15 research outputs found
Overestimation of Vitamin a Supplementation Coverage from District Tally Sheets Demonstrates Importance of Population-Based Surveys for Program Improvement: Lessons from Tanzania.
Tanzania has conducted a national twice-yearly Vitamin A supplementation (VAS) campaign since 2001. Administrative coverage rates based on tally sheets consistently report >90% coverage; however the accuracy of these rates are uncertain due to potential errors in tally sheets and their aggregation, incomplete or inaccurate reporting from distribution sites, and underestimating the target population. The post event coverage survey in Mainland Tanzania sought to validate tally-sheet based national coverage estimates of VAS and deworming for the June 2010 mass distribution round, and to characterize children missed by the national campaign. WHO/EPI randomized cross-sectional cluster sampling methodology was adapted for this study, using 30 clusters by 40 individuals (nâ=â1200), in addition to key informant interviews. Households with children 6-59 months of age were included in the study (12-59 months for deworming analysis). Chi-squared tests and logistic regression analysis were used to test differences between children reached and not reached by VAS. Data was collected within six weeks of the June 2010 round. A total of 1203 children, 58 health workers, 30 village leaders and 45 community health workers were sampled. Preschool VAS coverage was 65% (95% CI: 62.7-68.1), approximately 30% lower than tally-sheet coverage estimates. Factors associated with not receiving VAS were urban residence [ORâ=â3.31; pâ=â0.01], caretakers who did not hear about the campaign [ORâ=â48.7; p<0.001], and Muslim households [OR<3.25; p<0.01]. There were no significant differences in VAS coverage by child sex or age, or maternal age or education. Coverage estimation for vitamin A supplementation programs is one of most powerful indicators of program success. National VAS coverage based on a tally-sheet system overestimated VAS coverage by âŒ30%. There is a need for representative population-based coverage surveys to complement and validate tally-sheet estimates
Linear programming can help identify practical solutions to improve the nutritional quality of food aid.
OBJECTIVES: To assess the nutritional quality of food aid delivered by food banks in France and to identify practical modifications to improve it. DESIGN: National-level data were collected for all food aid distributed by French food banks in 2004, and its nutrient content per 2000 kcal was estimated and compared with French recommendations for adults. Starting with the actual donation and allowing new foods into the food aid donation, linear programming was used to identify the minimum changes required in the actual donation to achieve the French recommendations. RESULTS: French food-bank-delivered food aid does not achieve the French recommendations for dietary fibre, ascorbic acid, vitamin D, folate, magnesium, docosahexaenoic acid, alpha-linolenic acid and the percentage of energy from saturated fatty acids. Linear programming analysis showed that these recommendations are achievable if more fruits, vegetables, legumes and fish were collected and less cheese, refined cereals and foods rich in fat, sugar and/or salt. In addition, new foods not previously collected are needed, particularly nuts, wholemeal bread and rapeseed oil. These changes increased the total edible weight (42%) and economic value (55%) of the food aid donation, with one-third of its edible weight coming from fruits and vegetables, one-third from staples, one-quarter from dairy products and approximately a tenth from meat/fish/eggs. CONCLUSIONS: Important changes in the types and amounts of food collected will improve the nutritional quality of food-bank-delivered food aid in France. Such changes are recommended to improve the diets of deprived French populations
Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data
Objective: To utilize complementary biochemical and dietary data collected before the initiation of national flour fortification to (i) identify micronutrient insufficiencies or deficiencies and dietary inadequacies in Palestinian women and children in vulnerable communities and (ii) assess the suitability of the current wheat flour fortification formula. Design: Quantitative dietary intake questionnaires were administered and fasting venous blood samples collected in randomly selected households in Gaza City and Hebron. The impact of fortification was simulated by estimating the additional micronutrient content of fortified wheat flour. Setting: Households in Gaza City and Hebron that were not receiving food aid from social programmes. Subjects: Non-pregnant women (18â49 years) and children aged 36â83 months. Results: The micronutrients with highest prevalence of insufficiency were vitamin D in women (84â97 % with serum 25-hydroxyvitamin D \u3c50 nmol/l) and vitamin B12 in women and children (43â82 % with serum B12 \u3c221 pmol/l). Deficiencies of vitamin A, Fe and Zn were also of public health concern. Current levels of wheat flour fortificants were predicted to improve, but not eliminate, micronutrient intake inadequacies. Modification of fortificant concentrations of vitamin D, thiamin, vitamin B12, Zn and folic acid may be indicated. Conclusions: Micronutrient insufficiencies or deficiencies and intake inadequacies were prevalent based on either biochemical or dietary intake criteria. Adjustments to the current fortification formula for wheat flour are necessary to better meet the nutrient needs of Palestinian women and children
Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data
To utilize complementary biochemical and dietary data collected
before the initiation of national flour fortification to (i) identify micronutrient
insufficiencies or deficiencies and dietary inadequacies in Palestinian women and
children in vulnerable communities and (ii) assess the suitability of the current
wheat flour fortification formula.
Design: Quantitative dietary intake questionnaires were administered and fasting
venous blood samples collected in randomly selected households in Gaza City
and Hebron. The impact of fortification was simulated by estimating the additional
micronutrient content of fortified wheat flour.
Setting: Households in Gaza City and Hebron that were not receiving food aid
from social programmes.
Subjects: Non-pregnant women (18â49 years) and children aged 36â83 months.
Results: The micronutrients with highest prevalence of insufficiency were vitamin
D in women (84â97 % with serum 25-hydroxyvitamin D <50 nmol/l) and vitamin
B12 in women and children (43â82 % with serum B12 <221 pmol/l). Deficiencies of
vitamin A, Fe and Zn were also of public health concern. Current levels of wheat
flour fortificants were predicted to improve, but not eliminate, micronutrient
intake inadequacies. Modification of fortificant concentrations of vitamin D,
thiamin, vitamin B12, Zn and folic acid may be indicated.
Conclusions: Micronutrient insufficiencies or deficiencies and intake inadequacies
were prevalent based on either biochemical or dietary intake criteria. Adjustments
to the current fortification formula for wheat flour are necessary to better meet the
nutrient needs of Palestinian women and children.Financial support: This article was made possible by the
generous support of the US Agency for International Development (USAID) under the terms of Cooperative
Agreement No. GHS-A-00-05-00012-00 to FHI-360 (and
before to AED). USAID had no role in the design, analysis,
or writing of this article. Conflict of interest: None.
Authorship: Z.A. was responsible for field work and data
collection, and contributed in interpretation of results.
A.âA.A. contributed in the interpretation of the results.
L.H.A. advised the project, supervised biochemical analyses
and assisted with data interpretation and publication.
A.C. calculated estimates of usual food and nutrient intakes.
O.D. acted as study coordinator. S.D. was responsible for
field work and data collection. D.D. assisted with data
interpretation and was responsible for manuscript preparation.
R.Q. entered and cleaned data, and assisted with
statistical analysis. Z.R. carried out statistical analyses. A.R.
assisted with study design and liaised with the Ministry of
Health of the Palestinian Authority. R.S. facilitated transfer of
biological specimens and coordinated data analysis. S.S.-F.
conducted biochemical analyses of the serum samples.
Ethics of human subject participation: The study was
conducted according to the guidelines laid down in the
Declaration of Helsinki and all procedures involving
human subjects were approved by the Committee on
Human Subjects Research at the Directorate of Primary
Health Care and Public Health of the Ministry of Health of
the Palestinian Authority, as well as the Office of Research
of Al-Quds University
Comparison of estimates of the nutrient density of the diet of women and children in Uganda by Household Consumption and Expenditures Surveys (HCES) and 24-hour recall
PRIFPRI3; ISI; HarvestPlus; CRP4HarvestPlus; PHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Un colis de référence pour une aide alimentaire équilibrée
National audiencePractical and specific guidelines are needed to design nutritionally adequate food baskets for food aid. Since the weight of foods is the only information on food easily available and understandable by non nutritionist field-workers, weight-based guidelines were presently developed. They are compatible with the French foodbased dietary guidelines and take into account that food-insecure individuals have limited access to some foods, such as meat, fish, fruit and vegetables, while refined cereals are the main component of their diets. These guidelines can also be used to evaluate the dietary quality of existing food aid. factual food baskets delivered by food aid agencies in France were compared to the recommended food basket. The results show that fruit and vegetables are severely lacking (only 10% of total food basket weight instead of 33% recommended) while staples, mainly refined cereals, are given in excess (40% instead of 15%), as well as sugar- or saltcontaining food products (9% instead of 2%). This results show that it is necessary to improve the dietary quality of food aid in France and suggest that simple weight-based recommendations can be helpfulLâobjectif de cette Ă©tude Ă©tait dâĂ©laborer un colis alimentaire qui puisse servir de rĂ©fĂ©rence pour concevoir des colis alimentaires Ă©quilibrĂ©s et pour Ă©valuer lâĂ©quilibre alimentaire de dons existants. Le poids Ă©tant la seule information sur les aliments facilement accessible aux bĂ©nĂ©voles et salariĂ©s travaillant dans les structures dâaide alimentaire, les pourcentages pondĂ©raux des groupes et sous-groupes dâaliments dans le colis de rĂ©fĂ©rence forment la base des critĂšres de constitution dâun colis adĂ©quat. Le colis de rĂ©fĂ©rence est en accord avec les repĂšres de consommation du PNNS tout en Ă©tant spĂ©cifique Ă lâaide alimentaire, car il donne la prioritĂ© aux aliments de bonne qualitĂ© nutritionnelle que les populations en situation de prĂ©caritĂ© ont du mal Ă se procurer. Par rapport au colis de rĂ©fĂ©rence, les paniers et colis dĂ©livrĂ©s par les structures dâaide alimentaire en France, manquent sĂ©vĂšrement de fruits et lĂ©gumes (10 % du poids total des colis au lieu des 33 % recommandĂ©s) et contiennent trop de produits sucrĂ©s ou salĂ©s (9 % vs 2 %) et trop de fĂ©culents, notamment raffinĂ©s (40 % vs 15 %). Cette Ă©tude montre quâil est nĂ©cessaire dâamĂ©liorer la qualitĂ© nutritionnelle des dons alimentaires en France, et suggĂšre que la simple diffusion de recommandations basĂ©es sur le poids des aliments pourrait y contribue
Knowledge of Vitamin A Among Village Leaders, Healthcare Workers and Community Health Workers.
<p>*Village leaders were not asked questions pertaining to methods of combatting VAD</p
Flow of participants in final analytical sample.
<p>Flow of participants in final analytical sample.</p
Predicted efficacy of the Palestinian wheat flour fortification programme: complementary analysis of biochemical and dietary data
Objective: To utilize complementary biochemical and dietary data collected before the initiation of national flour fortification to (i) identify micronutrient insufficiencies or deficiencies and dietary inadequacies in Palestinian women and children in vulnerable communities and (ii) assess the suitability of the current wheat flour fortification formula. Design: Quantitative dietary intake questionnaires were administered and fasting venous blood samples collected in randomly selected households in Gaza City and Hebron. The impact of fortification was simulated by estimating the additional micronutrient content of fortified wheat flour. Setting: Households in Gaza City and Hebron that were not receiving food aid from social programmes. Subjects: Non-pregnant women (18â49 years) and children aged 36â83 months. Results: The micronutrients with highest prevalence of insufficiency were vitamin D in women (84â97 % with serum 25-hydroxyvitamin D This article is from Public Health Nutrition 18 (2015): 1358, doi: 10.1017/S1368980014001554.</p