Effects of nutritional intervention on anemia and cognitive development among pre-school children: Field experiments in India

Iron deficiency anemia (IDA) is widespread and is a global health challenge that undermines the physical as well as cognitive development of children. The proposed study will implement a field experiment among 3-5 years old preschoolers in rural Bihar, India. The study team will randomly assign 50 schools to the treatment groups that will receive fortified lunch (micronutrient mixed lunch) and 50 schools will serve as control groups. A baseline and 12-month follow-up survey will be administered to collect primary data on measures of child development such as anthropometrics, morbidity, learning outcomes, and cognitive outcomes. The preschool children will be recruited from the Anganwadi Centers (AWC). AWCs, which are the community-based lowest tier of health service delivery, provide primary medical care and nutritional services to infants and their mothers in the community. There are about 1.4 million AWC in India, each serving a catchment area of 400- 800 people. Our hypothesis is that the proposed intervention will decrease anemia and improve test scores, and cognitive and executive functions. The findings will inform policies about the optimal timing of micronutrient supplementation and will demonstrate the effectiveness of AWC as the delivery platform for nutritional interventions.