The objective of this research was to develop a locally appropriate home fortification program (HFP) for children (6-18mo) and assess feasibility/acceptability.
Formative research was used to develop and contextualize an integrated HFP and IYCF program that was implemented as a cluster randomized community pilot in Western Bihar where 70 health sub-centers (HSC) were randomly allocated to intervention (counseling + HFP) or control (counseling only). Cross-sectional surveys at baseline/endline (1yr) among 4340 children, 6-18mo and 560 Field Level Workers (FLWs) will examine acceptability/utilization of HFP and impact on IYCF practices, hemoglobin, growth and development (currently ongoing). To examine program-impact-pathways monitoring data are collected using checklists at various levels to measure HFP receipt/use at household and FLW level and attendance/training content at FLW meetings. At 4-5 months a program maturity assessment was conducted by surveying 840 households and 420 FLWs, alongside qualitative in depth interviews and focus group discussions with HHs and FLWs.
Midline program maturity survey confirmed HSC meetings occurred as planned with 99% FLW participation and reports of high program knowledge. In intervention HSCs, 76% of households reported having heard of HFP, 40% of households reported receiving HFP within the last month and 71% of these reported consumption within the last week.
The use of monitoring data are critical to identify supply issues and develop a strategy to improve program delivery. Acceptability of the product was high. Insights from ongoing monitoring and evaluation data are needed and will be used to inform potential program scale up.