Emel Khan, Sm Ziauddin Hyder, Melody C Tondeur, Shabina Raza, Noor Ahmad Khan, Stanley H Zotkin.
Home fortification with Sprinkles™ to reduce childhood anemia: lessons learned in North West Frontier Province, Pakistan.
Pak J Med Res Jan ;45(2):35-40.

Objective: To study the compliance and acceptability of the Sprinkles (TM) intervention and assess its effect on childhood anaemia, in Mardan, North West Frontier Province (NWFP) of Pakistan. Design: One-Group Pretest-Posttest design. Methods: A total of 270 children were selected randomly from the 844 Afghan refugee and Pakistani children aged 6-36 months within the catchments area of Kagan Health Care Centre of Frontier Primary Health Care. Each child was given 60 single-dose sachets of SprinklesTM to be consumed in 60 days. Haemoglobin concentrations (Hb) were assessed at baseline and at the end of the intervention. Data on compliance was collected once a month. Acceptability was assessed at the end by care giver interviews and focus group discussions (FGD). Results: Mean (SD) Hb increased from 95 g/L to 110 g/L (p<0.05). Anaemia prevalence significantly decreased from 86% to 51% (p<0.05). Mean compliance was 73%. A significant dose-response association between anaemia prevalence and number of multiple micronutrient doses consumed was observed (p=0.007). Interviews and FGDs revealed a high acceptance rate of the intervention. Major perceived benefits included children`s higher appetite and playfulness. Conclusion: The high acceptance of and compliance with the Sprinkles intervention resulted in a significant reduction in the prevalence of childhood anaemia in NWFP.

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