The purpose of this study is 1) to evaluate the effectiveness in reducing anemia among children 6-24 months of age by providing daily micronutrient Sprinkles through the Government of Pakistan's Lady Health Worker program; 2) to assist in the monitoring the National Sprinkles Pilot Project.
According to the recent National Nutrition Survey in Pakistan (2001-2002), approximately 66.5% of children under five have anaemia. Looking at the magnitude of the problem, National Program for Family Planning (FP) and Primary Health Care (PHC) (also known as the Lady Health Workers (LHW) Program) has developed National Sprinkles Pilot Project Proposal with technical assistance of Micronutrient Initiative and Aga Khan University (AKU). As the projects technical partner, AKU is responsible to conduct the monitoring and evaluation of the project. The study will use a cluster randomized pre-post intervention design that compares before and after hemoglobin (Hb) measurements, serum ferritin, serum retinol and urinary iodine among children who received Sprinkles and age-appropriate feeding advice (Sprinkles-Advice group) and children who only receive age-appropriate feeding advice (Advice-only group). Age-appropriate feeding advice is part of the standard nutrition messages given by all Lady Health Workers (LHWs) during their community visits. However, intervention LHWs, will give additional advice regarding the benefits of Sprinkles and its appropriate use. The target population selected for the study consisted of children between the ages of six and eighteen months of age in the catchment area of the Lady Health Workers.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
610
Sprinkles is a multiple micronutrient fortificant. It is packed as a single serving sachets each containing micro encapsulated iron (12.5 mg), zinc (7.5 mg), vitamin C (30 mg), vitamin A (300 µg), vitamin D (5 µg), folic acid (150 µg) and iodine (90µg). Two month supply of the Sprinkle sachet along with advice on its benefits as well as its appropriate use will be given by the LHWs. The LHWs will also provide their age-appropriate nutritional advice as per their regular door to door community services.
Nutrition education will be provided by LHWs as per their regular routine monthly door to door community services
AKU-Peds Naushero Feroze Site Office
Naushero Feroze, Sindh, Pakistan
Number of Participants With Anemia
number with mild to severe anemia (hemoglobin(Hb)\<11g/dL)
Time frame: Baseline hemoglobin (Hb) taken at time of enrollment; Endline Hb taken 4-5 months post enrollment
Number of Participants With Moderate to Severe Anemia
number of participants with moderate - severe anemia defined as Hb \< 10g/dL
Time frame: Baseline Hb taken at time of enrollment; Endline Hb taken 4-5 months post enrollment
Mean Hemoglobin of Participants Post Intervention
Time frame: Endline Hb taken 4-5 months post enrollment
Vitamin A Status of Participants - Post Intervention
Categorized as \<20ug/dL; 20-40 ug/dL; \>40 ug/dl
Time frame: Measurement taken 4-5 months post enrollment
Mean Vitamin A Serum Retinol (ug]dl) Taken Post Intervention
Time frame: Measurement taken 4-5 months post enrollment
Percentage of Underweight Participants
Underweight defined as Weight for Age Z score \< -2 standard deviation (SD)
Time frame: Baseline measurements taken at time of enrollment; Endline measurements taken 4-5 months post enrollment
Percentage of Participants With Stunted Growth
Stunted defined as Height for Age Z-score \< -2 standard deviation
Time frame: Baseline measurements taken at time of enrollment; Endline measurments taken 4-5 months post enrollment
Percentage of Participants With Wasted Growth
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Wasted defined as Weight for Height Z-score \< -2SD
Time frame: Baseline measurements taken at time of enrollment; Endline measurements taken 4-5 months post enrollment