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Delivering Sprinkles Plus through the Integrated Child Development Services (ICDS) to Reduce Anemia in Pre-school Children in India

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The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess the effectiveness of micronutrient powder (MNP) supplementation in reducing anemia levels in children aged 6 mo to 6 y in India.

Methods

Sixty sachets of MNP (Sprinkles Plus) were administered flexibly over a 4 mo period to 17,124 children at anganwadi centers or at home through Integrated Child Development Services (ICDS). Compliance was monitored using compliance cards and an assessment of mother’s recall at post-intervention survey. Hemoglobin was measured in separate random samples of 1,786 children before and 1,782 children after MNP supplementation.

Results

Mean compliance rate was estimated at 56.4 % (based on mother’s recall) and 91.7 % (based on compliance cards) for children who received MNP at home. Mean compliance was 96.9 % (based on compliance cards) for children who received MNP at anganwadis. A significant reduction in anemia (50 % to 33 % in boys; p-value < .000; 47.4 % to 34.2 % in girls) was seen following MNP supplementation.

Conclusions

Integration of a flexibly administered MNP supplementation into the ICDS is effective in reducing and treating anemia in children 6 mo to 6 y age.

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Acknowledgments

The authors are grateful to the ICDS officers, supervisors and Anganwadi workers for their role in implementation of the intervention. Also, they are grateful to all the mothers who consented for their children to participate in this intervention.

Contributions

SH, EM, SKJ, AB, NH, DLY, AP contributed to the concept and design of the study. SH, EM, SKJ, DA, MM, SJ, contributed to the data acquisition, data analysis and data interpretation. SH, SJ, contributed to drafting the manuscript. EM, SKJ, DA, AB, MS, MM, NH, DLY, AP contributed to critically revising the manuscript for important intellectual content. All authors approved the final manuscript.

Conflict of Interest

None.

Role of Funding Source

This work was supported by HJ Heinz Foundation and Helen Keller International.

Author information

Authors and Affiliations

  1. Vadu Rural Health Program, KEM Hospital Research Center, Rasta Peth, Pune, 411011, India

    Siddhivinayak Hirve, Sanjay K. Juvekar & Dhiraj Agarwal

  2. Helen Keller International, Jakarta, Indonesia

    Elviyanti Martini

  3. Department of Pediatrics, KEM Hospital Research Center, Pune, India

    Ashish Bavdekar & Anand Pandit

  4. Helen Keller International, New York, NY, USA

    Mayang Sari

  5. Integrated Child Development Services, Ministry of Women and Child Welfare, Govt. of Maharashta, Mumbai, India

    Manjusha Molwane

  6. Department of Clinical Nutrition, St. Michael’s Hospital, Toronto, ON, Canada

    Sabrina Janes

  7. Asia Pacific Helen Keller International, Phnom Penh, Cambodia

    Nancy Haselow

  8. HJ Heinz Micronutrient Campaign, Pittsburg, PA, USA

    David L. Yeung

Authors
  1. Siddhivinayak Hirve
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  2. Elviyanti Martini
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  3. Sanjay K. Juvekar
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  4. Dhiraj Agarwal
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  5. Ashish Bavdekar
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  9. Nancy Haselow
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  10. David L. Yeung
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  11. Anand Pandit
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Corresponding author

Correspondence to Siddhivinayak Hirve.

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Hirve, S., Martini, E., Juvekar, S.K. et al. Delivering Sprinkles Plus through the Integrated Child Development Services (ICDS) to Reduce Anemia in Pre-school Children in India. Indian J Pediatr 80, 990–995 (2013). https://doi.org/10.1007/s12098-013-1063-2

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  • DOI: https://doi.org/10.1007/s12098-013-1063-2

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