El Salvador (2014): Evaluation of the SuperCipotes School-Based Program to Reduce Micronutrient Deficiencies and Diarrheal Disease and to Improve Cognitive Development

OBS/OPTIMUS FOUNDATION The study will yield results that demonstrate the ability of the SuperCipotes program to encourage the use of MNPs and handwashing to reduce anemia prevalence and diarrheal disease, respectively, and to reduce school absenteeism due to illness. A secondary component will demonstrate that children who receive the intervention perform better in school as a result of reduced absenteeism and better cognitive development attributable to better nutrition and overall health. Specifically, measured indicators include: Prevalence of anemia, measured by hemoglobin concentration in the blood using a HemoCue brand test. This indicator will determine the effectiveness of MNP supplementation to increase hemoglobin concentration. Prevalence of diarrhea, measured caregiver reporting of incidence of four or more watery stools in a 24-hour period in the last two weeks. This indicator will determine the effectiveness of handwashing education integrated into school curricula. Handwashing, measured by caregiver reporting of handwashing with soap before mealtimes and after using the bathroom. This indicator will determine the effectiveness of handwashing education integrated into school curricula. School absenteeism, measured by school attendance records and referring to percentage of child-days missed due to illness. This indicator will serve as a proxy for improved health status among students as a result of reduced anemia and diarrhea prevalence. Knowledge of the benefits of MNP supplements and handwashing to prevent illness in children, measured by questionnaire administered to caregivers and defined as knowing at least one benefit of each behavior and at least one critical moment at which to wash hands. This indicator will demonstrate the effectiveness of the educational component of the SuperCipotes program. Cognitive development, measured by caregiver reports of child cognitive and motor skills. This indicator will demonstrate the associations between MNP supplementation (and resulting improved health) and cognitive development outcomes. This will add to the existing evidence that micronutrient deficiencies can have negative effects on early childhood development.