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other·public health, nutrition, pediatrics, micronutrients, epidemiology·PMC10257226

Design, Methods, and Select Baseline Results from a School Nutrition Project for Adolescents in Bangladesh

Current Developments in Nutrition · 10 authors, 6 centres

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The study presents the design and baseline results for the School Nutrition for Adolescents Project (SNAP), an integrated intervention in 65 schools in Bangladesh.

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The study presents the design and baseline results for the School Nutrition for Adolescents Project (SNAP), an integrated intervention in 65 schools in Bangladesh. Baseline findings revealed low awareness of anemia and interventions among adolescents, with only 4% of girls taking iron-folic acid supplements in the last month. Micronutrient analysis showed 25% anemia prevalence and 76% red blood cell folate insufficiency. Menstrual hygiene challenges were evident, with 35% of girls missing school during menstruation. School WASH indicators were poor, with only 3% achieving basic hygiene service. Implications are that the planned classroom sessions, supplementation, and WASH/MHM support are needed to improve adolescent health outcomes.

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public health

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ORIGINAL PAPER

PMC10257226

Design, Methods, and Select Baseline Results from a School Nutrition Project for Adolescents in Bangladesh

Current Developments in Nutrition

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ABSTRACT

Abstract Background The School Nutrition for Adolescents Project (SNAP) provided weekly iron and folic acid (WIFA) supplementation and menstrual hygiene management (MHM) support for girls; actions to improve water, sanitation, and hygiene (WASH) practices; and behavior change interventions to adolescents aged 10–19 y in 65 intervention schools in 2 districts of Bangladesh. Objectives We aimed to describe the project design and select baseline results of students and school project implementers. Methods Girls (n = 2244) and boys (n = 773) in 74 schools (clusters) and project implementers [headteachers (n = 74), teachers (n = 96), and student leaders (n = 91)] participated in a survey assessing nutrition, MHM, and WASH knowledge and experience. Hemoglobin, inflammation-adjusted ferritin, retinol-binding protein, and serum and RBC folate (RBCF) levels in girls were measured. School WASH infrastructure was observed and drinking water was tested for E. coli . Results IFA and deworming tablet intake in the last 1 and 6 mo were 4% and 81% for girls and 1% and 86%, respectively. Applying the Minimum Dietary Diversity for Women (MDD-W) tool, most (63%–68%) girls and boys achieved minimum dietary diversity. Fewer adolescents (14%–52%) had ever heard of anemia, IFA tablets, or worm infestation than project implementers (47%–100%). Girls (35%) missed school during menstruation; 39% reported of ever leaving school due to unexpected menstruation. The micronutrient status and deficiency severity varied: anemia (25%), RBCF insufficiency (76%), risk of serum folate deficiency (10%), deficiencies of iron (9%), and vitamin A (3%). WASH in school sustainable development goal (SDG) indicators achievement varied: basic drinking water service (70%), basic sanitation service (42%), and basic hygiene service (3%); 59% of sampled drinking water access points complied with WHO E. coli standards. Conclusions There is room for improvement of nutrition and health awareness, practices, micronutrient status, SDG basic WASH in-school services, and E coli contamination in school drinking water. This trial was registered in clinicaltrials.gov as NCT05455073 . Keywords: Bangladesh, adolescent, anemia, micronutrient status, school nutrition intervention, water, sanitation, hygiene

CITATION EXPORT

Maku E Demuyakor, Chowdhury Jalal, Anne M Williams et al.. Design, Methods, and Select Baseline Results from a School Nutrition Project for Adolescents in Bangladesh. Current Developments in Nutrition. (2023). https://doi.org/10.1016/j.cdnut.2023.100070

AUTHORS

10 · 6 CENTRES

Maku E Demuyakor, Chowdhury Jalal, Anne M Williams, Kimberley P Bouckaert, Ralph D Whitehead, Muhammad M Bhuiyan, Saiqa Siraj, Riffat Ara, Vanessa Pike, Maria Elena D Jefferds

1Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
2McKing Consulting Corporation, Atlanta, GA, United States
3Nutrition International, Ottawa, Ontario, Canada
4Nutrition International, Gulshan 1, Dhaka, Bangladesh
5Centre for Qualitative Research, Ibrahimpur, Dhaka, Bangladesh
6BRAC Health, Nutrition and Population Program, Mohakhali BRAC Center, Dhaka, Bangladesh