Objectives
To scale and sustain an evidence-based Home Fortification with Micronutrient Powder (MNP) programme for improved complementary feeding of children 6-23 months in Rwanda.
Methods
A multi-phase protocol was developed to bridge evidence and implementation of Home Fortification with MNP at scale for improving complementary feeding practices. Formative research and an effectiveness study were followed by a phased national scale-up. Advocacy activities and capacity building were carried out with government ministries, UN and NGOs, and partnerships were formed for sensitization and implementation activities.
Results
Partnerships were formed with 7 implementing partners in 19/30 districts. Trainings on hygiene, complementary feeding, and usage of MNP were conducted with all 344 hospital and health centre nutritionists, supervisors of community health workers (CHWs) and 29,635 CHWs using community based training materials. Monthly distribution to caregivers took place during nation-wide growth monitoring activities along with cooking demonstrations and continuous trainings on the appropriate use of MNP which provided a platform for reinforcing key Infant and Young Child Nutrition messages and practices. Current beneficiaries are ~300,000 children 6-23 months.
Conclusions
The scale-up of MNP as a component of improved complementary feeding has been integrated within Rwandas health care system and highly accepted amongst the community. Essential to this process has been strong government ownership, available technical NGO support, a well-developed functional CHW system, and intensive external monitoring. The process has reached women and men caregivers countrywide with behaviors sustained across the scale-up. Sustainability is supported through national policy and commitment from development partners as well as assured, sustainable funding.
