The impact of an integrated community-based micronutrient and health programme on anaemia in non-pregnant Malawian women

Abstract

Conclusions:The MICAH programme was an effective public health nutrition programme that was associated with significant reductions in the prevalence of anaemia among non-pregnant rural Malawian women.

Anemia among Women of Reproductive Age: An Overview of Global Burden, Trends, Determinants, and Drivers of Progress in Low- and Middle-Income Countries

“…The 21 studies included in this review [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] include data from 38 countries from Asia, Africa and Latin America ( Figure 3 ), and assess trends in anemia among WRA between 1990 and 2017. The characteristics and quality appraisal scores of the included studies, as well as the observed annualized reduction in WRA anemia, are presented in Table S1 .…”

“…The median methodological quality score was 7 (range: 5.5–8), resulting in eight studies classified as low quality, eight studies [ 19 , 24 , 27 , 29 , 30 , 32 , 34 , 36 ] classified as moderate, and five studies [ 20 , 28 , 33 , 38 , 39 ] classified as high quality. Reduction in WRA anemia varied widely across the included studies, with CAGR ranging from −0.4 to −13.0%, with a median of −3.8%.…”

“…In rural Vietnam, among women who participated in a weekly IFA supplementation and regular deworming program, anemia prevalence decreased from 37.8 to 14.3% (CAGR = −13.0%), and soil-transmitted helminth infections decreased from 83.7 to 13.9% between 2006 and 2012 [ 21 ]. Similarly in Malawi, non-pregnant women who lived in districts where a micronutrient and health program (MICAH) (including IFA supplementation and regular deworming) was carried out between 2000 and 2004, had significantly lower odds of being anemic compared to women who lived in control areas (OR: 0.67, 95% CI 0.57 to 0.80; CAGR = −4.7%) [ 30 ]. The MICAH program also included components for malaria control, specifically, treatment with SP and promotion of insecticide-treated bed-nets, and as mentioned above, anemia prevalence in program districts decreased significantly (OR: 0.67, 95% CI 0.57 to 0.80; CAGR = −4.7%) [ 30 ].…”

“…In addition, among pregnant women in India, an increase of 10 mg/day/HH in iron intake, and a decrease of 100 ug/day/HH in phytate intake was found to contribute to a 10% and 1% decrease in anemia, respectively [ 22 ]. The MICAH program in Malawi also included a dietary diversity component aimed at increasing the consumption of animal-source foods and, as mentioned above, anemia prevalence in program districts decreased significantly between 2000 and 2004 (OR: 0.67, 95% CI 0.57 to 0.80; CAGR = −4.7%) [ 30 ].…”

Soil-type influences human selenium status and underlies widespread selenium deficiency risks in Malawi

“…However, such approaches are challenging when baseline Se intakes are low and where there is a lack of purchasing power for foods rich in Se, as in many low-income countries. Short- and medium-term policies to alleviate iron, iodine, zinc, and vitamin A deficiencies have been adopted in Malawi and elsewhere, including dietary iron supplements and salt iodisation2627, although such programmes are not used for Se. Longer-term crop-based approaches (biofortification) are also underway to increase iron, zinc and vitamin A intakes in the region2829, although the breeding potential to biofortify crops with Se via conventional breeding is low1429.…”