Home Fortification With Micronutrient Powders: Building Evidence Across Six Low-resource Countries

Introduction: International guidelines suggest that young children aged 6–23 months should receive fortified foods or micronutrient supplements to ensure adequate growth and development. Many low resource countries are implementing home fortification with Micronutrient Powders (MNP) due to its proven effectiveness and low cost; however, limited operational guidance exists to inform effective and sustainable programs.

Methods: The Micronutrient Project at the University of British Columbia has developed a methodology for scaling-up home fortification with MNP protocols for integration into national Infant and Young Child Feeding (IYCF) programs. We present an overview of lessons learned from formative research in six countries: Rwanda, Zambia, Uganda, Cameroon, Sierra Leone, and Lao PDR, where we conducted formative research and acceptability trials of MNP.

Results: Key lessons learned acquired from 2011 to 2014, include:  i) formative research prior to introducing home fortification with MNP programs is imperative for successful implementation and scale-up; ii) information is needed on country-specific IYCF beliefs and practices, particularly complementary feeding; iii) messages and training materials must be culturally appropriate and regionally specific to promote compliance and effectiveness; iv) uptake of MNP may be compromised where food vehicles, or feeding practices, are not in accordance with global guidelines; v)  acceptability, compliance, and willingness to continue using MNP are very high where caregivers are well informed and given simple, adaptable options in local circumstances.

Conclusion: Our findings confirm the need for formative research in implementing  home fortification with MNP programs to promote culturally appropriate and regionally specific messages, images, and guidelines.