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An adequacy evaluation of a 10-year, four-country nutrition and health programme.


ABSTRACT:

Background

Evaluations of large-scale health and nutrition programmes in developing countries are needed for determining the effectiveness of interventions. This article critically analyses a non-governmental organization (NGO)-led large-scale, multi-country, 10-year micronutrient and health (MICAH) programme with an 'adequacy evaluation', that is, a documentation of time trends in the expected direction.

Methods

MICAH was implemented from 1996 to 2005 in selected areas of Ethiopia, Ghana, Malawi and Tanzania, reaching >6 million people with numerous health and nutrition interventions. Coverage and impact were monitored through surveys at baseline, midpoint and end of funding. The data were subjected to post-hoc methods of quality determination, and, if of suitable quality, included in the adequacy evaluation.

Results

Most collected data were of moderate or high quality and therefore included in the adequacy evaluation. There were moderate to large improvements in vitamin A status in Ethiopian school-age children, children <5 years of age in Tanzania and Ghana and mothers in Ghana. Iodine status improved in Malawi and Tanzania. Anaemia rates and malaria prevalence decreased in women, pregnant women and pre-school children in Ghana, Malawi and Tanzania, but anaemia increased in Ethiopian women. Large increases were reported for rates of exclusive breastfeeding and immunization. Child growth improved to the maximum that would be predicted with the given interventions.

Conclusions

Numerous nutrition and health impacts were observed in the intervention areas, often of a magnitude equal to or larger than observed in controlled interventions or trials. These results show the value of integrated long-term interventions.

SUBMITTER: Berti PR 

PROVIDER: S-EPMC2846447 | biostudies-literature | 2010 Apr

REPOSITORIES: biostudies-literature

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An adequacy evaluation of a 10-year, four-country nutrition and health programme.

Berti Peter R PR   Mildon Alison A   Siekmans Kendra K   Main Barbara B   Macdonald Carolyn C  

International journal of epidemiology 20100303 2


<h4>Background</h4>Evaluations of large-scale health and nutrition programmes in developing countries are needed for determining the effectiveness of interventions. This article critically analyses a non-governmental organization (NGO)-led large-scale, multi-country, 10-year micronutrient and health (MICAH) programme with an 'adequacy evaluation', that is, a documentation of time trends in the expected direction.<h4>Methods</h4>MICAH was implemented from 1996 to 2005 in selected areas of Ethiopi  ...[more]

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