ABSTRACT
Objectives: To address the high prevalence of anemia and chronic malnutrition (71% and 43% among children <5 respectively), UNICEF and CDC supported the Ministry of Public Health to develop an integrated IYCN pilot program in October 2012, which includes the distribution of a small-quantity, lipid-based nutrition supplement (SQ-LNS), through the routine health system. The program targets 16,500 children 0-12 months and their mothers. Methods: The program involves i) monthly individual and group IYCN counseling by trained health workers and volunteers, and ii) a monthly distribution of SQ-LNS (locally known as Kulabora) to children 6-12 months through the health system, for daily consumption. Formative research was conducted to generate culturally acceptable key counseling messages and product branding. Routine health system reporting and bi-annual Lot Quality Assurance Surveys (LQAS) are used for program monitoring. Results: After 10 months of intervention, LQAS data showed 65% of mothers received the Kulabora at the last monthly health center visit, 53% received IYCN counseling at this visit, and additionally 55% received counseling by volunteers at home. Routine monitoring data reports that 3,100 women have enrolled in the program and approximately 2,000 children receive Kulabora monthly. Results from two rounds of LQAS show improvements in several IYCN indicators. LQAS data has allowed for targeted corrective action and further formative work will be used for program strengthening. Conclusions: Formative research has been important for program success, and program implementation is possible even in difficult settings. The impact assessment in October 2014 will inform a possible scaling up of the program.
ABSTRACT
Objectives: Home fortification is an innovative way to improve the diet with essential nutrients for targeted vulnerable groups who have higher requirements or do not benefit from other micronutrient interventions. As a relatively new program, there is a tremendous need for technical support. The idea of a community of practice was developed to facilitate inter-country and inter-agency dialogue and learning, with the following objectives: 1. To provide an opportunity and space to exchange information and experiences between program. Implementers. 2. To enhance learning, generate new knowledge and document lessons learned and best practices; and 3. To facilitate coordination, harmonization and support for the scale up of home fortification. Methods: Online survey and informal interviews were conducted to incorporate target users’ opinions on the online community’s organizational, technical and operational features, and the desired benefits and potential barriers to participation. Lessons from existing successful online communities were used to inform stakeholders’ engagement and increase their awareness and involvement. Results: The Home Fortification Network (network.hftag.org) was branded and created as an online discussion forum with organized topics and with document-sharing capabilities. A moderator helps to connect users and facilitate discussion. Different stakeholders around the world are engaged and promote its global awareness and participation. Conclusions: The Home Fortification Network at network.hftag.org is an online community of practice created to facilitate and improve inter-country and inter-agency communication and collaboration to support the implementation and scaling-up of home fortification programs around the world.