Delivery of iron-fortified yoghurt, through a dairy value chain program, increases hemoglobin concentration among children 24 to 59 months old in Northern Senegal: A cluster-randomized control trial

Agnes Le Port, Tanguy Bernard, Melissa Hidrobo, Ousmane Birba, Rawul Rawat and Marie Ruel ()
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Agnes Le Port: UMR MoISA - Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) - Cirad - Centre de Coopération Internationale en Recherche Agronomique pour le Développement - IRD - Institut de Recherche pour le Développement - CIHEAM-IAMM - Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier - CIHEAM - Centre International de Hautes Études Agronomiques Méditerranéennes - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - Institut Agro Montpellier - Institut Agro - Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement

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Abstract: Background Innovative strategies are needed to enhance the nutritional impact of agriculture. Value chain approaches, which use supply chains to add value (usually economic) to products as they move from producers to consumers, can be used to increase access to nutritious foods and improve nutritional status. This study tested whether a dairy value chain could be used to distribute a micronutrient-fortified yoghurt (MNFY) (conditional upon the producer supplying a minimum amount of cow milk/day) to improve hemoglobin and reduce anemia among preschool children in a remote area in Northern Senegal. Methods A cluster randomized control trial was used to compare 204 children (24 to 59 months of age at baseline) from households who received the MNFY coupled to a behavior change communication (BCC) campaign focusing on anemia prevention to 245 children from a control group (receiving BCC only) after one year. Randomization was done at the level of the family concession (households from the same family) (n = 321). Eligible households had a child of the target age and were willing to deliver milk to the dairy factory. Changes in anemia and hemoglobin between groups were assessed using mixed regression models. Key findings Anemia prevalence was very high at baseline (80%) and dropped to close to 60% at endline, with no differences between intervention groups. Hemoglobin increased by 0.55 g/dL, 95%CI (0.27; 0.84) more in the intervention compared to the control group after one year, in models that controlled for potentially confounding factors. The impact was greater (0.72 g/dL, 95%CI (0.34; 1.12)) for boys, compared to girls (0.38 g/dL, 95%CI (-0.03; 0.80)). Conclusion The dairy value chain was a successful strategy to distribute MNFY among pastoralists in Northern Senegal, and increase Hb concentrations among their children. This study is one of the first proofs of concept showing that a nutrition-sensitive agriculture value chain approach can contribute to improved child nutrition in a remote pastoralist population.

Keywords: Animals; Humans; Female; health care access; human; prevalence; major clinical study; child nutrition; Nutritional Status; Male; anemia; preschool child; randomized controlled trial; Child; Preschool; health behavior; hemoglobin; hemoglobin blood level; regression analysis; sex difference; Cluster Analysis; disease severity; Regression Analysis; migration; season; rural population; Senegal; Anemia; behavior change; chemistry; Child Nutritional Physiological Phenomena; food insecurity; Food; fortified food; grazing; Health Behavior; Hemoglobins; Iron; iron intake; maternal attitude; Micronutrients; Milk; milk production; nutritional value; Rural Population; Sample Size; trace element; Yogurt (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (8)

Published in PLoS ONE, 2017, 12 (2), pp.e0172198. ⟨10.1371/journal.pone.0172198⟩

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Journal Article: Delivery of iron-fortified yoghurt, through a dairy value chain program, increases hemoglobin concentration among children 24 to 59 months old in Northern Senegal: A cluster-randomized control trial (2017)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03033593

DOI: 10.1371/journal.pone.0172198

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