23 results on '"Adu-Afarwuah, Seth"'
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2. Additional file 2 of Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana
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Kyei-Arthur, Frank, Situma, Ruth, Jevaise Aballo, Mahama, Abraham B., Selenje, Lilian, Esi Amoaful, and Adu-Afarwuah, Seth
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Additional file 2: Supplementary file 2 Appendix 2. Key Informants Interview Guide. This interview guide was used to collect information on mothers’ and caregivers’ observations or experiences and difficulties participating in the Micronutrient Powder Initiative.
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- 2020
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3. Additional file 3 of Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana
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Kyei-Arthur, Frank, Situma, Ruth, Jevaise Aballo, Mahama, Abraham B., Selenje, Lilian, Esi Amoaful, and Adu-Afarwuah, Seth
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Additional file 3: Supplementary file 3 Appendix 3. Focus Group Discussion (FGD) Guide. This discussion guide was used to collect information on mothers’ and caregivers’ observations or experiences participating in the Micronutrient Powder Initiative.
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- 2020
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4. Additional file 1 of Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana
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Kyei-Arthur, Frank, Situma, Ruth, Jevaise Aballo, Mahama, Abraham B., Selenje, Lilian, Esi Amoaful, and Adu-Afarwuah, Seth
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ComputingMilieux_THECOMPUTINGPROFESSION - Abstract
Additional file 1: Supplementary file 1 Appendix 1. Questionnaire guide for Staff of Ghana Health Service. This questionnaire guide was used to elicit information about program implementation and staff observations, experiences and lessons learned.
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- 2020
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- View/download PDF
5. Exposure to a slightly sweet lipid-based nutrient supplement during early life does not increase the level of sweet taste most preferred among 4- to 6-year-old Ghanaian children: follow-up of a randomized controlled trial
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Okronipa, Harriet, Arimond, Mary, Arnold, Charles D, Young, Rebecca R, Adu-Afarwuah, Seth, Tamakloe, Solace M, Ocansey, Maku E, Kumordzie, Sika M, Oaks, Brietta M, Mennella, Julie A, and Dewey, Kathryn G
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Male ,Sucrose ,Clinical Trials and Supportive Activities ,Reproductive health and childbirth ,Ghana ,Medical and Health Sciences ,Food Preferences ,Engineering ,children ,Clinical Research ,Monell forced-choice test ,Humans ,Child ,Preschool ,Nutrition ,Pediatric ,integumentary system ,Nutrition & Dietetics ,Prevention ,Infant ,Nutrients ,Lipid Metabolism ,sweet taste preference ,Taste ,Infant Food ,Female ,lipid-based nutrient supplement ,Follow-Up Studies - Abstract
BACKGROUND:The impact of feeding a slightly sweet nutrient supplement early in life on later sweet taste preference is unknown. OBJECTIVE:We tested the hypothesis that the level of sucrose most preferred by 4-6-y-old children exposed to a slightly sweet lipid-based nutrient supplement (LNS) early in life would not be higher than that of children never exposed to LNS. DESIGN:We followed up children born to women (n=1,320) who participated in a randomized trial in Ghana. In one group, LNS was provided to women on a daily basis during pregnancy and the first 6 mo postpartum and to their infants from age 6 to 18 mo (LNS group). The control groups received daily iron and folic acid or multiple micronutrients during pregnancy and the first 6 mo postpartum, with no infant supplementation (non-LNS group). At age 4-6 y, we randomly selected a subsample of children (n=775) to assess the concentration of sucrose most preferred using the Monell 2-series, forced-choice, paired-comparison tracking procedure. We compared LNS with non-LNS group differences using a noninferiority margin of 5% weight/volume (wt/vol). RESULTS:Of the 624 children tested, most (61%) provided reliable responses. Among all children, the mean±SD sucrose solution most preferred (% wt/vol) was 14.6±8.6 (LNS group 14.9±8.7; non-LNS group 14.2±8.4). However, among children with reliable responses, it was 17.0±10.2 (LNS group 17.5±10.4; non-LNS group 16.5±10.0). The upper level of the 95% CI of the difference between groups did not exceed the noninferiority margin in either the full sample or those with reliable responses, indicating that the LNS group did not have a higher sweet preference than the non-LNS group. CONCLUSION:Exposure to a slightly sweet nutrient supplement early in life did not increase the level of sweet taste most preferred during childhood. This trial was registered at clinicaltrials.gov as NCT00970866.
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- 2019
6. Maternal-Infant Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Does Not Affect Child Blood Pressure at 4-6 Y in Ghana: Follow-up of a Randomized Trial
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Kumordzie, Sika M, Adu-Afarwuah, Seth, Young, Rebecca R, Oaks, Brietta M, Tamakloe, Solace M, Ocansey, Maku E, Okronipa, Harriet, Prado, Elizabeth L, and Dewey, Kathryn G
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Adult ,prenatal ,Clinical Trials and Supportive Activities ,lipid-based nutrient supplements ,Reproductive health and childbirth ,Cardiovascular ,Ghana ,Young Adult ,Food Sciences ,Animal Production ,Clinical Research ,Humans ,Child ,Preschool ,Nutrition ,Pediatric ,Nutrition and Dietetics ,infant nutrition ,Nutrition & Dietetics ,Infant ,blood pressure ,Perinatal Period - Conditions Originating in Perinatal Period ,Ghanaian children ,Lipids ,Community and International Nutrition ,Child, Preschool ,Hypertension ,Dietary Supplements ,supplementation ,Female ,Follow-Up Studies - Abstract
BackgroundIn the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana trial, prenatal small-quantity lipid-based nutrient supplements (LNSs) had a positive effect on birth weight. Birth weight may be inversely related to blood pressure (BP) later in life.ObjectivesWe examined the effect of the intervention on BP at 4-6 y of age, and maternal and child factors related to BP.MethodsThe iLiNS-DYAD-Ghana study was a partially double-blind, randomized controlled trial which assigned women (n=1320) ≤20 weeks of gestation to daily supplementation with: 1) iron and folic acid during pregnancy and 200 mg Ca for 6 mo postpartum , 2) multiple micronutrients during pregnancy and postpartum, or 3) LNSs during pregnancy and postpartum plus LNSs for infants from 6 to 18 mo of age. At 4-6 y of age (n=858, 70% of live births), we compared BP, a secondary outcome, between non-LNS and LNS groups and examined whether BP was related to several factors including maternal BP, child weight-for-age z score (WAZ), and physical activity.ResultsNon-LNS and LNS groups did not differ in systolic (99.2±0.4 compared with 98.5±0.6 mm Hg; P=0.317) or diastolic (60.1±0.3 compared with 60.0±0.4 mm Hg; P=0.805) BP, or prevalence of high BP (systolic or diastolic BP ≥90th percentile of the US National Heart, Lung, and Blood Institute reference: 31% compared with 28%; P=0.251). BP at 4-6 y of age was positively related to birth weight; this relation was largely mediated through concurrent WAZ in a path model. Concurrent WAZ and maternal BP were the factors most strongly related to child BP.ConclusionsDespite greater birth weight in the LNS group, there was no intervention group difference in BP at 4-6 y. In this preschool population at high risk of adult hypertension based on BP at 4-6 y, high maternal BP and child WAZ were key factors related to BP. This trial was registered at clinicaltrials.gov as NCT00970866.
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- 2019
7. Prenatal and postnatal lipid-based nutrient supplementation and cognitive, social-emotional, and motor function in preschool-aged children in Ghana: a follow-up of a randomized controlled trial
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Ocansey, Maku E, Adu-Afarwuah, Seth, Kumordzie, Sika M, Okronipa, Harriet, Young, Rebecca R, Tamakloe, Solace M, Oaks, Brietta M, Dewey, Kathryn G, and Prado, Elizabeth L
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Adult ,Male ,prenatal supplementation ,Maternal-Child Health Services ,Clinical Trials and Supportive Activities ,Emotions ,multiple micronutrients ,Child Behavior ,Reproductive health and childbirth ,Ghana ,postnatal supplementation ,Medical and Health Sciences ,Young Adult ,Child Development ,Cognition ,Engineering ,Clinical Research ,Pregnancy ,Behavioral and Social Science ,Complementary and Integrative Health ,Humans ,Interpersonal Relations ,Micronutrients ,Child ,Preschool ,Infant Nutritional Physiological Phenomena ,Nutrition ,Pediatric ,Family Characteristics ,Nutrition & Dietetics ,Prevention ,Infant ,lipid-based nutrient supplementation ,Prenatal Care ,Maternal Nutritional Physiological Phenomena ,Lipids ,preschool development ,Dietary Supplements ,Mental health ,Female ,Follow-Up Studies ,cognitive development - Abstract
Background:Adequate nutrition is necessary for brain development during pregnancy and infancy. Few randomized controlled trials of supplementation during these periods have measured later developmental outcomes. Objective:Our objective was to investigate the effects of provision of prenatal and postnatal lipid-based nutrient supplements (LNS) on child development at preschool age. Methods:We conducted a follow-up study of 966 children aged 4-6 y in 2016, born to women who participated in the International Lipid-Based Nutrient Supplements-DYAD trial conducted in Ghana in 2009-2014, representing 79% of eligible children. Women ≤20 weeks of gestation were randomized to daily LNS or multiple micronutrient (MMN) capsules during pregnancy through 6 mo postpartum or iron and folic acid (IFA) capsules during pregnancy and calcium placebo capsules during 6 mo postpartum. Children in the LNS group received LNS from 6 to 18 mo. Primary outcomes of this follow-up study were (1) a cognitive factor score based on a test battery adapted from several standard tests, 2) fine motor score (9-hole pegboard test), and (3) social-emotional difficulties (Strengths and Difficulties Questionnaire; SDQ). Eight secondary outcomes were calculated in specific domains (e.g., language, SDQ prosocial). Analysis was by a complete case intention to treat in a 2-group comparison: LNS compared with non-LNS (MMN+IFA). Results:Children in the LNS group had significantly lower social-emotional difficulties z-scores than children in the non-LNS group (adjusted for child age β=-0.12, 95% CI: -0.25, 0.02, P=0.087; fully adjusted β=-0.16, 95% CI: -0.29, -0.03, P=0.013). The effect of LNS on social-emotional difficulties score was larger among children living in households with lower home environment scores (P-interaction=0.081). No other outcomes differed between the 2 intervention groups. Conclusions:Provision of LNS during the first 1000 d of development improved behavioral function, particularly for children from low nurturing and stimulation households, but did not affect cognition at preschool age in this setting. Trial Registration: clinicaltrials.gov, Identifier NCT00970866.
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- 2019
8. Maternal and Infant Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Increases Infants' Iron Status at 18 Months of Age in a Semiurban Setting in Ghana: A Secondary Outcome Analysis of the iLiNS-DYAD Randomized Controlled Trial
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Adu-Afarwuah, Seth, Young, Rebecca T, Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Ashorn, Ulla, Oaks, Brietta M, Arimond, Mary, Dewey, Kathryn G, Lääketieteen ja terveysteknologian tiedekunta - Faculty of Medicine and Health Technology, and Tampere University
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Adult ,Male ,Kansanterveystiede, ympäristö ja työterveys - Public health care science, environmental and occupational health ,Iron ,Ghana ,Young Adult ,Folic Acid ,Food Sciences ,Animal Production ,Pregnancy ,Humans ,Micronutrients ,Infant Nutritional Physiological Phenomena ,multiple micronutrient supplements ,Nutrition and Dietetics ,Nutrition & Dietetics ,infants ,Infant ,Naisten- ja lastentaudit - Gynaecology and paediatrics ,Maternal Nutritional Physiological Phenomena ,micronutrient supplementation ,Newborn ,Lipids ,iron and folic acid ,Dietary Supplements ,Female ,small-quantity lipid-based nutrient supplements - Abstract
BackgroundInterventions are needed to address iron deficiency in low-income settings.ObjectiveThis secondary outcome analysis aimed to compare the hemoglobin (Hb) and iron status [zinc protoporphyrin (ZPP)] of children born to women enrolled in the iLiNS-DYAD trial in Ghana.MethodsWomen ≤20 wk pregnant (n=1320) were assigned to receive 60 mg Fe/d and 400 µg folic acid/d until delivery and placebo thereafter, and no supplementation for infants (IFA group); or multiple micronutrients containing 20 mg Fe/d until 6 mo postpartum and no supplementation for infants (MMN); or small-quantity lipid-based nutrient supplements (SQ-LNSs) containing 20 mg Fe/d until 6 mo postpartum, and SQ-LNSs for infants from 6 to 18 mo of age (LNS). We compared infants' Hb (g/L) and ZPP (µmol/mol heme) at 6 and 18 mo of age.ResultsAt 6 mo of age, groups did not differ in mean±SD Hb (overall: 113±9.9 g/L) or geometric mean (95% CI) ZPP [overall: 62.6 (60.6, 64.7)]. At 18 mo of age, mean±SD Hb (overall: 112±10.4 g/L) did not differ significantly between groups, whereas geometric mean (95% CI) ZPP was lower (P=0.031) in the LNS group [53.9 (50.7, 57.3)] than the IFA [60.4 (56.7, 64.3)] but not the MMN [58.8 (55.6, 62.2)] group. Further, the LNS group, compared with the IFA and MMN groups combined, had a lower prevalence of elevated (>70) ZPP (27.5% compared with 35%; P=0.02) and a marginally lower prevalence of anemia (38.7% compared with 44.9%; P=0.06). These results generally remained unchanged when controlling for prespecified covariates or correcting for inflammation.ConclusionsIn this setting, providing SQ-LNSs or multiple micronutrients with 20 mg Fe/d, compared with iron (60 mg/d) and folic acid, to pregnant women does not affect their infants' Hb or iron status at 6 mo of age, but maternal and infant supplementation with SQ-LNSs increases infants' iron status at 18 mo of age. This trial was registered at clinicaltrials.gov as NCT00970866.
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- 2019
9. The effects of a nutrient supplementation intervention in Ghana on parents' investments in their children
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Adams, Katherine P, Adu-Afarwuah, Seth, Bentil, Helena, Oaks, Brietta M, Young, Rebecca R, Vosti, Stephen A, Dewey, Kathryn G, and Zereyesus, Yacob
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Adult ,Male ,General Science & Technology ,Science ,Nutritional Status ,Reproductive health and childbirth ,Ghana ,Young Adult ,Child Development ,Pregnancy ,Clinical Research ,Behavioral and Social Science ,Humans ,Birth Weight ,Sibling Relations ,Parent-Child Relations ,Infant Nutritional Physiological Phenomena ,Nutrition ,Pediatric ,Prevention ,Infant ,Maternal Nutritional Physiological Phenomena ,Newborn ,Dietary Supplements ,Medicine ,Female ,Generic health relevance ,Follow-Up Studies - Abstract
A child's endowment is a reflection of his/her genetic makeup and the conditions faced in early life. Parents build on their child's endowment by investing resources in their child, and together, a child's endowment and subsequent investments act as input into important later-life outcomes. A positive or negative shock to a child's endowment can have a direct biological effect on a child's long-term outcomes but may also affect parents' decisions about investments in the health and human capital of their children. Using follow-up data collected several years after a randomized trial in Ghana, we explored whether maternal and child supplementation with small-quantity lipid-based nutrient supplements (SQ-LNS) throughout much of the first 1,000 days influenced parental investments in the health and human capital of their children. Across the domains of family planning, breastfeeding, health, education, and paternal financial support, we found that, in general, the intervention did not affect investments in the treated child nor his/her untreated siblings. These results suggest that given production technologies, constraints, and preferences, the intervention either did not change parents' optimal investment strategies or that the effects of the intervention, namely increased birth size and attained length at 18 months of age, were too small for parents to perceive or to have any meaningful impact on parents' expectations about the returns to investments in their children.
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- 2019
10. Ghanaian parents' perceptions of pre and postnatal nutrient supplements and their effects
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Adams, Katherine P, Okronipa, Harriet, Adu-Afarwuah, Seth, Arimond, Mary, Kumordzie, Sika, Oaks, Brietta M, Ocansey, Maku E, Young, Rebecca R, Vosti, Stephen A, and Dewey, Kathryn G
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Parents ,Adult ,Male ,and promotion of well-being ,Iron ,multiple micronutrients ,Clinical Trials and Supportive Activities ,Reproductive health and childbirth ,Ghana ,Medication Adherence ,Young Adult ,perceptions ,Folic Acid ,Pregnancy ,Clinical Research ,Behavioral and Social Science ,Humans ,Child ,Preschool ,Infant Nutritional Physiological Phenomena ,3.3 Nutrition and chemoprevention ,Nutrition ,Pediatric ,Practice ,Nutrition and Dietetics ,Nutrition & Dietetics ,Health Knowledge ,Infant ,child nutrition ,Maternal Nutritional Physiological Phenomena ,Newborn ,Prevention of disease and conditions ,Attitudes ,Dietary Supplements ,Female ,small-quantity lipid-based nutrient supplements ,psychological phenomena and processes ,Follow-Up Studies ,maternal nutrition - Abstract
Small-quantity lipid-based nutrient supplements (SQ-LNS) have been studied in efficacy and effectiveness trials, but little is known about how parents perceive the products and their effects. In a randomised trial in Ghana, efficacy of SQ-LNS provided to women during pregnancy and the first 6months postpartum and to their children from 6 to 18months of age was assessed by comparison with iron-folic acid (IFA) capsules and multiple micronutrient (MMN) capsules provided to women. In a follow-up study conducted when the index children from the original trial were between 4 and 6years of age, we used survey-based methods to assess retrospective and current parental perceptions of nutrient supplements generally and of SQ-LNS and their effects compared with perceptions IFA and MMN capsules. Most parents perceived that the assigned supplements (SQ-LNS, IFA, or MMN) positively impacted the mother during pregnancy (approximately 89% of both mothers and fathers) and during lactation (84% of mothers and 86% of fathers). Almost all (≥90%) of mothers and fathers perceived that the assigned supplement positively impacted the index child and expected continued positive impacts on the child's health and human capital into the future. A smaller percentage of parents perceived negative impacts of the supplements (7%-17% of mothers and 4%-12% of fathers). Perceptions of positive impacts and of negative impacts did not differ by intervention group. The results suggest that similar populations would likely be receptive to programs to deliver SQ-LNS or micronutrient capsules.
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- 2018
11. Unintended effects of a targeted maternal and child nutrition intervention on household expenditures, labor income, and the nutritional status of non-targeted siblings in Ghana
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Adams, Katherine P., Lybbert, Travis J., Vosti, Stephen A., Ayifah, Emmanuel, Arimond, Mary, Adu-Afarwuah, Seth, and Dewey, Kathryn G.
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Pediatric ,and promotion of well-being ,Economics ,Prevention ,Intrahousehold spillovers ,Prevention of disease and conditions ,Article ,Studies in Human Society ,Clinical Research ,Behavioral and Social Science ,Income ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Zero Hunger ,Generic health relevance ,Randomized trial ,Development Studies ,Expenditures ,Nutrition ,Child nutrition - Abstract
Highlights • The targeted provision of maternal and infant SQ-LNS affected household behavior. • Targeted SQ-LNS had a positive effect on household food and non-food expenditures. • Higher labor income may have permitted higher expenditures. • We find evidence of positive nutritional spillovers onto some non-target children. • Targeted interventions may affect the wellbeing of non-target household members., It is common for health and nutrition interventions to target specific household members and for evaluations of their effects to focus exclusively on those members. However, if a targeted intervention changes a household’s utility maximization problem or influences decision-making, households might respond to the intervention in unintended ways with the potential to affect the wellbeing of non-targeted members. Using panel data from a randomized controlled nutrition trial in Ghana, we evaluate household behavioral responses to the provision of small-quantity lipid-based nutrient supplements (SQ-LNS) to mothers and their infants to prevent undernutrition. We find that targeted supplementation with SQ-LNS had a positive effect on household expenditures on food, including some nutrient-rich food groups, as well as on non-food goods and services. We also find a positive impact on labor income, particularly among fathers. We then explore intrahousehold spillover effects on the nutritional status of non-targeted young children in the household. We find evidence that the targeted provision of SQ-LNS led to higher height-for-age z-scores among non-targeted children in the LNS group compared to the non-LNS group, though only among those with relatively taller mothers, which is an indicator of a child’s growth potential. These findings support existing evidence and suggest that unintended behavioral responses and spillover are a real possibility in the context of nutrition interventions targeting nutritionally-vulnerable household members. Thoughtfully considering this possibility in the design, analyses, and evaluation of targeted nutrition interventions may provide a more complete picture of overall effects.
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- 2018
12. Supplementation during pregnancy with small-quantity lipid-based nutrient supplements or multiple micronutrients, compared with iron and folic acid, increases women's urinary iodine concentration in semiurban Ghana: A randomized controlled trial
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Adu‐Afarwuah, Seth, Young, Rebecca T., Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Ashorn, Ulla, Zeilani, Mamane, Dewey, Kathryn G., Lääketieteen ja biotieteiden tiedekunta - Faculty of Medicine and Life Sciences, and University of Tampere
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Adult ,Urban Population ,Iron ,Dietary ,Reproductive health and childbirth ,Ghana ,Folic Acid ,Clinical Research ,Pregnancy ,Humans ,Micronutrients ,Nutrition ,iodine intakes ,iLiNS DYAD‐Ghana ,Nutrition and Dietetics ,Nutrition & Dietetics ,Evaluation of treatments and therapeutic interventions ,Original Articles ,Naisten- ja lastentaudit - Gynaecology and paediatrics ,Vitamins ,Maternal Nutritional Physiological Phenomena ,multiple micronutrient capsules ,urinary iodine concentration ,Lipids ,6.1 Pharmaceuticals ,Dietary Supplements ,small‐quantity lipid‐based nutrient supplements ,iLiNS DYAD-Ghana ,Original Article ,Female ,small-quantity lipid-based nutrient supplements ,Iron, Dietary ,pregnant women ,Iodine - Abstract
There is little information on whether prenatal multiple micronutrient (MMN) supplements containing iodine affect women's iodine status. In the International Lipid-based Nutrient Supplements DYAD-Ghana trial, we aimed to assess women's urinary iodine concentration (UIC, μg/L) during pregnancy, as one of the planned secondary outcomes. Women (n=1,320)
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- 2018
13. Willingness to pay for small-quantity lipid-based nutrient supplements for women and children: Evidence from Ghana and Malawi
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Adams, Katherine, Vosti, Stephen, Ayifah, Emmanuel, Phiri, Thokozani, Adu-Afarwuah, Seth, Maleta, Kenneth, Ashorn, Ulla, Arimond, Mary, Dewey, Kathryn, Lääketieteen ja biotieteiden tiedekunta - Faculty of Medicine and Life Sciences, and University of Tampere
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Pediatric ,Adult ,Male ,Malawi ,Nutrition and Dietetics ,integumentary system ,Nutrition & Dietetics ,Infant ,Naisten- ja lastentaudit - Gynaecology and paediatrics ,demand ,Patient Acceptance of Health Care ,Lipids ,Ghana ,Pregnancy ,Dietary Supplements ,Humans ,Zero Hunger ,Female ,Micronutrients ,Longitudinal Studies ,Child ,Preschool ,small-quantity lipid-based nutrient supplements ,willingness to pay ,Nutrition - Abstract
Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000days. Scaling up the delivery of supplements such as SQ-LNS hinges on understanding private demand and creatively leveraging policy-relevant factors that might influence demand. We used longitudinal stated willingness-to-pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ-LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ-LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ-LNS (and by extension, the options for effective delivery of SQ-LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ-LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ-LNS was not associated with WTP in either site.
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- 2018
14. Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial
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Okronipa, Harriet, Adu-Afarwuah, Seth, Lartey, Anna, Ashorn, Per, Vosti, Stephen A, Young, Rebecca R, and Dewey, Kathryn G
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Adult ,Lipid-based nutrient supplements ,Psychiatry ,Depression ,Clinical Trials and Supportive Activities ,Reproductive health and childbirth ,Lipids ,Ghana ,Young Adult ,Mental Health ,Good Health and Well Being ,Postpartum ,Pregnancy ,Clinical Research ,Postpartum depression ,Dietary Supplements ,Humans ,Lactation ,Psychology ,Female ,Cognitive Sciences ,Nutrition - Abstract
We examined the impact on depression at 6months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20weeks gestation (n=1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6months postpartum. Maternal depressive symptoms were measured at 6months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS=382, IFA=387 and MMN=382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n=1151) and those who were not (n=169). At 6months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS=13.1%, IFA=11.2% and MMN=14.7%. P=0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed=0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.
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- 2018
15. Additional file 2: of Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
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Richmond Aryeetey, Hromi-Fiedler, Amber, Adu-Afarwuah, Seth, Esi Amoaful, Gifty Ampah, Gatiba, Marian, Akosua Kwakye, Otoo, Gloria, Gyikua Plange-Rhule, Sagoe-Moses, Isabella, Selenje, Lilian, and PĂŠrez-Escamilla, Rafael
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Appendix S2. Infographic. This document is an infographic which was developed and shared with key stakeholders in breastfeeding in Ghana who were invited to participate in the fifth committee meeting of the Becoming Breastfeeding Friendly Committee. (PDF 860 kb)
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- 2018
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16. Additional file 1: of Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
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Richmond Aryeetey, Hromi-Fiedler, Amber, Adu-Afarwuah, Seth, Esi Amoaful, Gifty Ampah, Gatiba, Marian, Akosua Kwakye, Otoo, Gloria, Gyikua Plange-Rhule, Sagoe-Moses, Isabella, Selenje, Lilian, and PĂŠrez-Escamilla, Rafael
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Appendix S1. Benchmark scores. This table presents the benchmark scores as well as gear total scores generated by the Becoming Breastfeeding Friendly Country committee in Ghana. (DOCX 18 kb)
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- 2018
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17. Additional file 3 of Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
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Richmond Aryeetey, Hromi-Fiedler, Amber, Adu-Afarwuah, Seth, Esi Amoaful, Gifty Ampah, Gatiba, Marian, Akosua Kwakye, Otoo, Gloria, Gyikua Plange-Rhule, Sagoe-Moses, Isabella, Selenje, Lilian, and PĂŠrez-Escamilla, Rafael
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Appendix S3. Policy Brief. This document is a policy brief developed and shared with high level decision makers across government and non-government stakeholders who participated in a high level decision makers consultation aimed at increasing awareness and uptake of the findings of the Becoming Breastfeeding Friendly Toolbox in Ghana. (PDF 1017 kb)
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- 2018
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18. Additional file 1: of A method to develop vocabulary checklists in new languages and their validity to assess early language development
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Prado, Elizabeth, Phuka, John, Ocansey, Eugenia, Maleta, Kenneth, Ashorn, Per, Ashorn, Ulla, Adu-Afarwuah, Seth, Brietta Oaks, Lartey, Anna, and Dewey, Kathryn
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Table S1. Preschool Developmental Assessment Methods in Ghana. Table S2. Maternal and Household Characteristics Descriptive Statistics for Developmental Scores. (DOCX 38Â kb)
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- 2018
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19. Maternal and Child Supplementation with Lipid-Based Nutrient Supplements, but Not Child Supplementation Alone, Decreases Self-Reported Household Food Insecurity in Some Settings
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Adams, Katherine P, Ayifah, Emmanuel, Phiri, Thokozani E, Mridha, Malay K, Adu-Afarwuah, Seth, Arimond, Mary, Arnold, Charles D, Cummins, Joseph, Hussain, Sohrab, Kumwenda, Chiza, Matias, Susana L, Ashorn, Ulla, Lartey, Anna, Maleta, Kenneth M, Vosti, Stephen A, and Dewey, Kathryn G
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Adult ,Malawi ,Clinical Trials and Supportive Activities ,lipid-based nutrient supplements ,Reproductive health and childbirth ,Ghana ,Food Supply ,Young Adult ,Food Sciences ,Animal Production ,Clinical Research ,food insecurity ,Behavioral and Social Science ,Animals ,Humans ,Infant Nutritional Physiological Phenomena ,Nutrition ,Pediatric ,Family Characteristics ,Bangladesh ,Nutrition and Dietetics ,Nutrition & Dietetics ,Infant ,Maternal Nutritional Physiological Phenomena ,Lipids ,Community and International Nutrition ,Milk ,Dietary Supplements ,Female ,Zero Hunger ,Seasons ,Powders - Abstract
Background: It is unknown whether self-reported measures of household food insecurity change in response to food-based nutrient supplementation. Objective: We assessed the impacts of providing lipid-based nutrient supplements (LNSs) to women during pregnancy and postpartum and/or to their children on self-reported household food insecurity in Malawi [DOSE and DYAD trial in Malawi (DYAD-M)], Ghana [DYAD trial in Ghana (DYAD-G)], and Bangladesh [Rang-Din Nutrition Study (RDNS) trial]. Methods: Longitudinal household food-insecurity data were collected during 3 individually randomized trials and 1 cluster-randomized trial testing the efficacy or effectiveness of LNSs (generally 118 kcal/d). Seasonally adjusted Household Food Insecurity Access Scale (HFIAS) scores were constructed for 1127 DOSE households, 732 DYAD-M households, 1109 DYAD-G households, and 3671 RDNS households. The impact of providing LNSs to women during pregnancy and the first 6 mo postpartum and/or to their children from 6 to 18–24 mo on seasonally adjusted HFIAS scores was assessed by using negative binomial models (DOSE, DYAD-M, and DYAD-G trials) and mixed-effect negative binomial models (RDNS trial). Results: In the DOSE and DYAD-G trials, seasonally adjusted HFIAS scores were not different between the LNS and non-LNS groups. In the DYAD-M trial, the average household food-insecurity scores were 14% lower (P = 0.01) in LNS households than in non-LNS households. In the RDNS trial, compared with non-LNS households, food-insecurity scores were 17% lower (P = 0.02) during pregnancy and the first 6 mo postpartum and 15% lower (P = 0.02) at 6–24 mo postpartum in LNS households. Conclusions: The daily provision of LNSs to mothers and their children throughout much of the “first 1000 d” may improve household food security in some settings, which could be viewed as an additional benefit that may accrue in households should policy makers choose to invest in LNSs to promote child growth and development. These trials were registered at clinicaltrials.gov as NCT00945698 (DOSE) NCT01239693 (DYAD-M), NCT00970866 (DYAD-G) and NCT01715038 (RDNS).
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- 2017
20. Impact of small quantity lipid-based nutrient supplements on infant and young child feeding practices at 18 months of age: results from four randomized controlled trials in Africa
- Author
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Arimond, Mary, Abbeddou, Souheila, Kumwenda, Chiza, Okronipa, Harriet, Hemsworth, Jaimie, Jimenez, Elizabeth Yakes, Ocansey, Eugenia, Lartey, Anna, Ashorn, Ulla, Adu-Afarwuah, Seth, Vosti, Stephen A, Hess, Sonja Y, and Dewey, Kathryn G
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Male ,Malawi ,breastfeeding ,Nutritional Status ,feeding practices ,Ghana ,Nutrition Policy ,Risk Factors ,Burkina Faso ,Humans ,Micronutrients ,Infant Nutritional Physiological Phenomena ,nutrient supplements ,Nutrition ,Pediatric ,Nutrition and Dietetics ,Nutrition & Dietetics ,young child ,Malnutrition ,Infant ,Dietary Fats ,Diet ,Zinc ,Sample Size ,Dietary Supplements ,Africa ,Female - Abstract
Optimal infant and young child feeding (IYCF) practices can help ensure nutrient adequacy and support healthy growth and development. Small-quantity lipid-based nutrient supplements (SQ-LNS) have been proposed to help fill nutrient gaps, but little is known about the impact of provision of SQ-LNS on breastfeeding or complementary feeding practices. In the context of four coordinated randomized controlled nutrient supplementation trials in diverse sites in Africa, we compared IYCF practices at infant age 18months (after 9-12months of supplementation) between those receiving and not receiving SQ-LNS. Practices were assessed by caregiver recall. Continued breastfeeding ranged from 74% (Ghana site) to 97% (Burkina Faso site) and did not differ between groups in any site; prevalence of frequent breastfeeding also did not differ. In two sites (Burkina Faso and Malawi), infants receiving SQ-LNS were more likely to meet the World Health Organization recommendations for frequency of feeding (percentage point differences of 12-14%, P 
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- 2017
21. Maternal Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Compared with Multiple Micronutrients, but Not with Iron and Folic Acid, Reduces the Prevalence of Low Gestational Weight Gain in Semi-Urban Ghana: A Randomized Controlled Trial
- Author
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Adu-Afarwuah, Seth, Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Ashorn, Ulla, Zeilani, Mamane, Arimond, Mary, Vosti, Stephen, Dewey, Kathryn G, Lääketieteen ja biotieteiden tiedekunta - Faculty of Medicine and Life Sciences, and Tampere University
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Nutrition and Dietetics ,maternal supplementation ,Nutrition & Dietetics ,Iron ,Body Weight ,lipid-based nutrient supplements ,Naisten- ja lastentaudit - Gynaecology and paediatrics ,Vitamins ,Lipids ,Ghana ,Folic Acid ,Food Sciences ,Animal Production ,Pregnancy ,Dietary Supplements ,gestational weight gain ,iron and folic acid supplementation ,Prevalence ,Humans ,Female ,Micronutrients ,multiple micronutrient supplementation ,Prenatal Nutritional Physiological Phenomena - Abstract
Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight.Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana.Methods: Women (n = 1320
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- 2017
22. Small-quantity, lipid-based nutrient supplements provided to women during pregnancy and 6 mo postpartum and to their infants from 6 mo of age increase the mean attained length of 18-mo-old children in semi-urban Ghana: a randomized controlled trial
- Author
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Adu-Afarwuah, Seth, Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Peerson, Janet M, Arimond, Mary, Ashorn, Ulla, Zeilani, Mamane, Vosti, Stephen, and Dewey, Kathryn G
- Subjects
Risk ,Adult ,Male ,multiple micronutrients ,lipid-based nutrient supplements ,Ghana ,Medical and Health Sciences ,Suburban Health ,Fetal Development ,Child Development ,Engineering ,Double-Blind Method ,Pregnancy ,Prevalence ,Humans ,Lactation ,Micronutrients ,Infant Nutritional Physiological Phenomena ,First ,Growth Disorders ,home fortification ,Fetal Growth Retardation ,Nutrition & Dietetics ,Infant ,Maternal Nutritional Physiological Phenomena ,Newborn ,Dietary Fats ,Infant Nutrition Disorders ,Body Height ,child growth ,Dietary Supplements ,supplementation ,Female ,Pregnancy Trimester - Abstract
BackgroundChildhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life.ObjectiveWe evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age.DesignIn this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and folic acid (IFA group), multiple micronutrients (MMN group), or SQ-LNS (LNS group) daily until delivery, and then placebo, MMNs, or SQ-LNS, respectively, for 6 mo postpartum; infants in the LNS group received SQ-LNS formulated for infants from 6 to 18 mo of age (endline). The primary outcome was child length by 18 mo of age.ResultsAt endline, data were available for 85% of 1228 infants enrolled; overall mean length and length-for-age z score (LAZ) were 79.3 cm and -0.83, respectively, and 12% of the children were stunted (LAZ
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- 2016
23. Are out-of-school adolescents at higher risk of adverse health outcomes? Evidence from 9 diverse settings in sub-Saharan Africa
- Author
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De Neve, Jan-Walter, Karlsson, Omar, Canavan, Chelsey R., Chukwu, Angela, Adu-Afarwuah, Seth, Bukenya, Justine, Darling, Anne Marie, Harling, Guy, Moshabela, Mosa, Killewo, Japhet, Fink, Günther, Fawzi, Wafaie W., and Berhane, Yemane
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4. Education ,1. No poverty ,3. Good health
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