower (P , 0.01) in the intervention group; some spread of knowledge and practices to controls occurred. Conclusions: Our community-based dietary strategies reduced the predicted prevalence of inadequate intakes of protein, calcium, zinc and vitamin B 12 , but not iron, in children from Malawian households with very limited resources.

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supporting

confidence: 73%

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

Yeudall

Gibson

Cullinan

et al. 2005

Public Health Nutr.

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“…This increase was more pronounced for iron than for vitamin A, indicating that even at baseline, there was greater awareness of vitamin A as compared to iron. Eventually, this could be attributed to previous programmes and studies focused on vitamin A [6,21,32,34].…”

Section: Discussionmentioning

confidence: 99%

Effect of nutrition education on the knowledge scores of urban households with home gardens in Morogoro, Tanzania

2016

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Background: Home gardens are an old agricultural practice playing a key role in household food security and diversity. Proximity of gardens to the home facilitates easy access to food and reduces household expenditure. Home gardens combined with nutrition education could improve household diets both quantitatively and qualitatively. The objective of this study was to assess the effect of a nutrition education intervention on families with home gardens in Morogoro, Tanzania. Methods:Two cross-sectional nutrition surveys were conducted at different time points, the baseline in OctoberNovember 2013 and endline in May-June 2014. Between the surveys, an intervention consisting of three interactive nutrition education sessions was conducted in December 2013. The study targeted forty households owning home gardens in urban areas of Morogoro municipality. Mixed methods were used to collect data, including semi-structured questionnaires for quantitative data and focus group discussions for qualitative data. Results:The estimated marginal means showed small statistically non-significant improvements in knowledge scores for vitamin A (p = 0.145, partial η 2 = 0.065) and iron (p = 0.403, partial η 2 = 0.022). There were more positive scores observed for both nutrients at endline compared with baseline. Composite knowledge scores calculated for participants showed improvements in the category with scores between 3 and 6 points, for both nutrients. Conclusion:While a statistically significant improvement in knowledge scores was not observed, an increase in number of positive scores and composite knowledge scores indicate an improvement in nutrition knowledge among participants. These results show that families having home gardens and who are provided with nutrition education can improve the quality of their household diets. Nutrition education in combination with other agricultural interventions could be a potential tool to improve nutritional status and should be integrated into public health programmes and strategies.

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“…Unlike supplementation, there is evidence that they continue to function, at least partially, even once external funding has been withdrawn (Hussain and Kvåle 1996), (Kidala, Greiner, and Gebre-Medhin 2000), (Faber et al 2011). From the perspective of the host nation and particularly to communities and families that benefit from them, the net money costs of food-based approaches may be small or even negative in the sense that people can earn money by selling part of their harvest.…”

Section: Designing Food-based Approachesmentioning

confidence: 99%

“…First, there are many different types with unequal emphasis on the various components (Faber et al 2001); (Kidala, Greiner, and Gebre-Medhin 2000); (Greiner and Mitra 1995). Since a large range of beneficial outcomes can accrue from implementing such programs, a wide range have also been studied, making them nearly impossible to compare.…”

Section: The Impact Of Food-based Interventionsmentioning

confidence: 99%

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Combatting Vitamin A deficiency

Greiner

2017

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Food-based approaches to combat vitamin A deficiency (VAD) continue to be largely ignored by governments and donor agencies. This review deals with common misperceptions as well as constraints that may lay behind this reality. First, highdose vitamin A capsules provided to preschool age children are no solution for VAD. Second, researchers may assume that it is not possible to standardize foods adequately to study their efficacy in controlled trials. This review summarizes the results of 57 such trials, providing an overview that may assist researchers in making decisions on target groups to study, types of food supplements to provide, quantities, supplementation periods, impacts that are realistic to expect, and sample sizes. Even more complex is to design efficacy trials or impact evaluations of interventions. Again, the paper reviews 40 such trials, providing summary information on approaches, target groups, sample sizes, periods of intervention, and impacts measured using a variety of indicators. There are a number of barriers or constraints that must be planned for and overcome World Nutrition 2017;8(2) 151if food-based approaches are to work. This paper reviews several of the most important ones, briefly touching on many of the most effective ways that have been found to overcome them. Food-based approaches can reach all members of the community, are safe for pregnant women, tend to be at least partially sustainable, and confer a wide range of nutritional and other benefits in addition to improving vitamin A status. Food-based approaches are sometimes described as expensive, but this is based on a narrow view. For example, biofortification and dissemination of sweet potatoes cost $9 to $30 per disability-life-year (DALY) gained, while that from VAS was estimated at the estimated cost effectiveness of VAS is $73per DALY gained. From the community point of view, the economic benefits of food based approaches are likely to subsidize or outweigh their costs.

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Five-year follow-up of a food-based vitamin A intervention in Tanzania

Cited by 42 publications

References 22 publications

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

Effect of nutrition education on the knowledge scores of urban households with home gardens in Morogoro, Tanzania

Combatting Vitamin A deficiency

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