HOME FORTIFICATION WITH SPRINKLES TO REDUCE CHILDHOOD ANAEMIA: LESSONS LEARNED IN NWFP, PAKISTAN

Khan E, Hyder Z, Tondeur M, Raza S, Khan S, Zotkin SH

Objectives: To study the effect of the Sprinkles intervention on childhood anaemia, compliance and acceptability in Mardan, North West Frontier Province (NWFP) of Pakistan.

Design: A pre-post intervention design without any placebo control group.

Methods: Sprinkles were given to 844 Afghan refugee and Pakistani children aged 6-36 months within the catchments area of Kagan Health Care Centre of Frontier Primary Health Care to be used daily for 60 days. A sub-sample of children (n=270) was selected randomly to be included in the study. Haemoglobin concentrations (Hb) were assessed at baseline and end. Data on compliance was collected once a month. Acceptability was assessed at the end by interviews and focus group discussions (FGD).

Results: Anaemia prevalence significantly decreased from 86% to 51% (p<0.05) with Hb (SD) increasing from 95 (13) g/L to 110 g/L (12) (p<0.05). Mean percent compliance (SD) was 73% (18). A step-wise decrease of anaemia prevalence was observed with groups of children consuming increased number of Sprinkles sachets (p=0.007). Interviews and FGDs revealed a high acceptance of the intervention. Major perceived benefits included children's higher appetite and playfulness.

Conclusion: The Sprinkles intervention was found to be acceptable with a significant effect on the reduction of childhood anaemia in NWFP of Pakistan.