A Simple, Affordable Solution to Addressing Nutrient Deficiencies in Women and Children
Lucky Iron Fish
Esi*, a mother of three living in rural Benin, was deeply concerned about her son’s health. As a 9 year-old boy living with sickle cell anemia, he frequently suffered from jaundice and often spent long stretches of time in the hospital.
“He has received regular blood transfusions and every year we are in the hospital, especially in December.”
Though Esi’s son was experiencing an extreme form of anemia due to his condition, iron deficiency anemia (IDA) itself is the most common nutritional disorder in the world. It limits cognitive development in children, predisposing them to infection and reduced energy levels, which can lead to decreased school attendance, chronic illness, and even death. In adults, anemia reduces work productivity and quality of life, and can lead to poor pregnancy outcomes. In Benin, the social and economic costs of anemia are huge, with median estimates of GDP loss as high as 4%.
Lucky Iron Fish Enterprise (LIFE) and their local partners CARE Benin/Togo have been working in Benin for years to address anemia by promoting the use of the Lucky Iron Fish (LIF), a scientifically proven tool used to fortify meals with natural iron and reduce the prevalence of anemia in women and children. Each LIF, which consists of a small, fish-shaped piece of iron, can be used for five years. Training on how to use the LIF was typically conducted in large group settings and included cooking demonstrations. During the COVID-19 pandemic, these gatherings could not be held.
In response to these restrictions, LIFE and CARE Benin/Togo tested an innovative solution aimed at reducing micronutrient deficiencies in women by educating the public about anemia through digital tools (WhatsApp, texts or calls), speaking books (books that have recorded audio activated by pushing a button) and radio programming. This innovation sought to mitigate the effects of COVID-19 by providing an alternative to face-to-face interactions. The innovation also sought to empower women to make nutritional and economic decisions in their household through messaging aimed at both men and women, since men have traditionally held domestic decision-making power.
The results of this innovative solution were affected by physical challenges (due to COVID-19 restrictions and illness) and supply chain issues related to food availability and the LIF itself. Despite this, the overall data demonstrates that including regular use of the LIF in preparing meals has a positive impact on the iron status of women. Blood tests performed on 250 women revealed a 31.8% decrease in anemia in the experimental group (125 women) versus a 6-7% reduction in the control group (an additional 125 women). There was a significant improvement in knowledge of anemia. At the start of the trial only 20% of participants reported hearing about anemia but by endline 100% of the women indicated they had heard of the condition. By endline, the women were also more knowledgeable about the signs and symptoms of anemia, while knowledge of iron rich foods and ways to enrich meals with iron increased from 8% to 86%. The level of women’s decision-making roles for better household nutrition increased from 11% at baseline to 21% at endline.
Esi was given an LIF as part of the innovation, along with nutritional information about iron rich foods and the risks of anemia. She applies this knowledge when cooking for her family.
“I use it every day to make porridge or heat simple water for my boy. I did not encounter any difficulty in using it, and my husband found no objection to me using it. He supports and encourages me in daily use. Over the days, I have noticed a change in my child, who is no longer pale as usual. And the good news is that we did not spend a day in the hospital this December 2021. I am relieved and happy to see my child’s health improve.”
