Recent reviews of dietary intake data from Benin showed that recommended daily intakes of key micronutrients, such as vitamin A and Fe, were not met( 1 – 4 ). At the sub-national level, in northern Benin, macronutrient intakes are also too low( 5 , 6 ). Lack of dietary diversity is a particularly severe problem in Benin where diets are based predominantly on starchy staples with little or no animal products and few fresh fruits and vegetables( 1 , 2 , 7 ). According to the last Demographic and Health Survey (DHS) carried out in 2012, only 28 % of rural children satisfied the minimum diversity criterion of eating at least four out of seven food groups and 14 % consumed the minimum acceptable diet. In addition, the prevalence of stunting, wasting and underweight was respectively 40, 5 and 19 % among children aged 6–59 months, while 9 % of rural women had chronic energy deficiency (BMI<18·5 kg/m2)( 7 ). To improve the nutrition situation of women and children in Benin, the Ministry of Health has undertaken several interventions through its Strategic Plan for Food and Nutrition Development, comprising the supplementation of three major nutrients (vitamin A, Fe and iodine) and other promotive activities, such as exclusive breast-feeding, appropriate complementary feeding, and improved maternal and child nutrition( 8 ).
Despite the efforts of the line ministry and its stakeholders, Beninese women aged 15–49 years (41 %) and children aged 6–59 months (58 %) are significantly affected by anaemia with greater prevalence in rural areas( 7 ). Other nutritional data, such as Fe and vitamin A status, however, were not documented in the Benin 2012 DHS. In the 2006 Benin DHS, vitamin A deficiency (VAD) as measured by serum retinol <20 μg/dl was estimated to affect 66·0 % of children aged 12–71 months while the prevalence of night blindness was 11·8 % among pregnant women( 9 ). The few studies of micronutrient deficiencies among rural populations were conducted in specific localized groups and revealed greater prevalence rates of VAD among 12–71 month-old children (82 %) and pregnant women (14 %) in northern Benin( 9 ), while 33–49 % of children under 5 years of age were Fe deficient( 10 ). Until now, to our knowledge, there have been no population-based studies permitting generalization about the epidemiology of anaemia and its principal determinants in non-pregnant women, despite the problem being among the top ten causes of morbidities in the country( 11 , 12 ). The only study that identified anaemia risk factors among Beninese children was carried out in 2007 and found that incomplete immunization, stunted growth, recent infection, absence of a bednet, low household living standard, low maternal education and low community development index increased the risk of anaemia( 13 ).
As such, identifying the magnitude of anaemia and deficiencies of Fe and vitamin A and their determinants in high-risk groups, such as women of childbearing age and children, is essential for evidence-based intervention modalities, particularly in rural areas, where women and children may suffer not only from micronutrient deficiencies but also a shortage of food( 14 ). The present study is a very important step forward to avail of evidence-based information on the distribution of anaemia and micronutrient deficits and their predisposing diet and health factors among rural women and children in northern Benin. It will help understand the contemporary health profile of the rural populations of the study area in terms of dietary, socio-economic and environmental factors.