Halimatou Alaofè

Education and improved iron intakes for treatment of mild iron-deficiency anemia in adolescent girls in southern Benin.

Background To our knowledge, the impact of a nutrition education program combined with an increase in bioavailable dietary iron to treat iron-deficiency anemia has never been studied in adolescent girls. Objective To evaluate the impact of an intensive dietary program for the treatment of iron-deficiency anemia in 34 intervention and 34 control boarding-school girls aged 12 to 17 years from Benin. Methods A quasi-experimental design consisting of 4 weeks of nutrition education combined with an increase in the content and bioavailability of dietary iron for 22 weeks was implemented in the intervention school, but not in the control school. Data were obtained from both groups from a nutrition knowledge questionnaire, 24-hour dietary recalls, anthropometric measurements, measurement of iron status indices, and screening for malarial and intestinal parasitic infections. Results Nutrition knowledge scores and mean intakes of nutrients, including dietary iron, absorbable iron, and vitamin C, were significantly higher in the intervention group (p < .05) than in the control group after 26 weeks. Mean hemoglobin and serum ferritin values were also significantly higher in the intervention group than in the control group (122 vs. 112 g/L [p = .0002] and 32 vs. 19 μg/L [p = .04], respectively), whereas the prevalence of anemia (32% vs. 85% [p = .005] and iron-deficiency anemia (26% vs. 56% [p = .04]) was significantly lower in the intervention group than in the control group. No significant differences between the groups were observed in intestinal parasitic infections or malaria status postintervention. Conclusions A multidietary strategy aiming to improve available dietary iron can reduce iron-deficiency anemia in adolescent girls.

Solar-Powered Drip Irrigation Impacts on Crops Production Diversity and Dietary Diversity in Northern Benin

Background: Meeting the food needs of Africas growing population will require innovative and appropriate technologies whose effectiveness needs to be assessed. Objective: To evaluate the impact of Solar Market Gardens (SMGs) on crops production diversity and dietary diversity in the Kalalé district of Northern Benin. Methods: In 2007, SMGs were installed in 2 villages for womens agricultural groups as a strategy for enhancing food and nutrition security. Data were collected through interviews at installation and 1 year later from all womens group households (30–35 women/group) and from a random representative sample of 30 households in each village, for both treatment and matched-pair comparison villages. Results: Comparison of baseline and endline data indicated increases in the variety of fruits and vegetables produced and consumed by SMG womens groups compared to other groups. The proportion of SMG women’s group households engaged in vegetable and fruit production significantly increased by 26% and 55%, respectively (P < .05). After controlling for baseline values, SMG womens groups were 3 times more likely to increase their fruit and vegetable consumption compared with comparison non-womens groups (P < .05). In addition, the percentage change in corn, sorghum, beans, oil, rice and fish purchased was significantly greater in the SMG women’s groups compared to other groups. At endline, 57% of the women used their additional income on food, 54% on health care, and 25% on education. Conclusions: Solar Market Gardens have the potential to improve household nutritional status through direct consumption and increased income to make economic decisions.

Prevalence of anaemia, deficiencies of iron and Vitamin A and their determinants in rural women and young children: A cross-sectional study in Kalalé district of northern Benin

OBJECTIVE To identify the magnitude of anaemia and deficiencies of Fe (ID) and vitamin A (VAD) and their associated factors among rural women and children. DESIGN Cross-sectional, comprising a household, health and nutrition survey and determination of Hb, biochemical (serum concentrations of ferritin, retinol, C-reactive protein and α1-acid glycoprotein) and anthropometric parameters. Multivariate logistic regression examined associations of various factors with anaemia and micronutrient deficiencies. SETTING Kalalé district, northern Benin. SUBJECTS Mother-child pairs (n 767): non-pregnant women of reproductive age (15-49 years) and children 6-59 months old. RESULTS In women, the overall prevalence of anaemia, ID, Fe-deficiency anaemia (IDA) and VAD was 47·7, 18·3, 11·3 and 17·7 %, respectively. A similar pattern for anaemia (82·4 %), ID (23·6 %) and IDA (21·2 %) was observed among children, while VAD was greater at 33·6 %. Greater risk of anaemia, ID and VAD was found for low maternal education, maternal farming activity, maternal health status, low food diversity, lack of fruits and vegetables consumption, low protein foods consumption, high infection, anthropometric deficits, large family size, poor sanitary conditions and low socio-economic status. Strong differences were also observed by ethnicity, womens group participation and source of information. Finally, age had a significant effect in children, with those aged 6-23 months having the highest risk for anaemia and those aged 12-23 months at risk for ID and IDA. CONCLUSIONS Anaemia, ID and VAD were high among rural women and their children in northern Benin, although ID accounted for a small proportion of anaemia. Multicentre studies in various parts of the country are needed to substantiate the present results, so that appropriate and beneficial strategies for micronutrient supplementation and interventions to improve food diversity and quality can be planned.

Association Between Women’s Empowerment and Maternal and Child Nutrition in Kalalé District of Northern Benin:

Background: Evidence on effectiveness of women’s empowerment (WE) to reduce undernutrition is limited in sub-Sahara Africa, and few studies incorporate multidimensional measures of WE. Objective: To examine whether a WE status, in sum and across leadership, decision-making, mobility, economic security, male involvement in housework, and nonfamily group domains, is associated with women and their children nutritional status in Kalalé district of northern Benin. Methods: Data were obtained from the 2014 Solar Market Garden baseline study: 767 paired reproductive-age women aged 15 to 49 years and children 6 to 59 months old. Exploratory principal component (cross-validate with confirmatory) factor analysis was first conducted to identify the structure of empowerment. Then, using a new survey-based index, regression analysis was conducted to examine associations between WE measures and maternal dietary diversity score (DDS) and body mass index (BMI), as well as their child’s DDS, height-for-age z score (HAZ), weight-for-height z score (WHZ), and weight-for-age z score (WAZ). Results: Positive associations were observed between women’s composite empowerment, leadership, maternal DDS and BMI, and female child’s DDS. However, opposite signs were found between economic security and child’s DDS. Mobility was positively associated with female children’s WHZ and male children’s HAZ and WAZ, while decision-making was correlated with male child’s WHZ and female children’s WAZ. Conclusions: Women’s empowerment can be associated with undernutrition. Efforts to improve nutrition may benefit from empowerment initiatives that promote women’s self-confidence and decision-making in Benin. However, additional qualitative and longitudinal research may enhance understanding of WE in the present area.

Emergency transportation interventions for reducing adverse pregnancy outcomes in low- and middle-income countries: a systematic review protocol

BackgroundTransportation interventions seek to decrease delay in reaching a health facility for emergency obstetric care and are, thus, believed to contribute to reductions in such adverse pregnancy and childbirth outcomes as maternal deaths, stillbirths, and neonatal mortality in low- and middle-income countries (LMICs). However, there is limited empirical evidence to support this hypothesis. The objective of the proposed review is to summarize and critically appraise evidence regarding the effect of emergency transportation interventions on outcomes of labor and delivery in LMICs.MethodsThe following databases will be searched from inception to March 31, 2018: MEDLINE/PubMed, EMBASE, Web of Science, EBSCO (PsycINFO and CINAHL), the Cochrane Pregnancy and Child Birth Group’s Specialized Register, and the Cochrane Central Register of Controlled Trials. We will search for studies in the grey literature through Google and Google Scholar. We will solicit unpublished reports from such relevant agencies as United Nations Fund for Population Activities (UNFPA), the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United States Agency for International Development (USAID), and the United Kingdom Department for International Development (DfID) among others. Data generated from the search will be managed using Endnote Version 7. We will perform quantitative data synthesis if studies are homogenous in characteristics and provide adequate outcome data for meta-analysis. Otherwise, data will be synthesized, using the narrative synthesis approach.DiscussionAmong the many barriers that women in LMICs face in accessing life-saving interventions during labor and delivery, lack of access to emergency transportation is particularly important. This review will provide a critical summary of evidence regarding the impact of transportation interventions on outcomes of pregnancy and childbirth in LMICs.Systematic review registrationPROSPERO CRD42017080092

Measuring Women's Empowerment in Sub-Saharan Africa: Exploratory and Confirmatory Factor Analyses of the Demographic and Health Surveys

Background: Womens status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on womens empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA. Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize womens empowerment. Pooled data from all countries were randomly divided into two datasets—one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)—to verify the factor structure hypothesized during EFA. Results: Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define womens empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of womens empowerment. Conclusion: This foremost study advances scholarship on womens empowerment by providing a validated measure of womens empowerment for researchers and other stakeholders in health and development.

Impacts of Double Up SNAP Farmers’ Market Incentive Program on Fruit and Vegetable Access, Purchase and Consumption

Citation: Alaofè H, Freed N, Jones K, Plano A, Taren D (2017) Impacts of Double Up SNAP Farmers’ Market Incentive Program on Fruit and Vegetable Access, Purchase and Consumption. J Nutr Health Sci 4(3): 304. doi: 10.15744/2393-9060.4.304 Volume 4 | Issue 3 Journal of Nutrition and Health Sciences

Community Health Workers in Diabetes Prevention and Management in Developing Countries

BACKGROUND There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs. METHODS To identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Groups Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017. FINDINGS Ten studies were included (4 pre- and post-studies, 2 randomized controlled trials, 2 cohort studies, 1 cross-sectional study, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of social support through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes. CONCLUSIONS CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time.