Economic Cost of Iron Deficiency Anemia The ... - The INCLEN Trust
Economic Cost of Iron Deficiency Anemia The ... - The INCLEN Trust
Economic Cost of Iron Deficiency Anemia The ... - The INCLEN Trust
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PepsiCo Pilot in Andhra Pradesh: Guntur and Tenali Districts
<strong>Iron</strong> deficiency <strong>Anemia</strong> is rampant in India<br />
<strong>Anemia</strong> is prevalent at all income levels<br />
• Low income Group :76% / Middle income Group :69% / High<br />
Income Group :56%<br />
Impacts most vulnerable age groups<br />
• India : Women :56%, Children 70%<br />
• State - A.P: Women: 63% Children: 71%<br />
• Pregnant women age 15-49 who are anemic: 57.9%<br />
• Ever-married women age 15-49 who are anemic: 56.2<br />
%<br />
Source: NFHS 2005-06<br />
Estimated economic cost <strong>of</strong> iron deficiency to S. Asia (India, Bangladesh,<br />
Pakistan, Sri Lanka) is appx. $4.2BN annually: World Bank<br />
2
In India, consumption <strong>of</strong> nutrient iron is<br />
also a concern<br />
65.7% <strong>of</strong> women, and 71% <strong>of</strong> children<br />
consume less than 50% <strong>of</strong> the RDA for iron<br />
<strong>The</strong> issue remains un-changed much in latest NNMB<br />
Report (2004-05)* National Nutrition Monitoring<br />
Bureau<br />
3
Andhra Pradesh is one state with severe <strong>Anemia</strong>. Our<br />
pilot test is being undertaken here<br />
• Population Base – Large - 5 th most populous, 75<br />
Million People, 55 Million Rural<br />
• Condusive Infrastructure: Good network <strong>of</strong><br />
roadways, 85 % villages connected by road and<br />
60% electrification<br />
• Human Development Index: Relatively high literacy<br />
( 60%), 8 th in HD index at 0.344 & healthy Female :<br />
Male ratio (1.02)<br />
• Good market access: Highest self help groups,<br />
Highest NGO presence, 2 nd highest in Rural<br />
markets (“Mandi)<br />
• One <strong>of</strong> the top states in Per-capita income in the<br />
country<br />
Source: Census 2001, NCAER 2001-02, RMAI 2008
PepsiCo Pilot Project Overview<br />
1)Affordable Product Development<br />
2)Reach and Education Process<br />
3)Key learning’s and, Way forward<br />
In line with PepsiCo “Performance with Purpose” agenda leverage PepsiCo’s<br />
expertise to provide sustainable Affordable Nutrition to the deserving communities<br />
5
Developing Affordable Tasty fortified products<br />
Program plan
Good nutrients + local ingredients was the focus in the<br />
product development<br />
•Commonly used Food ingredients with strong consumer<br />
beliefs: a) Ragi –Finger Millet, b) Rice etc.<br />
•Health benefits through ingredients: a) Soy flour to<br />
enhance protein quantity and quality b) <strong>Iron</strong> fortification and<br />
Vitamin premix containing B2, B12 and Folate<br />
•Superior Taste Delivery – through unique technology<br />
• Locally relevant Masala seasoning.<br />
• Higher protein leading to crispier texture<br />
•Superior Consumer Acceptance: Product Mean score <strong>of</strong><br />
8.2 in Rural and 8.5 in Urban AP (Monadic, Hedonic)<br />
7
Product added Micro- Nutrient : Vitamin Pr<strong>of</strong>ile<br />
Nutrient RDA Nutrients Per<br />
Serve<br />
% RDA per<br />
Serve<br />
Benefit<br />
<strong>Iron</strong> (NaFe<br />
EDTA)<br />
28mg 7mg 25% Reduce Tiredness<br />
Vitamin B12 1mcg 0,50mcg 50% Energy Releasing<br />
Vitamin B2 1,4mg 0,70mg 50% Energy Releasing<br />
Folate 100mcg 50mcg 50% Prevents neural tube and<br />
other birth defects<br />
Soya Ragi Puffs
Consumer Reach Nutrition Education (Target:<br />
Adolescent girls 13-19 Yrs)<br />
100% coverage <strong>of</strong> 83 villages in intervention geography<br />
100% coverage <strong>of</strong> all schools in 2 urban towns and 83<br />
villages and, 100% coverage <strong>of</strong> Target in schools contacted<br />
100% direct coverage <strong>of</strong> TG households by Change Agents<br />
100% coverage <strong>of</strong> Retail outlets in villages through Rural<br />
entrepreneurs<br />
74,000 out <strong>of</strong> 150000 contacted directly<br />
9
Our Commitment to roll out and increase reach is long<br />
term<br />
2011-12 work plan<br />
PepsiCo Pilots Education Program<br />
• 83 villages. 52 schools, 10000+ girls and<br />
mothers in rural enviorns <strong>of</strong> Guntur and<br />
Tenali<br />
• 2 towns, 72 Mohallas, 254 schools, 25000+<br />
girls and mothers in Guntur and Tenali<br />
Towns<br />
2012-13 plan<br />
Pilot Success Proven<br />
•Roll into 20 Districts in AP<br />
•Rural: 4800 schools in 3450 villages,<br />
0.7Million girls and mothers<br />
•Urban: 4356 schools, 0.8Million girls and<br />
mothers
Our job clearly is to create a social impact and a<br />
behavior change in the target groups<br />
Adolescent girl 13-19<br />
years (Bulls Eye)<br />
Mothers<br />
Product: Offer a tasty and iron +<br />
vitamin fortified affordable<br />
nutrition solution<br />
<strong>Iron</strong> fortified extruded snack<br />
Education and habitual change:<br />
•What is <strong>Iron</strong>, and its role<br />
•Symptoms <strong>of</strong> <strong>Iron</strong> <strong>Deficiency</strong><br />
•Foods that can prevent <strong>Iron</strong><br />
deficiency<br />
•Simple tips to reduce <strong>Iron</strong> deficiency
We have done <strong>Iron</strong> nutrient education at various touch<br />
points . We are in the right direction<br />
Baseline<br />
Mid Line Impact<br />
September’11- Jan’12<br />
• School + Mohalla (Home / Area)<br />
education<br />
March ‘ 2012<br />
MOHALLA<br />
March- April’ 2012<br />
June to August’11<br />
• School intervention, Education +<br />
Competition<br />
Mid Line Impact<br />
April- June
We have used multiple education modes and materials<br />
including Audi0-visuals and in vernacular language<br />
Awareness <strong>of</strong> <strong>Anemia</strong> and<br />
Its Identification<br />
Dos and Don’t’s<br />
Quick facts about <strong>Iron</strong><br />
<strong>Deficiency</strong>
Impact assessment <strong>of</strong> the education program<br />
Education program exceeded expectations on consumer metrics delivery<br />
Measurement<br />
Metrics<br />
Pre Pilot<br />
(Fieldwork<br />
Mar 2011)<br />
Post Pilot<br />
(Fieldwork<br />
Nov 2011)<br />
Action<br />
Consumption <strong>of</strong> 7<br />
and more <strong>Iron</strong> Rich<br />
Food among girls<br />
36% 58%<br />
Understand<br />
Aware<br />
Symptoms <strong>of</strong> <strong>Iron</strong> deficiency<br />
I.Unusual tiredness<br />
II. Pale nails<br />
III. Weakness/ decrease in physical performance<br />
Awareness <strong>of</strong> at least three food items that are<br />
rich in <strong>Iron</strong><br />
<strong>Iron</strong> deficiency causes tiredness which prohibits me from<br />
achieving my dreams<br />
Aware <strong>of</strong> <strong>Iron</strong> <strong>Deficiency</strong><br />
16% 80%<br />
10% 78%<br />
15% 74%<br />
26% 95%<br />
17% 60%<br />
37% 91%
Measurement <strong>of</strong> Nutrient Bundle Efficacy being our next<br />
assessment step , is currently progressing<br />
Direct Invasive testing: Increased Hemoglobin Count →<br />
Reduced Severity <strong>of</strong> <strong>Anemia</strong> (Clinical measurement)<br />
Indirect measures <strong>of</strong> success:<br />
• Increased productivity <strong>of</strong> the test group<br />
• Increased earning potential <strong>of</strong> the test group as an<br />
outcome <strong>of</strong> productivity<br />
• Increased muscle strength, stamina, cognitive abilities<br />
<strong>of</strong> the test group (test)<br />
Social Impact <strong>of</strong> Education Program will be measured by<br />
Independent Experts
Key Learnings / Key Questions to ask<br />
1. Micro-nutrient<br />
deficiency is wide<br />
spread.<br />
2. <strong>Economic</strong> cost<br />
impacts are so severe<br />
3. Food fortification is<br />
so inexpensive and<br />
effective<br />
4. How can we harness<br />
support groups to<br />
help scale intervention<br />
support?<br />
1. <strong>The</strong> Private Sector<br />
community, especially the<br />
Food Industry can make a<br />
significant contribution by<br />
both delivering nutrition<br />
through affordable and<br />
value-added food products<br />
2. Helping to build<br />
awareness for malnutrition<br />
prevention by partnering in<br />
creation and delivery <strong>of</strong><br />
communication programs<br />
to the population at large<br />
Partnerships<br />
are critical:<br />
Partnerships<br />
using expertise<br />
<strong>of</strong> each sector –<br />
Govt,NGOs,foo<br />
d industry,civil<br />
society and<br />
developmental<br />
organizations<br />
can bring about<br />
a positive<br />
change<br />
16
Way Forward – Recommendation to the approach to the<br />
micro-nutrient deficiency problem<br />
Partnerships to<br />
address the issue<br />
Multisectoral<br />
engagement to<br />
create positive<br />
awareness<br />
Scale-up in states<br />
with nutrition<br />
enabled<br />
environment<br />
17
Thank You