Fighting anaemia and malnutrition in Hebron (Palestine): impact evaluation of a humanitarian project
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Michele Magoni1, Muhammed Jaber, Redaelli Piera
1Terre des Hommes Italy,Viale Gorizia 13, 25126 Brescia, Italy. magoni@med.unibs.it <magoni@med.unibs.it>
Insights
An emergency project in Palestine significantly reduced childhood anemia by 38% through iron supplementation and improved nutrition. This intervention also decreased malnutrition rates, enhancing children's overall health.
Area of Science:
- Public Health
- Nutrition Science
- Pediatrics
Background:
- Childhood anemia is a significant public health issue, particularly in emergency settings like Palestine.
- The nutritional situation of children in Palestine worsened due to the second intifada, with iron deficiency anemia being a major concern.
Purpose of the Study:
- To evaluate the impact of an emergency intervention project on childhood anemia and malnutrition in the Hebron governorate.
- To assess the effectiveness of universal iron supplementation, disease treatment, food supplementation, and community health education.
Main Methods:
- Two random surveys were conducted: one before and one after the intervention project.
- Data collection included anemia prevalence (hemoglobin levels) and anthropometric indices (weight-for-age, weight-for-height).
- Intervention involved universal iron supplementation for 12,300 children and targeted support for 3,275 anemic/malnourished children.
Main Results:
- Anemia prevalence decreased by 38%, from 30.1% to 18.8% (p=0.001).
- Significant reductions in anemia were observed in areas with previous prevention activities and where iron supplementation was provided.
- Low weight-for-age declined from 10.9% to 3.8% (p=0.0006), and low weight-for-height decreased from 6.0% to 1.4% (p=0.0025).
Conclusions:
- The emergency intervention project was effective in reducing childhood anemia and malnutrition in the Hebron governorate.
- Iron supplementation and integrated health programs are crucial for improving child health in crisis-affected populations.
- Simple epidemiological tools can effectively measure the impact of public health interventions.
Abstract:
Iron supplementation in children is recommended by WHO when prevalence of anaemia is above 40%. In Palestine, due to the emergency situation caused by the outburst of the second intifada, the nutritional situation of children is worsening and iron deficiency anaemia represent one of the most serious problem. An emergency project which included universal iron supplementation (for 12,300 children), free treatment for common diseases and food supplementation to vulnerable families (for 3,275 children found anaemic or/and malnourished) and community health education was implemented in part of Hebron governorate. To evaluate project's impact we performed two random surveys: one before and one after the project. Before the project 30.1% of children (CI 95%=24.5-35.6%) were found anaemic (<11 g/dl), while after the prevalence was 18.8% (CI 95%=14.8-22.8%; decrease of 38%, p=0.001). Levels and reduction in anaemia prevalence were different according to geographical areas: where prevention activities had been implemented in previous years, prevalence of anaemia was 17.1% and remained stable at lower levels (14.7%). In other areas it sharply declined from 47.4 to 21.7% (p<0.0005): the declined was present only for children who received iron supplementation. Comparison of anthropometrics index before versus after the project showed that low "weight for age" declined from 10.9 to 3.8% (p=0.0006), low "weight for height" declined from 6.0 to 1.4% after (p=0.0025). With simple epidemiological tools we could demonstrate and measure the effectiveness of our interventions on the health status of the general population: a 50% reduction of anaemia and a 70% reduction of global acute malnutrition.