The impact of an integrated community-based micronutrient and health programme on anaemia in non-pregnant Malawian women.
OBJECTIVE
To 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 15-49 years from communities that participated in the 1996-2005 MICAH programme.


METHODS
Prospective study of two large-scale cross-sectional surveys conducted in 2000 and 2004 as part of programme evaluation in MICAH and Comparison areas.


METHODS
Rural 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.


METHODS
Non-pregnant women of childbearing age (15-49 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.


RESULTS
In 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 %, chi2 = 28.2, P < 0.0001) but not in Comparison areas (52.8 % to 54.0 %, chi2 = 0.3, P = 0.6).


CONCLUSIONS
The 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.
Kalimbira
Alexander A
AA
Department of Home Economics and Human Nutrition, Bunda College of Agriculture, University of Malawi, Lilongwe, Malawi.
MacDonald
Carolyn
C
Simpson
Janis Randall
JR
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000097:blood* / Q000453:epidemiology*; D003153:Community Health Services; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage*; D008295:Malawi / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D015397:Program Evaluation; D011446:Prospective Studies; D011634:Public Health; D012424:Rural Population / Q000706:statistics & numerical data; D055815:Young Adult
D006454:Hemoglobins; D019266:Iron, Dietary