scholarly journals Improved Effect of School Meals with Micronutrient Supplementation and Deworming

2005 ◽  
Vol 26 (2_suppl2) ◽  
pp. S220-S229 ◽  
Author(s):  
Tara Gopaldas
Keyword(s):  
Vitamin A ◽  
Tamil Nadu ◽  
Vitamin A Deficiency ◽  
Parasite Prevalence ◽  
Micronutrient Supplementation ◽  
School Year ◽  
The Sixties ◽  
Health Inputs ◽  
The Government ◽  
The Cost

A mid-day meal or school lunch program commenced in Gujarat, India from the sixties. In 1994, it was serving approximately 3 million schoolchildren. In 1994, the program was improved with the addition of a “package” of health inputs, including anthelmintics and micronutrient supplementation of iron and vitamin A, and iodine fortified salt. Tara Consultancy Services (TCS), India, a member of the Partnership of Child Development, Oxford University, evaluated Gujarat's improved midday meal program from 1993 to 1996. The program was implemented by the Commissionerate of the mid-day meal program, part of the government of Gujarat. The cost of the 'health package' in 1994, per child per year was 35 US cents (1 US $ = Rs.30). The study to evaluate the improved program included the following components: Focus group discussions Government officials, teachers, students, parents, and community members participated in focus groups to elicit opinions on the proposed program which were predominantly positive. Process evaluation Logistical delivery defined as the adequacy, timeliness and cost of procurement of the anthelmintic drugs and micronutrients and the cost of this 'health package' per schooler per school year by the pharmaceutical companies was 100%. Efficiency of logistics to the schools, defined as the efficiency and cost of logistical delivery of the 'Health Package', from the State Head Quarters to the District to the Taluka to the School was 100%. Coverage defined as consumption of the 'Health Package' by schooler at least once in the 6–9 months of the school year, as stated by the implementing agency was 94%–100% (urban) and 42%–94% (rural); coverage as stated by the schoolchildren was 71%–79% (urban) and 50%–67% (rural). Impact evaluation On average, students who received supplements were 1.1 kg heavier and 1.1 cm taller than those who did not; hemoglobin (Hb) levels were > 12 g/dL intestinal parasite prevalence rates dropped from 71% to 39%; prevalence of night blindness and vitamin A deficiency were reduced from 67% to 34%. Lesson learned Since 2003, 4 states in India, namely, Gujarat, Andhra Pradesh, Karnataka, and Tamil Nadu covering approximately 30 million schoolers have adopted the “Gujarat Model.”

scholarly journals Micronutrient Status and Intervention Programs in Malaysia

2005 ◽  
Vol 26 (2_suppl2) ◽  
pp. S281-S285 ◽  
Author(s):  
Geok Lin Khor
Keyword(s):  
Vitamin A ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Vitamin A Deficiency ◽  
Nutrition Transition ◽  
Nutrition Intervention ◽  
Deficiency Anemia ◽  
Government Sector ◽  
Micronutrient Status ◽  
The Government

Approximately 70% of the world's malnourished children live in Asia, giving that region the highest concentration of childhood malnutrition worldwide. Prevalence of stunting and underweight are high especially in south Asia where one in every two preschool children is stunted. Iron-deficiency anemia affects 40%–50% of preschool and primary schoolchildren. Nearly half of all vitamin A deficiency and xerophthalmia in the world occurs in south and southeast Asia. Iodine deficiency disorders have resulted in high goiter rates in India, Pakistan, and parts of Indonesia. Compared with other developing countries in Asia, the nutrition situation in Malaysia is considerably better, owing to rapid economic and socioeconomic development that has occurred since Malaysia gained its independence in 1957. Prevalence of undernutrition and micronutrient deficiency is markedly lower in Malaysian children. Nonetheless, undernutrition in the form of underweight, stunting, and anemia can be found in poor communities throughout the country. A prevalence of 25% underweight and 35% stunting is reported among young children from poor rural households. Anemia and subclinical forms of vitamin A deficiency were reported in children under 5 years old. Typical of a country in nutrition transition, Malaysia faces the dual burden of malnutrition in children, with the persistence of undernutrition problems especially among the poor and the emerging overweight problem especially in urban areas. Since 1996, nutrition programs of the government sector are coordinated under the National Plan of Action for Nutrition. These activities and other nutrition intervention efforts by other agencies are discussed in this paper.

scholarly journals Reducing micronutrient deficiencies in Pakistani children: are subsidies on fortified complementary foods cost-effective?

2018 ◽  
Vol 21 (15) ◽  
pp. 2893-2906 ◽  
Author(s):  
Simon Wieser ◽  
Beatrice Brunner ◽  
Christina Tzogiou ◽  
Rafael Plessow ◽  
Michael B Zimmermann ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Iron Deficiency ◽  
Vitamin A ◽  
Iodine Deficiency ◽  
Iron Deficiency Anaemia ◽  
Vitamin A Deficiency ◽  
Cost Effective ◽  
Micronutrient Deficiencies ◽  
Deficiency Anaemia ◽  
The Cost

AbstractObjectiveTo estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children.DesignThe study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by comparing the net social cost of price subsidies with the disability-adjusted life years (DALY) averted.SettingDistricts of Faisalabad and Hyderabad in Pakistan.SubjectsHouseholds with 6–23-month-old children stratified by socio-economic strata.ResultsThe lifetime social costs of iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in 6–23-month-old children amounted to production losses of $US 209 million and 175 000 DALY. Poor households incurred the highest costs, yet even wealthier households suffered substantial losses. Wealthier households were more likely to buy FPCF. The net cost per DALY of the interventions ranged from a return per DALY averted of $US 783 to $US 65. Interventions targeted at poorer households were most cost-effective.ConclusionsPrice subsidies on FPCF might be a cost-effective way to reduce the societal costs of micronutrient deficiencies in 6–23-month-old children in Pakistan. Interventions targeting poorer households are especially cost-effective.

scholarly journals An economic evaluation of implementing a decentralized dengue screening intervention under the National Vector Borne Disease Control Programme in Tamil Nadu, South India

2021 ◽  
Author(s):  
Malaisamy Muniyandi ◽  
Nagarajan Karikalan ◽  
Karunya Ravi ◽  
Senthilkumar Sengodan ◽  
Rajendran Krishnan ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Tamil Nadu ◽  
Screening Strategy ◽  
Early Screening ◽  
Current Strategy ◽  
Life Years ◽  
The Government ◽  
The Cost

Abstract Background Lack of effective early screening is a major obstacle for reducing the fatality rate and disease burden of dengue. In light of this, the government of Tamil Nadu has adopted a decentralized dengue screening strategy at the primary healthcare (PHC) facilities using blood platelet count. Our objective was to determine the cost-effectiveness of a decentralized screening strategy for dengue at PHC facilities compared with the current strategy at the tertiary health facility (THC) level. Methods Decision tree analysis followed a hypothetical cohort of 1000 suspected dengue cases entering the model. The cost-effectiveness analysis was performed at a 3% discount rate for the proposed and current strategy. The outcomes are expressed in incremental cost-effectiveness ratios (ICERs) per quality-adjusted life years gained. One-way sensitivity analysis and probabilistic sensitivity analysis were done to check the uncertainty in the outcome. Results The proposed strategy was found to be cost-saving and ICER was estimated to be −41 197. PSA showed that the proposed strategy had a 0.84 probability of being an economically dominant strategy. Conclusions The proposed strategy is cost-saving, however, it is recommended to consider optimal population coverage, costs to economic human resources and collateral benefits of equipment.

scholarly journals Intensive monitoring and interpersonal counselling by lady health worker improves the coverage of vitamin A among children between ages 6 and 59 months in selected low performing provinces of Pakistan

2018 ◽  
Vol 5 (7) ◽  
pp. 2952
Author(s):  
Tausif Akhtar Janjua ◽  
Khalid Nawaz ◽  
Deepika Nayar Chaudhery ◽  
S. Kaushik ◽  
Manoj Kumar Raut
Keyword(s):  
Vitamin A ◽  
Health Worker ◽  
Vitamin A Deficiency ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Absolute Increase ◽  
Frontline Workers ◽  
Intensive Monitoring ◽  
Lady Health Worker ◽  
The Government

Background: Nutrition International, previously known as Micronutrient Initiative, has been supporting the government of Pakistan to address vitamin A deficiency in 24 districts of Balochistan and Khyber Pakhtunkhwa and 78 union councils of Lahore and Karachi. The program aims to improve capacity of health managers and frontline workers on supply chain management and monitoring; monitoring of stock-outs at health facilities and frontline distribution points; and focus on regular monitoring and supervision through EPI and health departments. Challenge however remains in achieving meaningful coverage. The Nutrition International piloted an intensive monitoring strategy in a sub-set of four districts of Balochistan and KPK and 14 union councils in Karachi and Lahore with an aim to improve coverage of vitamin A. The study assessed the changes in coverage of vitamin A supplementation 2011 to 2012 due to the intensive monitoring.Methods: Two rounds of repeated cross-sectional mixed-methods surveys were conducted on a sample of 2,579 and 2,580 caregivers during baseline and end-line respectively. Low performing districts identified in each of the four provinces constituted the study domain. The sample of households in each region was selected using a two stage cluster sampling strategy.Results: The coverage of Vitamin A registered an absolute increase of 35.7 percent points in the intensive monitoring districts compared to the other districts, where it was 29.6 percent points in the end-line over the baseline.Conclusions: It was observed that intensive monitoring and interpersonal counselling by lady health worker is instrumental in improving the coverage of Vitamin A in certain programmatic settings in Pakistan. 

Quantification of Vitamin A in Fortified Rapeseed, Groundnut and Soya Oils Using a Simple Portable Device: Comparison to High Performance Liquid Chromatography

2013 ◽  
Vol 83 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Cécile Renaud ◽  
Jacques Berger ◽  
Arnaud Laillou ◽  
Sylvie Avallone
Keyword(s):  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Vitamin A ◽  
High Performance ◽  
Vitamin A Deficiency ◽  
Developed Countries ◽  
Portable Device ◽  
Least Developed Countries ◽  
Control Food ◽  
Assay Precision

Vitamin A deficiency is still one of the major public health problems in least developed countries. Fortification of vegetable oils is a strategy implemented worldwide to prevent this deficiency. For a fortification program to be effective, regular monitoring is necessary to control food quality in the producing units. The reference methods for vitamin A quantification are expensive and time-consuming. A rapid method should be useful for regular assessment of vitamin A in the oil industry. A portable device was compared to high-performance liquid chromatography (HPLC) for three plant oils (rapeseed, groundnut, and soya). The device presented a good linearity from 3 to 30 mg retinol equivalents per kg (mg RE.kg- 1). Its limits of detection and quantification were 3 mg RE.kg- 1 for groundnut and rapeseed oils and 4 mg RE.kg- 1 for soya oil. The intra-assay precision ranged from 1.48 % to 3.98 %, considered satisfactory. Accuracy estimated by the root mean squares error ranged from 3.99 to 5.49 and revealed a lower precision than HPLC (0.4 to 2.25). Although it offers less precision than HPLC, the device estimates quickly the vitamin A content of the tested oils from 3 or 4 to 15 mg RE.kg- 1.

Research Recommendations for Applying Vitamin A-Labelled Isotope Dilution Techniques to Improve Human Vitamin A Nutrition

2014 ◽  
Vol 84 (Supplement 1) ◽  
pp. 52-59 ◽  
Author(s):  
Sherry A. Tanumihardjo ◽  
Anura V. Kurpad ◽  
Janet R. Hunt
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Human Subjects ◽  
The Body ◽  
Pool Size ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Status Assessment ◽  
Total Body

The current use of serum retinol concentrations as a measurement of subclinical vitamin A deficiency is unsatisfactory for many reasons. The best technique available for vitamin A status assessment in humans is the measurement of total body pool size. Pool size is measured by the administration of retinol labelled with stable isotopes of carbon or hydrogen that are safe for human subjects, with subsequent measurement of the dilution of the labelled retinol within the body pool. However, the isotope techniques are time-consuming, technically challenging, and relatively expensive. There is also a need to assess different types of tracers and doses, and to establish clear guidelines for the use and interpretation of this method in different populations. Field-friendly improvements are desirable to encourage the application of this technique in developing countries where the need is greatest for monitoring the risk of vitamin A deficiency, the effectiveness of public health interventions, and the potential of hypervitaminosis due to combined supplement and fortification programs. These techniques should be applied to validate other less technical methods of assessing vitamin A deficiency. Another area of public health relevance for this technique is to understand the bioconversion of β-carotene to vitamin A, and its relation to existing vitamin A status, for future dietary diversification programs.

Vitamin A deficiency is associated with disease severity in patients with liver cirrhosis

2020 ◽  
Author(s):  
M Nagel ◽  
C Labenz ◽  
M Nguyen-Tat ◽  
N Cabezas Wallscheid ◽  
C Czauderna ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Vitamin A ◽  
Disease Severity ◽  
Vitamin A Deficiency

ANALISIS BIAYA KUALITAS DAN PRODUKTIVITAS PADA MAHASISIWA UNIVERSITAS ISLAM 45

2018 ◽  
Vol 9 (2) ◽  
pp. 234-257
Author(s):  
Anisa Putri
Keyword(s):  
Secondary Data ◽  
Total Quality ◽  
Quality Cost ◽  
Productivity Costs ◽  
School Year ◽  
Quality Costs ◽  
Qualitative Descriptive ◽  
The Cost ◽  
New Student ◽  
Academic Year

The aim to be achieved in this study is to analyze the quality and productivity costs of case studies at the Islamic University of 45 Bekasi. The research method used in this study is a qualitative descriptive method. The location of the study was conducted at the Islamic University of 45 Bekasi. The data used is secondary data from the financial statements of Islamic University of 45 Bekasi in the academic year 2013/2014. Methods of data collection using interviews and observation. The highest quality cost discussion results are prevention costs at the cost of seminars and training for lecturers as much as Rp. 450,561,400, -. The lowest quality cost is the assessment fee at the cost of lecturer accreditation of Rp. 1,925,000, -. The percentage of quality costs is 2.1% smaller than the fairness of the total quality costs of 2.5%. The realization of the output of new student admissions was obtained in the 2013/2014 school year as many as 1,339 people. Total students 6,364 people. The study period is more than 4 years and has not graduated as many as 992 people. Failure costs as much as 16% of total students. Realization of financial output was achieved in the amount of Rp. 39,384,232,556, - ​​Input Rp. 35,606,307,800, - used to obtain output. Company productivity is efficient because output is greater than input. Company productivity is effective because the company achieves financial goals by obtaining a surplus of Rp. 3,777,924,756, - The conclusion that can be drawn is that quality costs are able to obtain output in the form of income exceeding its input value so that productivity is efficient and effective and surplus.

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