Adolescents' diets are key to breaking the intergenerational cycle of malnutrition. This study will guide policies and programs on the adequacy, acceptability, and feasibility of implementing balanced energy protein and multiple micronutrient supplementations to fill nutrient gaps in adolescent girls. Using a trial, the study will assess dietary intake and nutrient gaps, acceptability of balanced energy protein and multiple micronutrient supplementations. In addition to the trial, the study will the assess willingness to pay for the supplements and the most effective delivery platform and model to reach vulnerable adolescent girls. The most effective delivery platform and model to reach vulnerable adolescent girls cost-effectively will also be assessed through interviews with (inter)national experts, producers, and the donor community.
In low- and middle-income countries, it is estimated that each year, 21 million adolescent girls become mothers. Infants of adolescent mothers are at increased risk of delivering babies preterm, with low birth weight or length. Targeting nutrition interventions to improve adolescent girls' diet and nutrition is crucial to breaking the intergenerational cycle of poor growth and development. There is a specific need to assess how a balanced energy protein (BEP) and multiple micronutrient (MMN) supplement interventions can be tailored to adolescent girls and women of reproductive age. This study aims to assess the adequacy, acceptability, and feasibility of implementing nutritional supplementations to fill nutrient gaps in adolescent girls in resource-limited settings. A trial will specifically: 1. assess the short-term acceptability of BEP and MMN supplements 2. assess how nutrition supplements increase nutrient adequacy of diets adolescent girls in resources-limited settings; Using a qualitative component, the study explores the food agency of adolescents and the most effective delivery platform to reach vulnerable adolescent girls cost-effectively. The overall aim is to guide policies and programs on new formulations of nutritional supplements for adolescent girls in resource-limited settings.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
400
The BEP supplement used in Burkina Faso is a fortified medium-quantity lipid-based nutrient supplement called Plumpy'Doz. The product is a peanut and milk-based ready-to-use nutritional formulation produced by Nutriset. A peanut-based BEP formulation with a trademark Plumpy'Sup produced by Hilina Enriched Foods PLC will be used in Ethiopia.
The MMN formulation is based on the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP). The formulation contains 15 minerals and vitamins and is administered as a tablet.
Agence de Formation, de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté)
Bobo-Dioulasso, Burkina Faso
Addis Continental Institute of Public Health
Addis Ababa, Ethiopia
Acceptability of the supplement
Acceptability to the nutritional supplements, as measured using a 9-item scale (1 "Dislike extremely" up to 9 "Like extremely")
Time frame: Day 8 (after 7 days of consumption)
Nutritional adequacy
Mean nutrient adequacy ratio of adolescent diets, using 24 h recall
Time frame: Day 8 (after 7 days of consumption)
Willingness to pay for the supplement
Mean household head's willingness to pay values elicited through their bids
Time frame: Day 8 (after 7 days of consumption)
Reported consumption of the supplement
Percent of the recommended nutritional supplement consumed during the intervention period, self-reported
Time frame: Day 8 (average of 7-day intervention)
Substitution of food and nutrient intake
Substitution of food and nutrition intake at group level, using 24 h recall
Time frame: Day 8 (after 7 days of consumption)
Nutrient intake
Mean energy, macronutrient and micronutrient intake between the BEP and MMN group, using 24 h recall
Time frame: Day 8 (after 7 days of consumption)
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