The impact of rice fortified with seven micronutrients fed through an Indian school mealprogram on hemoglobin and anemia prevalence amongst 6-12 years children

The impact of rice fortified with seven micronutrients fed through an Indian school meal program on hemoglobin and anemia prevalence amongst 6-12 years children
Sudip Mahapatra1, Ruchika Sachdeva1, Megan E. Parker1, Niraj Dave2, Arvind Betigeri3
1. PATH, New Delhi, DL, India, 2. Nielsen (India) Pvt. Ltd, New Delhi, DL, India, 3. World Food Program, Bankgkok, Thailand

Objective:
The objective of this study was to evaluate the impact of multiple micronutrient fortified rice on hemoglobin levels and anemia prevalence in schoolchildren of 6-12 years in Gujarat, India.

Methods:
A case control study was implemented before and after 8 months of intervention to assess the impact of fortified rice on hemoglobin and anemia prevalence. Fortified rice containing seven micronutrients (iron, folic acid, Vitamin A, Vitamin B1, Niacin, Vitamin B6, and Vitamin B12) was blended into the school meals and supplied to 666 schools (intervention) and school meals without fortified rice were distributed to 624 schools (control). From each group, 15 schools were randomly selected and 1,050 children was enrolled enrolled. Hemoglobin was measured in 484 and 489 children in the intervention and control groups, respectively, using a noninvasive technology.

Results:
In the intervention group, baseline mean hemoglobin level was 11.7 ± 0.104 g/dL; after intervention it was 11.9 ± 0.116 g/dL (p =0 .002); as compared to 11.8 ± 0121 g/dL and 11.6 ± 0.127 g/dL (p = .086) in control group. Estimated attributional effect was 0.4g/dl (p=0.001) improvemnt over the control group. Prevalence of anemia was reduced by 10.1 percent (p=0.001) amongst the children in the intervention group from baseline (44.6%) to end-line (34.5%), however, prevalence was increased by 4.3 percent (p=0.112) in the control group. Overall intervention effect was 14.4% (p=0.001) reduction in anemia prevalance.

Conclusions:
Fortified rice significantly improved mean hemoglobin value and reduced the prevalence of anemia amongst schoolchildren consuming fortified rice for eight months.