Tubaramure, a Food-Assisted Integrated Health and Nutrition Program in Burundi, Increases Maternal and Child Hemoglobin Concentrations and Reduces Anemia: A Theory-Based Cluster-Randomized Controlled Intervention Trial

This study examined the impact of a food-assisted program on hemoglobin and anemia in children and their mothers in eastern Burundi, and explored impact pathways. The program included food rations, strengthening and promotion of use of health services, and behavior change communication. Although hemoglobin levels declined over the course of the program, they deteriorated more quickly in the control group, and the program improved hemoglobin status in children and mothers who had delivered in the previous three months. The project also had positive intermediate impacts on anemia determinants: greater consumption of iron-rich foods, dietary diversity, bed-net use, and morbidity. The study highlights the importance of a multifactorial approach to combat anemia.