Using new research methodology, researchers in the United States and Tanzania have identified new recommendations for reducing nutritional deficiencies in the East African country.
Brandon McFadden, professor of agricultural and agribusiness economics and the Tyson Endowed Chair in Food Policy Economics for the Arkansas Agricultural Experiment Station, said a key recommendation of the study is that policymakers Politicians and public health officials in Tanzania are focusing on education about zinc deficiency.
“Zinc deficiency is a major health problem worldwide, particularly in developing countries, and a major health consequence is stunted growth in children,” McFadden said.
The study, titled “Knowledge Gaps on Micronutrient Deficiencies in Tanzania and the Effect of Information Interventions,” was published this month in the journal Global Food Security. The study identified gaps in knowledge about micronutrient deficiencies.
Pius Kilasy, co-author of the Tanzanian study, said the study would help his home country address a critical lack of knowledge.
“The results of the study are very important for Tanzania,” Kilasy said. “Understanding and managing the knowledge gap is very important in order to build a strong and stable workforce. »
Kilasy currently works as a research officer for the Tanzania Agricultural Research Institute, an independent institute under the Tanzanian Ministry of Agriculture. He completed his research on micronutrient deficiencies while a master’s student on an exchange program at the University of Delaware. McFadden previously conducted research and taught in Delaware before joining the Arkansas Agricultural Experiment Station in August 2022. The Experiment Station is the research arm of the University’s Division of Agriculture System from Arkansas.
Other co-authors of the study include Kelly Davidson, assistant professor of applied economics, and Leah Palm-Forster, associate professor of applied economics in the Department of Applied Economics and Statistics in the College of Agriculture and Resources Natural Resources from the University of Delaware.
FIND THE GAP
As in many low-income countries, Tanzania experiences widespread micronutrient malnutrition. According to the research article, about 58 percent of children aged 6 to 59 months are anemic in Tanzania. Thirty-four percent have vitamin A deficiency and up to 70 percent of hospitalized children in this age group have zinc deficiency. Similar surveys of women aged 15 to 49 in Tanzania also show high rates of anemia – 45 percent – and vitamin A deficiency – 36 percent.
Anemia is a condition that causes weakness and shortness of breath due to a lack of healthy red blood cells to carry oxygen throughout the body, according to the Mayo Clinic.
In response to these high levels of micronutrient malnutrition, McFadden said the Tanzanian government had developed education and vitamin supplementation strategies, including an emphasis on the use of biofortified foods.
“It’s difficult for vitamin supplementation to cause lasting behavior change,” he said. “If we could increase nutrient levels in staple foods, it might be more effective, especially in rural areas. »
Biofortified staple foods are selectively bred varieties of staple crops rich in specific micronutrients. For example, some varieties of biofortified rice provide high levels of zinc.
McFadden and his co-authors designed a series of survey experiments to uncover gaps in knowledge about iron, vitamin A and zinc deficiencies among residents of Tanzania.
“We were interested in knowing the different micronutrient deficiencies. And then also knowledge about biofortified foods that can help reduce those deficiencies,” McFadden said.
MEASURING AWARENESS
McFadden said study participants were limited to Tanzanian residents aged 18 to 49. Because the World Health Organization has identified women as being at higher risk of micronutrient deficiency, McFadden said women were oversampled in the study. Out of a total of 1,029 respondents, 806 were women.
Respondents were randomly assigned to one of six research groups and asked a series of questions about micronutrient deficiencies to determine their baseline understanding, McFadden said.
Next, respondents received different educational information about micronutrient deficiencies depending on their assigned group. Of the six groups, four received varied educational information on micronutrient deficiencies. For some groups, the materials included references to branded biofortified foods to assess the effect of food labeling. Additionally, a Tanzanian flag was placed on some groups’ educational materials to determine whether it increased attention to the information.
There was also a group that only received information about brand cultures, as well as a control group, which did not receive any educational information or reference to brand cultures.
The effects of the interventions were then measured using a follow-up survey, McFadden said.
“Economists are very touchy when it comes to saying something causes something,” he said. “But the great thing about experiments is that they are set up to find causal effects.
“We used a randomized group design to identify these knowledge gaps, and then we also used a randomized nutrient design with information so we could have high confidence in our results,” he said .
McFadden also noted that the study methodology provided a unique “internal reliability check.” The study focused on iron, vitamin A and zinc, but the researchers also included questions about iodine deficiency in the baseline and follow-up surveys.
Regarding educational interventions, researchers only provided information on iron, vitamin A, and zinc, not iodine. They could then compare the impact of providing educational materials on iron, vitamin A and zinc to that of not providing information on iodine. This allowed the researchers to validate the true effects of different levels of educational information provided.
PRIORITIZATION IS KEY
The initial baseline knowledge survey found that only about half of respondents were aware of zinc deficiency, compared to about 75 percent who knew of vitamin A and iron deficiency, McFadden said.
“A lot of programs have been put in place to target vitamin A and iron,” he said. “There was really low awareness of zinc.”
The study noted that women were more aware than men of the potential negative health effects of micronutrient deficiency. Respondents assigned to groups that received educational information were more likely to identify negative health effects with respect to iron, vitamin A, and zinc. It was also found that very poor households were generally less aware of the negative health consequences of micronutrient malnutrition.
Among different information groups, researchers found that providing a combination of educational information and branded crop information made the greatest improvement in closing knowledge gaps about micronutrient deficiencies .
The study concludes that “Tanzania should implement targeted communication strategies that provide information on the prevalence of micronutrient deficiencies and risk-reducing food options marked with targeted micronutrients to most effectively reduce knowledge gaps. »
Given the relative lack of awareness about zinc, McFadden said the study results suggest prioritizing public communications about this specific micronutrient to those who are at higher risk of micronutrient malnutrition, such as women.
“It’s about identifying those places, particularly where women of childbearing age, are likely to receive information,” he said. “For example, any type of women’s clinic.”
Kilasy said that world hunger has become so common that research like this can help policymakers “search for various alternatives to solve community challenges that arise due to lack of sufficient knowledge.”
“This study is very essential,” he said.
This research was funded in part by the Borel Global Fellows program at the University of Delaware.
