Young children living in remote Indigenous communities have long been known to suffer from iron deficiency and anaemia at many times the rates found among other Australian children. Now a new report shows rates of anaemia among these remote children at twice the level previously reported.
The Early Childhood Nutrition and Anaemia Prevention Project looked at six remote communities across the Northern Territory, Western Australia and Queensland, and found almost 90% of children had been anaemic at least once during the ages of six months to 24 months.
It also found that 56% of the infants were anaemic at their first haemoglobin check at six to nine months, which was worse than expected.
The World Health Organisation classifies these levels as a severe health problem.
The study was part of a broader project, run by the University of Western Australia, James Cook University and Menzies School of Health Research, in collaboration with NT Health and Community Services, Queensland Health and various community controlled health services, as well as the Fred Hollows Foundation.
Only 5% of mothers surveyed reported that fruit was part of their young child's diet and only 29% of children who were found to be anaemic received the full course of iron treatment needed.
The researchers tested the feasibility of a nutrient supplement program. As part of the project, local community-based health workers distributed to mothers sachets of multi-micronutrient powder called "Sprinkles", together with nutrition messages about breastfeeding and healthy food. The powder was mixed with semi-solid food for young children to eat.
The authors of the study looked at qualitative data collected over a two year period and found the Sprinkles supplement was well accepted into the communities and appears to have helped maintain good haemoglobin levels among non-anaemic children. Haemoglobin carries oxygen in the blood.
Cheap, easy junk food
Dympna Leonard, Senior Lecturer at James Cook University, who worked on the project said that, "no supplement is ever going to be a substitute for healthy food, but the Sprinkles can enhance a child's diet during a short period when nutrient requirements are particularly high."
Poor nutrition amongst children typically reflects poor diet and health across the wider community, "as well as impacting on children's health, iron deficiency and anaemia can have long lasting detrimental effects on children's educational attainment," Ms Leonard said.
"Prevention and intervention needs to start earlier, ideally before a woman becomes pregnant," she said.
"What we are finding in these remote Indigenous communities is the end point of the loss of their land and loss of their traditional food supply, meaning people now depend on what they can buy at their local food store, on a low income."
"The supply of healthy food to these remote communities has improved, but at the same time, the supply of junk food has also become more readily available and it is cheap, relative to more nutritious food," Ms Leonard said.
Associate Professor Kate Senior, anthropologist at the Menzies School of Health Research and a co-author of the report, said training the community workers allowed them to continue the job beyond the life of the project.
"Young women are now empowered to have conversations about these enduring problems in their communities," she said.
"A project over two years can't change what is an endemic problem, but it alerts and educates people to the importance of a good diet."
Recommendations from the study included ensuring remote health care centres performed regular child health checks and improved access to healthy and affordable food, especially for mothers, babes and young children.
Professor Amanda Lee, an expert in the field who was not involved in the study, said "it's great that they have identified high rates of anaemia, but this work should be done as a matter of course, not as a research project".
"Together with monitoring infant growth, this is a basic health care assessment that should be provided regularly in communities," she said.
"Sprinkles on food is great, but it's fiddling around the edges of a broader problem. We need a systematic approach to addressing food security in these communities. We need to do better as a nation."