title: Food assistance programmes are indirectly associated with anaemia status in children <5 years old in Mexico.
abstract: Anaemia in children is a public health concern in Mexico; Federal food assistance programmes are being implemented to prevent it. We undertook this research to investigate the indirect association between food assistance programmes (FAP) and anaemia through dietary and socio-economic conditions of beneficiary children. A structural equation model (SEM) was constructed to assess associations among FAP, dietary and socio-economic conditions, as well as anaemia. A cross-sectional comparative study was conducted based on a sample of 1214 households with children <5 years old, beneficiaries of two FAP: Prospera and rescue from malnutrition with amaranth (RMA) and a comparison group in San Luis Potosí, Mexico. The SEM and a decomposition effect analysis revealed the existence of a significant indirect association of FAP on the prevalence of anaemia via dietary and socio-economic conditions in children under 5 years old. The Prospera assistance programme showed a significant indirect positive association with the prevalence of anaemia (standard coefficient=0·027, P<0·031), and the RMA programme showed a significant indirect negative association with the prevalence of anaemia (standard coefficient=-0·029, P=0·047). There was a direct association between FAP and dietary and socio-economic conditions. FAP could indirectly modify the prevalence of anaemia in young children with a direct improvement on dietary and socio-economic conditions. The unexpected finding of the association between RMA, dietary and socio-economic conditions and the prevalence of anaemia reflects differences in the focus of the programmes.
authors.affiliation: 1Centro de Investigación en Nutrición y Salud,Instituto Nacional de Salud Pública,Cuernavaca,Mexico.
authors.forename: Teresa
authors.initials: T
authors.lastname: Shamah-Levy
authors.affiliation: 2Centro de Investigación en Matemáticas A.C., Unidad Aguascalientes,Mexico.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Méndez-Gómez-Humarán
authors.affiliation: 1Centro de Investigación en Nutrición y Salud,Instituto Nacional de Salud Pública,Cuernavaca,Mexico.
authors.forename: Elsa B
authors.initials: EB
authors.lastname: Gaona-Pineda
authors.affiliation: 1Centro de Investigación en Nutrición y Salud,Instituto Nacional de Salud Pública,Cuernavaca,Mexico.
authors.forename: Lucia
authors.initials: L
authors.lastname: Cuevas-Nasu
authors.affiliation: 1Centro de Investigación en Nutrición y Salud,Instituto Nacional de Salud Pública,Cuernavaca,Mexico.
authors.forename: Salvador
authors.initials: S
authors.lastname: Villalpando
mesh_terms: D000740:Anemia / Q000517:prevention & control*; D015362:Child Nutrition Disorders / Q000517:prevention & control; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D063105:Food Assistance / Q000458:organization & administration*; D006801:Humans; D008800:Mexico; D011203:Poverty
keywords: Anaemia; Children; FAP food assistance programmes; Food assistance programmes; Food insecurity; RMA rescue from malnutrition with amaranth; SE socio-economic; SEM structural equation model; SLP San Luis Potosí