Effects of Nutrition Package (Yingyangbao) Intervention on Children and Adolescents' Health in Myanmar

Study background:

Malnutrition among children and adolescents is a significant public health issue in developing countries, including Myanmar, severely affecting children and adolescents' growth, development, and overall health, and potentially leading to long-term adverse health outcomes or even death. Influenced by factors such as armed conflicts, the COVID-19 pandemic, and natural disasters, malnutrition in Myanmar has become even more pronounced.

Preliminary cross-sectional survey results indicate that the malnutrition rate among children and adolescents aged 7-15 in Special Region 4 of Myanmar is as high as 56.2%, with stunting, wasting (in children under 10), and underweight rates at 53.2%, 38.5%, and 5.0%, respectively. Additionally, health issues such as diarrhea, fever, skin and hair problems, and functional impairments are prevalent, with detection rates exceeding 40%. Analysis of influencing factors reveals that diet is a critical determinant of growth and development in this population. Nutrient assessments show insufficient daily intake of essential nutrients, including vitamin A, vitamin B1, vitamin B2, calcium, iron, and zinc. Children and adolescents aged 7-15 are in a critical period of growth and development, and nutrient deficiencies can lead to severe adverse health effects. Moreover, the prevalence of diseases such as diarrhea and fever may further impair nutrient absorption, creating a vicious cycle of malnutrition. Malnutrition among children and adolescents has become an urgent public health issue in Myanmar, necessitating interventions to improve these people's nutritional health.

Nutrition package, recommended by the WHO, has been proven effective in reducing the risks of anemia, stunting, underweight, and wasting in children under 5 in China. However, there is limited evidence on its effectiveness for older children and adolescents. Expert discussions have concluded that the current nutrition package formula, administered at a dose of two sachets per day, can meet the average nutrient requirements for different genders and age groups without exceeding the tolerable upper intake levels. The addition of probiotics to the nutrition packages may further enhance nutrient absorption, boost immune function, and reduce gastrointestinal diseases. The prior survey results indicate that children and adolescents in Special Region 4 of Myanmar currently do not have access to nutritional supplements, yet 98% of participants reported acceptance after using the nutrition package products. Therefore, implementing these nutritional interventions in this region might be safe, cost-effective, and feasible.

Based on the above facts, this study aims to conduct a pilot intervention using nutrition package among children and adolescents aged 7-15 in Special Region 4 of Myanmar. The goal is to evaluate the effectiveness and safety of these packages in improving the nutritional health of this population, providing essential scientific data to further enhance the growth, development, and nutritional health of children and adolescents in Myanmar.