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

摘要

ObjectiveTo assess the impact of an integrated community-based micronutrient and health (MICAH) programme on anaemia (Hb < 120 g/l) among non-pregnant rural Malawian women aged 15a€“49 years from communities that participated in the 1996a€“2005 MICAH programme.DesignProspective study of two large-scale cross-sectional surveys conducted in 2000 and 2004 as part of programme evaluation in MICAH and Comparison areas.SettingRural areas across Malawi. The MICAH programme implemented a comprehensive package of interventions to reduce anaemia, based on a broad range on direct and indirect causes in Malawi. The project approaches included: Fe supplementation; dietary diversification and modification; food fortification; and strengthening primary health care.ParticipantsNon-pregnant women of childbearing age (15a€“49 years old, n 5422), from randomly selected households that responded to a household questionnaire, had their Hb measured from finger-prick blood samples using the HemoCue??.ResultsIn 2000, there was no significant difference in Hb concentration between MICAH and Comparison areas (mean (se): 117?·4 (0?·4) v. 116?·8 (0?·5) g/l, P > 0?·05) and the corresponding prevalence of anaemia (53?·5 % v. 52?·9 %, P > 0?·05). By 2004, Hb concentration had increased significantly in MICAH but not in Comparison areas (mean (se): 121?·0 (0?·4) v. 115?·7 (0?·6) g/l, P < 0?·001), and the prevalence of anaemia had declined significantly in MICAH areas (53?·5 % to 44?·1 %, ??2 = 28?·2, P < 0?·0001) but not in Comparison areas (52?·8 % to 54?·0 %, ??2 = 0?·3, P = 0?·6).ConclusionsThe 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.