RESUMO
BACKGROUND: Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. OBJECTIVE: To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. METHODS: Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. RESULTS: Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. CONCLUSIONS: To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.
Assuntos
Anemia Ferropriva/tratamento farmacológico , Suplementos Nutricionais , Micronutrientes/administração & dosagem , Micronutrientes/economia , Distúrbios Nutricionais/tratamento farmacológico , Estado Nutricional , Adolescente , Adulto , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Criança , Pré-Escolar , Análise Custo-Benefício , Dieta/normas , Feminino , Alimentos Fortificados , Humanos , Lactente , Recém-Nascido , Masculino , Micronutrientes/deficiência , Distúrbios Nutricionais/epidemiologia , Distúrbios Nutricionais/prevenção & controle , Cooperação do Paciente , Peru/epidemiologia , Pobreza , Fatores de Risco , Resultado do Tratamento , População UrbanaRESUMO
BACKGROUND: The Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) implemented a campaign to promote weekly multimicronutrient supplementation among women and adolescent girls of childbearing age and children under 5 years of age. OBJECTIVES: To assess the impact of the campaign on the growth of children and on anemia among children and among women and adolescent girls of childbearing age. METHODS: Weekly multimicronutrient supplementation was provided for 8 weeks. Weights, heights, and hemoglobin concentrations were assessed at the beginning and end of the campaign. RESULTS AND CONCLUSIONS: Although supplementation did not significantly increase the hemoglobin concentrations of children (p = .80) or women and adolescent girls (p = .65) in the intervention group, the hemoglobin concentrations of the comparison groups were significantly lower after 8 weeks (p = .001 for children and p = .03 for women and adolescent girls). Furthermore, the percentage of anemic children in the comparison group increased significantly (p <.001), and the final value was significantly higher than that for the intervention group (p = .004). There were no significant effects of weekly multimicronutrient supplementation on the growth of children, but the study was too short to reliably determine any effects on growth.