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To identify determinants of egg consumption in infants and young children aged 6–23·9 months in Ethiopia.
Design and setting:
Data used were from the cross-sectional baseline survey of an egg campaign in Ethiopia implemented by the Global Alliance for Improved Nutrition.
Children aged 6–23·9 months (n 453) were sampled. Data on socio-demographic characteristics, economic resources, caregiver’s behaviour, child health and feeding practices, and egg consumption in the last 7 d were collected using interviewer-administered questionnaires. Multivariable ordinal logistic regression was used to examine the association between explanatory variables and egg consumption in the last 7 d.
About half of children (53·4 %) did not consume eggs in the last 7 d. The odds of children consuming eggs were 4·33 (P < 0·002) times higher when their caregivers had some college education compared with no education. Wealth was positively (OR, 1·13, P = 0·029) and household food insecurity was negatively (OR, 0·96, P = 0·117) associated with child egg consumption. Purchasing eggs (OR, 9·73, P < 0·001) and caregiver’s positive behavioural determinants (OR, 1·37, P = 0·005) were associated with child egg consumption. The associations of socio-demographic characteristics and economic resources with egg consumption provide evidence of partial mediation through caregiver behaviour and child health.
About half of children aged 6–23·9 months consumed eggs. Availability of eggs in households, mainly through purchase, was strongly associated with egg consumption. Education of caregivers and household heads and economic resources were associated with egg consumption and may operate through caregiver behaviour.
We estimated the cost-effectiveness of home fortification with micronutrient powder delivered in a sales-based programme in reducing the prevalence of Fe deficiency anaemia among children 6–59 months in Bangladesh.
Cross-sectional interviews with local and central-level programme staff and document reviews were conducted. Using an activity-based costing approach, we estimated start-up and implementation costs of the programme. The incremental cost per anaemia case averted and disability-adjusted life years (DALY) averted were estimated by comparing the home fortification programme and no intervention scenarios.
The home fortification programme was implemented in 164 upazilas (sub-districts) in Bangladesh.
Caregivers of child 6–59 months and BRAC staff members including community health workers were the participants for this study.
The home fortification programme had an estimated total start-up cost of 35·46 million BDT (456 thousand USD) and implementation cost of 1111·63 million BDT (14·12 million USD). The incremental cost per Fe deficiency anaemia case averted and per DALY averted was estimated to be 1749 BDT (22·2 USD) and 12 558 BDT (159·3 USD), respectively. Considering per capita gross domestic product (1516·5 USD) as the cost-effectiveness threshold, the home fortification programme was highly cost-effective. The programme coverage and costs for nutritional counselling of the beneficiary were influential parameters for cost per DALY averted in the one-way sensitivity analysis.
The market-based home fortification programme was a highly cost-effective mechanism for delivering micronutrients to a large number of children in Bangladesh. The policymakers should consider funding and sustaining large-scale sales-based micronutrient home fortification efforts assuming the clear population-level need and potential to benefit persists.
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