RESUMEN
Objectives Introduction: Home-based fortification of complementary food with micronutrient powders (MNPs) has been proven to reduce anemia. In resource constrained contexts - like Madagascar - where child diet is of poor quality and anemia levels high, the challenge lies in finding viable approaches for ensuring sustainable access to MNPs by vulnerable populations. Objective: To assess the effect of social marketing through community-based and private sector channels on access to MNP in rural and urban areas of Madagascar. Methods: Marketing research was conducted to develop product brand and logo. Quantitative and qualitative information was collected to assess infant feeding practices before and after introduction of IYCF [1] activities, awareness of child nutrition, and mothers' aspirations. Willingness-to-pay data helped determine price points and margins for intermediaries. [1] Infant and young child feeding practices. Results: Initial outcomes indicate high trial and acceptability rates among mothers both in urban and rural areas. The revenue from sales from the private channel is used to reinforce activities linked to the community based distribution. Between February and October 2013, 5,615 children received MNP. Of the 5,615 children, 21% (1,200 children) consumed 90 sachets in 6 months. Challenges with poor quality product (taste, odor) – influencing continuation rates -- were partially overcome through CHW counseling on food diversification. Conclusion: Social marketing appears a viable option for ensuring access to MNPs even by vulnerable segments of the population. Findings show this approach can improve communication around IYCF and provide evidence of a solid public-private sector partnership model that can be taken to scale.