Nutrition, Iron Deficiency Anemia, and the Demand for Iron-Fortified Salt: Evidence from an Experiment in Rural Bihar

Iron deficiency anemia (IDA) is frequent among the poor worldwide. While it can be prevented with supplements or food fortification, these programs often do not reach the poorest. Further, little is known about the impact of treating iron deficiency anemia on productivity. This paper is the first of a larger project that investigates the feasibility and the impact of addressing IDA through partly subsidized double fortified salt (DFS)--salt fortified with iron and iodine--in rural Bihar. Analysis of a baseline survey in 400 villages suggests that anemia is prevalent (over 50% of adult women are anemic) and is correlated with lower physical and cognitive fitness at all ages. This is despite the fact that consumption per capita is not particularly low by the standards of rural India (INR 56 per capita per day), and average BMI is not very low, indicating that overall caloric intake must be adequate. This suggests that micronutrient deficiency is likely playing a key role. Almost all households purchase salt, which makes DFS a possible channel to distribute supplemental iron. A randomized pricing experiment suggests that subsidizing DFS by about 55% led to fairly large take-up, even without a detailed information campaign.