Lessons Learned for Operational Guidance, Face-to-Face Meeting
Meeting the nutritional needs of young children is a particularly important issue in global health, as insufficient nutrition during periods of rapid growth can have serious effects on health and other outcomes1. The long-term solution for solving micronutrient inadequacy is ensuring a sustainable and diverse diet through food-based approaches. However, many times it is necessary to complement the nutritional value of the diet using specific interventions. One promising strategy for reaching young children is using supplements in the form of micronutrient powders (MNPs) which are consumed mixed in the child’s food, in a strategy popularly called ‘point-of-use’ fortification or ‘home-fortification.’ Evidence from efficacy studies has shown that MNPs improve iron status and reduce anemia2. The WHO currently recommends providing MNPs to children 6-23 months of age, in conjunction with malaria control measures.
Micronutrient powder programs have expanded rapidly. As of 2011, 22 countries were implementing MNP programs3 and by 2013, the number doubled to 43 with an additional 21 countries planning to start in 20144. Although many of these interventions are small in scope, MNPs reportedly have been delivered at scale in 14 countries.
On behalf of USAID, SPRING has been leading an MNPs consultation with the purpose of providing contextualized operational guidance on MNP programming to USAID missions. The objectives of the consultation are to: (1) identify and summarize experiences, emphasizing lessons learned from the field within MNP programming, using existing documents, reports, and country experiences, (2) define essential logistical components that should be included in any MNP program to ensure national-ownership, context specificity, and sustainability and (3) prioritize an MNP operational research agenda. The consultation began in July 2015, when 20 country and global-level experts were invited to participate in one of three working groups to develop white papers realizing these objectives.
On October 19th and 20th, 2015, a face-to-face meeting of consultation members was held to allow for wider deliberation of the working groups’ initial findings. Country-level programmers and policy makers from Bangladesh, Bolivia, Guatemala, Indonesia, Kyrgyzstan, Mongolia and Tanzania were in attendance along with global advisors from PAHO, CDC, GAIN, HKI, Hospital for Sick Children, IFPRI, Manoff Group, PSI, Swiss Institute of Technology, Tufts, UNICEF, and WFP for two days of discussions and working sessions. A total of 45 members participated, including USAID and SPRING staff.
The resources below include some of the background and meeting materials, and presentations from both days of the event.
A meeting report summarizing the proceedings will be disseminated later this year. It is expected that in 2016, the working group white papers will be published in a journal supplement, and finally, that a USAID Implementation Guidance Brief on the use of MNPs will be developed and finalized. Sign up for SPRING updates to be notified when these final reports and papers become available.
Resources
Agenda (PDF, 149 KB)
Participant Guide (PDF, 1.42 MB)
Day One
Inaugural Session
Setting the Context of MNPs in Public Health Nutrition Programming (PDF, 193 KB)
Objectives and Expected Results (PDF, 297 KB)
Session 1
Program Experiences Around Micronutrient Powders (PDF, 839 KB)
Existing guidance around MNPs (PDF, 735 KB)
Biological impact of MNPs: A Focus On Infants and Iron (PDF, 4.4 MB)
Session 2
Micronutrient Powders Project: Key Findings (PDF, 654 KB)
Lessons Learned From Market Based Approaches to MNP Distribution & Promotion (PDF, 1.2 MB)
Day Two
Recap of Day One (PDF, 381 KB)
Final Session
REFINE: Research Engagement on Food Innovation for Nutritional Effectiveness (PDF, 441 KB)
Highlights From the SQ-LNS Meeting (PDF, 925 KB)
1 Bhutta ZA (2008). Micronutrient needs of malnourished children. Curr Opin Clin Nutr Metab Care. 2008 May;11(3):309-14.
2 De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP (2011). Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review) Evid.-Based Child Health (Cochrane Review Journal) 8:1: 112–201 (2013)
3 UNICEF/CDC/HFTAG Global Assessment Report 2011- Data on MNPs HTFAG.org assessed 25/06/2015
4 UNICEF Nutridash 2013 Global Report of the Pilot Year