Abstract
Research demonstrates the importance of nutrition for early brain development. Few studies have examined the effectiveness of multiple micronutrient powders (MNP) on child development. This study examined the impacts of home fortification with MNP on motor and mental development, executive function and memory of children living in Bihar. This two-arm cluster-randomised effectiveness trial selected seventy health sub-centres to receive either MNP and nutrition counselling (intervention) or nutrition counselling alone (control) for 12 months. Front-line health workers delivered the intervention to all households in study communities with a child aged 6-18 months. Data were collected using cross-sectional surveys at baseline and endline by selecting households from intervention (baseline, n 2184; endline, n 2170) and control (baseline, n 2176; endline, n 2122) communities using a two-stage cluster-randomised sampling strategy. Children in the intervention group had a significantly larger improvement from baseline to endline compared with those in the control group on scores for motor and mental development (Cohen's d, motor=0·12; 95 % CI 0·03, 0·22; mental=0·15; 95 % CI 0·06, 0·25). Greater impacts of MNP on motor and mental development were observed in children from households with higher stimulation scores at baseline compared with those with lower stimulation (Cohen's d, motor=0·20 v. 0·09; mental=0·22 v. 0·14; P interaction<0·05). No significant treatment differences were seen for executive function or memory. Home fortification with MNP through the existing health infrastructure in Bihar was effective in improving motor and mental development and should be considered in combination with other child development interventions such as stimulation.
Highlights
Estimates indicate that 250 million children (43 %) under 5 years of age do not fulfil their developmental potential in low- and middle-income countries (LMIC)(1)
micronutrient powders (MNP) have previously been used in India[21,22], to our knowledge no large-scale effectiveness trials have examined the potential impact of such a programme using the existing front-line health workers (FLW) on early child development in this context
* All models account for clustering by health sub-centre and nested Anganwadi Centre
Summary
Estimates indicate that 250 million children (43 %) under 5 years of age do not fulfil their developmental potential in low- and middle-income countries (LMIC)(1). Impact of micronutrients on child development nutrients’ specific functions in synaptic efficiency, myelination and hippocampal development[11], micronutrient interventions may differentially affect specific cognitive functions that are masked in higher-order assessment tools Two such specific processes that underlie early cognitive development[12,13,14] and are hypothesised to be related to nutritional status are executive functions (cognitive processes associated with mental control and self-regulation)(15,16) and memory[17,18,19]. MNP have previously been used in India[21,22], to our knowledge no large-scale effectiveness trials have examined the potential impact of such a programme using the existing front-line health workers (FLW) on early child development in this context
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
