Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children

An integrated agriculture and nutrition program, the Enhanced Homestead Food Production (EHFP) program, implemented by Helen Keller International (HKI) in Burkina Faso from 2010–2012 significantly reduced anemia among young children. Although these results were promising, it was hypothesized that gr...

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Main Authors: Olney, Deanna K., Bliznashka, Lilia, Becquey, Elodie, Birba, Ousmane, Ruel, Marie T.
Format: Abstract
Language:Inglés
Published: Wiley 2017
Subjects:
Online Access:https://hdl.handle.net/10568/146240
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author Olney, Deanna K.
Bliznashka, Lilia
Becquey, Elodie
Birba, Ousmane
Ruel, Marie T.
author_browse Becquey, Elodie
Birba, Ousmane
Bliznashka, Lilia
Olney, Deanna K.
Ruel, Marie T.
author_facet Olney, Deanna K.
Bliznashka, Lilia
Becquey, Elodie
Birba, Ousmane
Ruel, Marie T.
author_sort Olney, Deanna K.
collection Repository of Agricultural Research Outputs (CGSpace)
description An integrated agriculture and nutrition program, the Enhanced Homestead Food Production (EHFP) program, implemented by Helen Keller International (HKI) in Burkina Faso from 2010–2012 significantly reduced anemia among young children. Although these results were promising, it was hypothesized that greater nutritional impacts could be achieved with longer program exposure, the addition of a water, sanitation and hygiene (WASH) intervention, and an intervention to address micronutrient gaps such as providing children 6–23.9 mo of age with a daily lipid-based nutrient supplement (LNS). To test these hypotheses we used a cluster randomized trial whereby the control and intervention villages from the 2010–12 EHFP evaluation were separately randomized to one of two groups for a total of four intervention groups (15 clusters each), all of which received HKI's base EHFP program. The 2010–12 control villages were randomized to receive the EHFP program for the first time from 2014–16, either alone (EHFP-2014) or with a WASH intervention (EHFP-2014+WASH) and the intervention villages that received the 2010–12 EHFP program were randomized to receive the EHFP program, for the second time at the community level, with WASH (EHFP-2010+WASH) or with WASH and LNS (EHFP-2010+WASH+LNS). Mothers with children 0–12 mo of age at baseline in 2014 were invited to participate in the 2 y program and associated evaluation. These groups helped answer the following 3 questions: 1) added benefit of prior community-level exposure to the EHFP program (EHFP-2010+WASH (n=353) compared to EHFP-2014+WASH (n=442)); 2) added benefit of WASH (EHFP-2014+WASH (n=442) compared to EHFP-2014 (n=402)); and 3) added benefit of providing LNS (EHFP-2010+WASH+LNS (n=356) compared to EHFP-2010+WASH (n=353)). Impacts on anemia, iron deficiency anemia (IDA) and vitamin A deficiency (VAD) among children aged 3–12 mo at baseline (in 2014) were assessed using difference-in-difference (DID) impact estimates that controlled for relevant covariates and adjusted standard errors for clustering. Anemia (−15 pp) and IDA (−17 pp) decreased and VAD increased (+12 pp) over the 2 y in the EHFP-2014 group. We found no additional benefit of prior exposure to the program on any of these outcomes. Adding WASH led to a significantly greater reduction in anemia compared to EHFP alone (DID=−11 pp; p<0.05)), but no impacts on IDA or VAD. Adding LNS to EHFP-2010+WASH led to significantly greater decreases in anemia (DID=−12 pp; p<0.05), IDA (DID=−13 pp; p<0.05) and a marginally significantly greater decrease in VAD (DID=−8 pp; p<0.10). The two EHFP programs implemented by HKI in Burkina Faso (2010–12; 2014–16) reduced anemia among young children. Adding WASH to the program in 2014 led to a significantly greater reduction in anemia, and including both WASH and LNS in communities with prior EHFP program exposure led to the largest and most diverse nutritional impacts including significant reductions in anemia, IDA and VAD. These results highlight the importance of addressing the multiple causes of undernutrition simultaneously, through multisectoral programs.
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spelling CGSpace1462402025-12-11T07:49:20Z Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children Olney, Deanna K. Bliznashka, Lilia Becquey, Elodie Birba, Ousmane Ruel, Marie T. anaemia water management human nutrition An integrated agriculture and nutrition program, the Enhanced Homestead Food Production (EHFP) program, implemented by Helen Keller International (HKI) in Burkina Faso from 2010–2012 significantly reduced anemia among young children. Although these results were promising, it was hypothesized that greater nutritional impacts could be achieved with longer program exposure, the addition of a water, sanitation and hygiene (WASH) intervention, and an intervention to address micronutrient gaps such as providing children 6–23.9 mo of age with a daily lipid-based nutrient supplement (LNS). To test these hypotheses we used a cluster randomized trial whereby the control and intervention villages from the 2010–12 EHFP evaluation were separately randomized to one of two groups for a total of four intervention groups (15 clusters each), all of which received HKI's base EHFP program. The 2010–12 control villages were randomized to receive the EHFP program for the first time from 2014–16, either alone (EHFP-2014) or with a WASH intervention (EHFP-2014+WASH) and the intervention villages that received the 2010–12 EHFP program were randomized to receive the EHFP program, for the second time at the community level, with WASH (EHFP-2010+WASH) or with WASH and LNS (EHFP-2010+WASH+LNS). Mothers with children 0–12 mo of age at baseline in 2014 were invited to participate in the 2 y program and associated evaluation. These groups helped answer the following 3 questions: 1) added benefit of prior community-level exposure to the EHFP program (EHFP-2010+WASH (n=353) compared to EHFP-2014+WASH (n=442)); 2) added benefit of WASH (EHFP-2014+WASH (n=442) compared to EHFP-2014 (n=402)); and 3) added benefit of providing LNS (EHFP-2010+WASH+LNS (n=356) compared to EHFP-2010+WASH (n=353)). Impacts on anemia, iron deficiency anemia (IDA) and vitamin A deficiency (VAD) among children aged 3–12 mo at baseline (in 2014) were assessed using difference-in-difference (DID) impact estimates that controlled for relevant covariates and adjusted standard errors for clustering. Anemia (−15 pp) and IDA (−17 pp) decreased and VAD increased (+12 pp) over the 2 y in the EHFP-2014 group. We found no additional benefit of prior exposure to the program on any of these outcomes. Adding WASH led to a significantly greater reduction in anemia compared to EHFP alone (DID=−11 pp; p<0.05)), but no impacts on IDA or VAD. Adding LNS to EHFP-2010+WASH led to significantly greater decreases in anemia (DID=−12 pp; p<0.05), IDA (DID=−13 pp; p<0.05) and a marginally significantly greater decrease in VAD (DID=−8 pp; p<0.10). The two EHFP programs implemented by HKI in Burkina Faso (2010–12; 2014–16) reduced anemia among young children. Adding WASH to the program in 2014 led to a significantly greater reduction in anemia, and including both WASH and LNS in communities with prior EHFP program exposure led to the largest and most diverse nutritional impacts including significant reductions in anemia, IDA and VAD. These results highlight the importance of addressing the multiple causes of undernutrition simultaneously, through multisectoral programs. 2017 2024-06-21T09:06:18Z 2024-06-21T09:06:18Z Abstract https://hdl.handle.net/10568/146240 en Wiley Olney, Deanna Kelly; Bliznashka, Lilia; Becquey, Elodie; Birba, Ousmane; and Ruel, Marie T. 2017. Adding a Water, Sanitation and Hygiene Intervention and a Lipid-Based Nutrient Supplement to an Integrated Agriculture and Nutrition Program Improved the Nutritional Status of Young Burkinabé Children. FASEB Journal 31(1): 455. https://doi.org/10.1096/fasebj.31.1_supplement.455.1
spellingShingle anaemia
water management
human nutrition
Olney, Deanna K.
Bliznashka, Lilia
Becquey, Elodie
Birba, Ousmane
Ruel, Marie T.
Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title_full Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title_fullStr Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title_full_unstemmed Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title_short Adding a water, sanitation and hygiene intervention and a lipid-based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of Young Burkinabé children
title_sort adding a water sanitation and hygiene intervention and a lipid based nutrient supplement to an integrated agriculture and nutrition program improved the nutritional status of young burkinabe children
topic anaemia
water management
human nutrition
url https://hdl.handle.net/10568/146240
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