Quality assurance and iron deficiency in Egypt.

OBJECTIVE To develop an intervention in rural Egypt to address the problem of iron deficiency anemia and to demonstrate the effectiveness of applying quality assurance (QA) methods in combating this. DESIGN Assessment of an intervention study utilizing QA methods. SETTING Rural primary care clinics in Egypt. STUDY PARTICIPANTS One hundred and eighty pregnant mothers (and their 180 children) were randomly selected at two clinic sites from all those who were diagnosed as having an iron deficiency disorder. INTERVENTION Multi-disciplinary teams were formed to develop and deliver health promotional approaches related to iron deficiency to the study participants. By using QA techniques the teams were able to strengthen local capacity and participant compliance to the educational messages. MAIN OUTCOME MEASURES Pre- and post-measurements of client satisfaction, results of hemoglobin lab tests, and the extent of retention of nutritional messages by the participants. RESULTS Eighty percent of the study population demonstrated satisfactory knowledge of the nutritional messages. There was a 75% improvement of client satisfaction with the clinic and an effective follow-up system of care was designed and implemented successfully for each clinic. On average, the number of children aged less than 5 years diagnosed with an iron deficiency disorder decreased from 37% to 5%. Similar success was achieved with the pregnant mothers: the prevalence of iron deficiency anemia was reduced from 100% to only 14%. CONCLUSIONS The use of QA process improvement techniques was extremely effective in reducing iron deficiency anemia among the target population. There is an increasing need to include quality methods in micronutrient intervention techniques.