Formative research, pilot study, and gradual national scale-up of home fortification with micronutrient powders programme for children 6 to 23 months (supported by the Ministry of Health and UNICEF Sierra Leone)

Background

The current burden of malnutrition among young children in Sierra Leone is reflected in the high prevalence of anaemia and stunting, or low height for age, an indicator of chronic undernutrition. The first 1,000 days of life, the period from conception to approximately two years of age, are considered critical for physical and cognitive development. It is well-recognized that the consequences of inadequate nutrition, often coupled with frequent infections, during the first 1,000 days of life, can permanently impact a child’s physical and cognitive potential. Inadequate access to nutritious food and sub-optimal infant and young child feeding practices are major contributors to nutritional deficiencies in children in Sierra Leone and hence there is a need for integrated solutions to improve the quality of young children’s diet.

Our work

Formative research was conducted by the Nourish team on home fortification with micronutrient powders in Sierra Leone from 2013 to 2014 in collaboration with the Government of Sierra Leone and UNICEF. The aim of this research was to ensure the effective and successful introduction of micronutrient powders through product packaging design, to improve understanding of child feeding practices, and to investigate appropriate distribution channels and optimal methods to integrate the programme with community-based nutrition education. The pilot study and gradual scale-up of the programme was postponed due to the Ebola emergency in the second half of 2014; however, our team returned to Sierra Leone in 2015 to assist with a 60-day pilot study that included a baseline and endline survey as well as a midpoint health worker assessment and responsive monitoring throughout the study. The intensive monitoring and evaluation component included knowledge, attitudes and practices on infant and young child feeding as well as intervention coverage, adherence, and acceptability to guide the national scale-up, which began in 2016 with the goal of reaching over 65,000
children.