Food-for-work programs in Indonesia had a limited effect on anemia

Area of Science:

• Public Health
• Nutrition Science
• Development Economics

Background:

• Indonesia faced an economic crisis in the late 1990s, leading to reduced consumption of nutrient-rich foods and increased micronutrient deficiencies, notably anemia.
• Nongovernmental organizations (NGOs) initiated Food for Work (FFW) programs to mitigate these effects by providing staple foods like rice, oil, and beans.

Purpose of the Study:

• To evaluate the impact of FFW programs on nutritional outcomes, specifically anemia prevalence, in postcrisis Indonesia.
• To identify factors influencing anemia and nutritional status among beneficiary and control households.

Main Methods:

• A quasi-experimental design was employed, involving 1500 beneficiary and 1500 control households randomly selected across 3 urban and 2 rural sites.
• Data collection occurred at baseline and approximately every 6 months for 2.5 years to track nutritional status and socioeconomic factors.
• Analysis included assessing anemia prevalence, household debt, and other risk factors like nutritional status and socioeconomic indicators.

Main Results:

• FFW programs successfully targeted impoverished households, with participation durations ranging from 4 to 18 months.
• A significant reduction in the odds of anemia was observed only among urban poor mothers in Surabaya (OR 0.60, 95% CI [0.40-0.89]).
• Maternal education, baseline anemia, low BMI, vitamin A supplementation, and child age were significant risk factors for anemia.

Conclusions:

• Postcrisis FFW programs demonstrated a limited overall effect on reducing anemia, the primary nutritional concern.
• Enhancing FFW programs necessitates improvements in food aid quality and quantity, alongside complementary non-food interventions.
• Direct interventions, such as micronutrient supplements and fortified foods, are crucial for addressing micronutrient deficiencies effectively.