A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3-12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial
A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3-12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial
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DOI：
10.3945/jn.114.203539
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发表时间：
2015-06-01
影响因子：
4.2
通讯作者：
Dillon, Andrew
中科院分区：
文献类型：
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作者：
Olney, Deanna K.;Pedehombga, Abdoulaye;Dillon, Andrew
背景资料：在布基纳法索的幼儿中，贫血和慢性及急性营养不良现象十分普遍。本研究评估了海伦·凯勒国际组织（HKI）针对妇女的2年综合农业[宅基地粮食生产（HFP）]和营养与健康行为改变交流（BCC）计划对儿童（基线时3-12.9月龄）人体测量（发育迟缓、消瘦和体重不足）、平均血红蛋白（Hb）、贫血（Hb < 11 g/dL）和腹泻患病率。我们使用了一个随机分组对照试验，55个村庄被随机分配到一个对照组（n = 25）或两个治疗组之一（每个n = 15），不同的是谁传递BCC信息[老年妇女领导人或健康委员会（HC）成员]。我们使用差异中的差异（DID）估计来评估对儿童结局的影响。（P < 0.10）对Hb的影响（DID：0.51 g/dL; P = 0.07）和消瘦[DID：-8.8个百分点（pp）; P = 0.08]，具有统计学显著性对腹泻的影响（P < 0.05）在3-12.9个月的儿童中，HC与对照村庄相比为-15.9 pp; P = 0.001，对贫血（DID：-14.6 pp; P = 0.03）和平均Hb的影响更大（DID：0.74 g/dL; P = 0.03）。然而，我们发现对发育迟缓或体重不足的患病率没有显着影响。可信度支持更大的改善，妇女的农业生产和孕产妇婴幼儿喂养和护理知识和做法，在HC与control villages.Conclusions相比：HKI的2-y综合HFP+BCC计划（HC组）显着改善了几个孩子的结果，包括浪费（边缘），腹泻，血红蛋白，贫血，特别是在最年轻的孩子。这是第一个关于HFP项目的随机分组对照试验，该试验记录了对这些儿童营养结果的统计学显著积极影响。本试验在clinicaltrials.gov上注册为NCT 01825226。
Background: Among young children in Burkina Faso, anemia and chronic and acute undernutrition are widespread.Objective: This study assessed the impact of Helen Keller International's (HKI) 2-y integrated agriculture [homestead food production (HFP)] and nutrition and health behavior change communication (BCC) program, targeted to women, on children's (3-12.9 mo old at baseline) anthropometry (stunting, wasting, and underweight), mean hemoglobin (Hb), anemia (Hb < 11 g/dL), and diarrhea prevalence.Methods: We used a cluster-randomized controlled trial, with 55 villages randomly assigned to a control group (n = 25) or 1 of 2 treatment groups (n = 15 each), which differed by who delivered the BCC messages [older women leaders or health committee (HC) members]. We used difference-in-difference (DID) estimates to assess impacts on child outcomes.Results: We found marginally significant (P < 0.10) impacts on Hb (DID: 0.51 g/dL; P = 0.07) and wasting [DID: -8.8 percentage point (pp); P = 0.08] and statistically significant (P < 0.05) impacts on diarrhea (-15.9 pp; P = 0.001 in HC compared with control villages among children aged 3-12.9 mo and larger impacts for anemia (DID: -14.6 pp; P = 0.03) and mean Hb (DID: 0.74 g/dL; P = 0.03) among younger children (aged 3-5.9 mo). However, we found no significant impacts on stunting or underweight prevalence. Plausibility was supported by greater improvements in women's agricultural production and maternal infant and young child feeding and care knowledge and practices in HC compared with control villages.Conclusions: HKI's 2-y integrated HFP+BCC program (HC group) significantly improved several child outcomes, including wasting (marginal), diarrhea, Hb, and anemia, especially among the youngest children. This is the first cluster-randomized controlled trial of an HFP program that documents statistically significant positive effects on these child nutrition outcomes. This trial was registered at clinicaltrials.gov as NCT01825226.