Effectiveness of Fortified Mid-Day Meal in Reducing Anemia Among School Children in Dhenkanal, Odisha : A Quasi-Experimental Study
BACKGROUND: Iron-deficiency anemia among school-aged children is widespread in India. The efficacy of micronutrient and iron fortified school-served meals in reducing iron deficiency anemia has been demonstrated in randomized controlled trials in other parts of the globe. The current study evaluates its effectiveness in real-world Indian settings.
METHODS: Mid-day-Meal (MDM) programme provides free lunch to students of grades 1 to 8 in all public-funded Indian schools. An implementation research project fortified MDM of all public schools of 4 out of 8 sub-districts ("blocks") of Dhenkanal district of Odisha state with fortified rice kernel (FRK). All the schools of the other 4 blocks fortified with micronutrient powders (MNP)-both FRK and MNP containing equal amounts of supplementary iron and other micronutrients. Schools of 4 matched blocks of neighboring nonimplementing Angul district served as control. Cross-sectional representative samples of students were drawn from the 3 arms, before and after intervention (n = 1764 and n = 1640 respectively). Pre-post changes in anemia prevalence and hemoglobin levels were estimated in the sampled children using difference-in-difference analysis after controlling for inter-arm differences in socioeconomic status, and iron and deworming tablet consumptions.
RESULTS: Factoring in pre-post changes in control and adjusting for potential confounders, the proportion of children without anemia and mean hemoglobin improved by 1.93 (1.38, 2.24, P < .001) times and 0.24 (-0.03, 0.51, P = .083) g/dL in MNP; and 1.63 (1.18, 2.24, P = .002) times and 0.18 (-0.09, 0.45, P = .198) g/dL in FRK arms.
CONCLUSIONS: Fortified MDM could effectively improve anemia status among Indian school-aged children under real-world conditions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Food and nutrition bulletin - 44(2023), 2 vom: 31. Juni, Seite 79-87 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mohapatra, Mrinal Kar [VerfasserIn] |
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| Links: |
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| Themen: |
Anemia |
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| Anmerkungen: |
Date Completed 23.06.2023 Date Revised 29.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/03795721231172253 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356685829 |
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| 100 | 1 | |a Mohapatra, Mrinal Kar |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effectiveness of Fortified Mid-Day Meal in Reducing Anemia Among School Children in Dhenkanal, Odisha |b A Quasi-Experimental Study |
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| 500 | |a Date Revised 29.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Iron-deficiency anemia among school-aged children is widespread in India. The efficacy of micronutrient and iron fortified school-served meals in reducing iron deficiency anemia has been demonstrated in randomized controlled trials in other parts of the globe. The current study evaluates its effectiveness in real-world Indian settings | ||
| 520 | |a METHODS: Mid-day-Meal (MDM) programme provides free lunch to students of grades 1 to 8 in all public-funded Indian schools. An implementation research project fortified MDM of all public schools of 4 out of 8 sub-districts ("blocks") of Dhenkanal district of Odisha state with fortified rice kernel (FRK). All the schools of the other 4 blocks fortified with micronutrient powders (MNP)-both FRK and MNP containing equal amounts of supplementary iron and other micronutrients. Schools of 4 matched blocks of neighboring nonimplementing Angul district served as control. Cross-sectional representative samples of students were drawn from the 3 arms, before and after intervention (n = 1764 and n = 1640 respectively). Pre-post changes in anemia prevalence and hemoglobin levels were estimated in the sampled children using difference-in-difference analysis after controlling for inter-arm differences in socioeconomic status, and iron and deworming tablet consumptions | ||
| 520 | |a RESULTS: Factoring in pre-post changes in control and adjusting for potential confounders, the proportion of children without anemia and mean hemoglobin improved by 1.93 (1.38, 2.24, P < .001) times and 0.24 (-0.03, 0.51, P = .083) g/dL in MNP; and 1.63 (1.18, 2.24, P = .002) times and 0.18 (-0.09, 0.45, P = .198) g/dL in FRK arms | ||
| 520 | |a CONCLUSIONS: Fortified MDM could effectively improve anemia status among Indian school-aged children under real-world conditions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a anemia | |
| 650 | 4 | |a child health | |
| 650 | 4 | |a health impact assessment | |
| 650 | 4 | |a nutritional status | |
| 650 | 4 | |a research design | |
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| 650 | 7 | |a Micronutrients |2 NLM | |
| 650 | 7 | |a Trace Elements |2 NLM | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 700 | 1 | |a Pradhan, Ashirbad |e verfasserin |4 aut | |
| 700 | 1 | |a Tiwari, Divya |e verfasserin |4 aut | |
| 700 | 1 | |a Yunus, Shariqua |e verfasserin |4 aut | |
| 700 | 1 | |a Patro, Binod Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Behera, Binod Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Sahu, Suchanda |e verfasserin |4 aut | |
| 700 | 1 | |a Bhatia, Vikas |e verfasserin |4 aut | |
| 700 | 1 | |a Bhattacharya, Shreeporna |e verfasserin |4 aut | |
| 700 | 1 | |a Paithankar, Pradnya |e verfasserin |4 aut | |
| 700 | 1 | |a Dutta, Ambarish |e verfasserin |4 aut | |
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