Problem

Despite China’s rapid growth, which has been driven by the economies of its coastal provinces, residents in inland provinces are still plagued by poverty. One of the outcomes of this poverty is that up to 50% of school aged children and even higher rates of preschool children suffer from micronutrient deficiencies, including anemia. Our previous work has targeted school-aged and preschool-aged children and shown that interventions of vitamin supplements and school lunch programs reduce anemia rates and raise test scores.

However, we may have missed working with one of the most vulnerable (and important) population groups. Research increasingly indicates the importance of the nutritional programming that occurs in the first two years of life. Nutritional improvements during this brief window have been shown to have large and significant effects on health and development throughout childhood and even into adulthood.

Our proposed project therefore targets infants (aged 6-24 months) and their caregivers in an effort to improve nutritional outcomes in poor communities in rural China.

Goals

The overall goal of our proposed work is to identify simple and sustainable ways of improving infant nutrition in rural China. Our project will create an infrastructure through which caregivers and local health care clinics can provide ongoing education and nutritional supplements to reduce and prevent anemia in their communities. Finally, we will present the project’s feasibility and results to key policymakers capable of funding and promoting the most effective solutions.

Approach

Our proposed project builds on a pilot that was rolled out in 2010 by the China Development Research Foundation (CDRF) and is composed of two parts:

a.) An educational intervention aimed at caregivers of infants (both mothers and grandmothers) and local clinicians (former barefoot doctors);

b.) A nutritional supplement program aimed at the infants themselves.

In the first part of our proposed project, we will work to identify the most effective way of educating caregivers about anemia. We hope to answer two primary research questions with this project: (1) Which individuals are the most receptive to nutritional training? (2) What is the best means of communicating with caregivers in remote rural areas?

In the second part of the project, we will work with local health centers and their network of village clinicians to provide nutritional supplements to infants in the form of vitamin and mineral “sprinkles” that can be mixed in with their breakfast porridge and/or infant formula each morning. Although our supplements will be provided free of charge, the results from this project will be used to establish a baseline for future work in which we will charge parents for the supplements to see if it is possible to sustain the program without subsidies or with lower rates of subsidies.

Evaluation

The project will quantitatively evaluate individual project components including training, follow-up, and nutritional supplementation to gather evidence on how well certain approaches work and at what cost. We will be administering pre-­ and post-­intervention tests of developmental progress, responsiveness, health, and other aspects. We will have a control group against which we can compare the impact of our proposed program, thus allowing us to evaluate the real-­life effect of our efforts to reduce and prevent early childhood anemia in rural China.

Results

This project is classified as on-going.