Evaluation of the Impact of a Food-Based Approach to Solving Vitamin A Deficiency in Bangladesh

Abstract

The impact of the third year (March 1992-March 1993) of a World view International Foundation project to increase the production and consumption of high-carotene foods in Gaibandah district, Bangladesh, was evaluated. The mothers of more than 2,500 children age one to six years, representative of Gaibandah, were interviewed at one-year intervals and compared with a similar sample in a geographically adjacent non-project area of equal size. A 24-hour recall was done regarding green leafy vegetables, yellow fruits and vegetables, oil-rich foods, and non-carotene-rich vegetables. This project was multidimensional and was based on community participation. It used women volunteers, health assistants, and schools to spread knowledge, skills, and encouragement for growing carotene-rich foods and feeding them to young children. Modern and traditional mass media reinforced the messages. Seeds for mainly local varieties of high-carotene foods were distributed free or in certain cases sold by a network of trained women volunteers. Knowledge of the problem and its causes increased in response to the communications. Home production of the targeted high-carotene foods increased remarkably in both the project and the non-project areas. Consumption patterns changed markedly but predictably toward more expensive foods during the study year due to an unprecedented drop in the price of rice. Children's consumption of all but the non-carotene rich vegetables increased significantly in Gaibandah. In the nonproject area, consumption of yellow fruits and vegetables increased as much as in Gaibandah, oil-rich foods less than in Gaibandah, and non-carotene-rich vegetables much more than in Gaibandah. However, consumption of green leafy vegetables decreased significantly in the non-project area and increased significantly in Gaibandah. In March 1993,26 % and 52 % of children, respectively, had eaten green leafy vegetables the day before the interview.