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Wind-up of field work and unwinding information from the BiZiFED2 study

This study blog was headed by Dr Swarnim Gupta, who is a Research Associate in Nutrition at the University of Central Lancashire, and Muhammad Javaid, a Project Manager with BiZiFED2

It is an exciting time for BiZiFED2- marking the end of field work and the beginning of a stage where enormous amount of information gathered under this large-scale project is going to be analysed. This will help us conclude the effectiveness of a zinc biofortified wheat variety to reduce zinc and iron deficiencies to help stakeholders, including policymakers, make informed decisions. In our previous blogs, we have talked about various challenges faced by this project running in marginalized communities of north-west Pakistan. 

To name a few- a massive hit by COVID -19 wave and associated restrictions, unfavourable weather to impact zinc concentrations and yield in the biofortified variety grown locally for distribution in the trial, and a hike in wheat prices as a consequence of natural calamities such as COVID-19 outbreak and locust attack that impacted wheat market . In this blog we bring you a sight of the finale of the ‘seemingly impossible’ community-based work and updates on our ongoing and upcoming activities.

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We successfully extended the first phase of the trial, where locally available non-biofortified flour was provided to participating households, by several months. Unfortunately, the duration of the second phase had to be compromised by a month. This second phase was an intervention phase where participating households were randomly assigned to either receive locally grown biofortified wheat flour or to a control group getting non-biofortified standard flour. 

Trimming down this phase to five months instead of the planned six-month period had to be done in response to an anticipated upward progression of the pandemic, and the uncertainty around the adequate supply of biofortified grain for full six months due to unprecedented rain that resulted in a lower yield. The fieldwork was successfully wrapped up by March this year, with 413 out of 517 pairs of adolescent girls and children still participating at the endpoint despite a stretch of the overall timeline by four months.

We are thankful to our participating communities for their splendid co-operation and our implementation partners for leaving no stone unturned to foster confidence in the communities towards the project. At the end of March, we organised community meetings in the project areas to convey our heartfelt gratitude to the members. We are eager to go back to them to share the study findings as soon as we can.

One of the project's achievements was the way in which our field team adjusted to the pandemic, following strict new procedures and precautions to safeguard the community against the spread of COVID-19 infection. The dedicated effort by our entire field team and management at Peshawar not only helped this project reach the climax, but also to a ‘safe’ culmination with no COVID-19 reported among the participating households during these data collection periods. 

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At the end of March, the project team celebrated hard-earned trial completion, and members also shared experiences of their journey on this occasion. To many, it seemed like a thrilling roller coaster ride ending up in great learning experiences. Staff members expressed that initially they were challenged by what they perceived as a complex structure of the research design and data gathering for multiple variables. Also, a difficult terrain with far spread of the households, unfavourable weather conditions and pandemic etc. added to the difficulties in the implementation.

They credit competent, experienced and committed leadership as well as continuous training that helped them build capacity and turned the project path from being bumpy to a smooth one. Dure Nayab, Nutritionist BiZiFED2, mentioned “In the beginning, females from the community were not at ease with us. With time, we learned the appropriate ways to approach them and make them feel comfortable. We developed bonds with them which made all the data gathering easy. These community women not only accepted us but are also grateful towards Abaseen Foundation for carrying out this project.”

In one of our previous blogs we mentioned about a short delay in spraying zinc on the biofortified wheat crop because of the wind and unprecedented heavy rains, while this crop to be used for flour feeding in the trial was growing in the farms near the Peshawar district. Our preliminary results confirm that this Zincol-2016 grain has been able to successfully assimilate high zinc concentration despite unforeseen circumstances in the ‘real world’ scenario.

This gives us more confidence in our agronomic fortification approach. We keenly look forward to understanding if these high zinc concentrations translate in terms of human health status benefits. Unfortunately, our plans for analysis have been slightly delayed as we have been facing massive challenges in moving samples for analysis to be conducted outside Pakistan due to pandemic induced interruptions in cross border flights. Currently, we are busy analysing the blood, hair, and flour samples at various labs located in Pakistan, UK, and US. Also, information gathered on other parameters such as anthropometry, dietary intake, incidences of diarrhoea and upper respiratory tract infection among participants is being made ready at UCLan for statistical analysis. These biochemical, morbidity and growth measurements will help to see if the intervention is making any impact in relation to iron and zinc deficiencies.

We have also completed our qualitative research to explore the perspectives of wheat farmers, flour millers and flour consumers in the study communities on factors influencing the decision to choose biofortified wheat and their experience of participating in our trial. Our enthusiastic team has already begun to analyse this data. Early scanning of the transcripts from the focus group discussions with consumers does hint towards, in general, an appreciation of flour quality, regular maintenance of supply even in pandemic, and some perceived health benefits. 

Though some members of the community who were not eligible to participate in the trial expressed dissatisfaction and felt some mistrust towards the programme, this was happily challenged by those who had participated. It is pleasing to note that the trial participants felt optimistic about the programme and wished for its continuation. Many of the participants have shown interest in buying the ‘new variety’ of flour via the market if it does not overburden their pockets compared to the regular flour.

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We had to put on hold organising a networking event for the stakeholder mapping due to travel restrictions imposed by COVID-19. This exercise would assist us in identifying influencers to scale up biofortified wheat in Pakistan, and possible ways to support local communities to access the biofortified wheat.

We are hoping to arrange this event in Islamabad, Pakistan in early 2022 when we will also share our findings with higher-level stakeholders.

We look forward to updating you once again on our activities and the study findings.

For more information please visit the BiZiFED project page