INTERVENTION TO FIGHT ANEMIA AND IMPROVE WELL-BEING IN A VERY LOW INCOME SETTING

6.在收入极低的情况下抗击贫血和改善福祉的干预措施 缺铁被认为是当今世界上最常见的营养缺乏症，与成人生产力低下、儿童认知和身体发育放缓以及老年人认知障碍、身体残疾和肌肉力量下降的风险增加有关。它还可能影响生产率和工资收入等经济指标。问题的核心是...的困难 制定一种可持续的铁补充剂分发方法。之前对铁强化面粉的一项研究发现，使用量下降会减弱任何积极影响。考虑到盐在社会各阶层中的广泛使用，以及在集中防御工事和分配计划中相对容易的后勤，提出了双强化盐(DFS)作为一种改进的替代方案。 这一分项目将调查补贴DFS对印度博伊普尔地区以贫血、低收入、农村人口为主的健康和经济影响。具体目标是：(1)与比哈尔邦政府的国家卫生协会合作，对私营和政府资助的商店实施外勤部补贴的效果进行群集级随机对照试验。(2)衡量可获得补贴的DFS对几个结果的影响。(3)具体调查该政策对老年人认知衰退的影响。(4)如果DFS可减少贫血，则将DFS的可用性作为一种工具来衡量血红蛋白水平升高对经济和健康结局以及认知能力的影响。(5)探讨既往贫血状况、贫困程度、文化程度对食盐摄取及最终效果的影响是否存在差异。(6)收集并公开比哈尔邦约1万户家庭的丰富健康福祉数据集。

6. INTERVENTION TO FIGHT ANEMIA & IMPROVE WELL-BEING IN A VERY LOW INCOME SETTING Iron deficiency is believed to be the most common nutrient deficiency in the worid today, linked to low productivity in adults; slowing of cognitive and physical growth among children; and increased risk of cognitive impairment, physical disability and decreased muscle strength in the elderly. It may also impact economic indicators such as productivity and wages earned. At the heart of the problem is the difficulty of putting in place a sustainable method of distributing iron supplements. A previous study of iron-fortified flour found that declining take-up muted any positive impacts. Double-fortified salt (DFS) was proposed as an improved alternative, given salt's broad use among all strata of society and the relative logistical ease in a centralized fortification and distribution program. This subproject will investigate the health and economic effects of subsidizing DFS in a predominantly anemic, low-income, rural population in Bhojpur district, India. The specific aims are: (1) To conduct, in collaboration with the State Health Society of the Government of Bihar, a cluster level randomized control trial of the effect of DFS subsidization in private and government sponsored shops. (2) To measure the effect of the availability of subsidized DFS on several outcomes. (3) To specifically investigate the effect of the policy on cognitive decay among older adults. (4) If DFS reduces anemia, to use the availability of DFS as an instrument to measure the effect of increased hemoglobin level on economic and health outcomes, and cognitive capacity. (5) To investigate whether the take up of the salt and the final effect differ by previous anemia status, poverty levels, and education level. (6) To collect and make publicly available a rich data set on health and well-being for about 10,000 households in Bihar.