Enhanced iron‐folic acid supplementation program reduces risk of under 5 mortality in Nepal (636.2)

Abstract

Objective To investigate the impact of a program to improve coverage of antenatal IFA supplementation on child survival in Nepal using pooled data from 3 Nepal DHS (2001, 2006 and 2011).Methods Survival information from 13,009 singleton most recent live‐born infants within the 5 years prior to each interview was used. The primary outcomes were mortality indicators for under‐5 children and the main exposure variable was implementation of enhanced IFA program. Multivariate Cox proportional hazards regression analyses was conducted and adjusted for X potential confounders and the sampling design.Results After the implementation of enhanced IFA program, early neonatal mortality was significantly reduced by 53% (aHR: 0.47, 95% CI 0.26, 0.84, p=0.012) compared to before the program started. The risk of infant mortality was significantly reduced by 49% (aHR: 0.51, 95% CI 0.31, 0.82, p=0.006), and by 38% (aHR: 0.62, 95% CI 0.39, 0.99, p=0.043) for under‐5 mortality after implementation of the enhanced program.Conclusion A program to improve IFA coverage significantly reduced the risk of under‐5 deaths in Nepal by nearly 40%. The greatest magnitude of risk reduction was for early neonatal deaths.