To pilot a Home Fortification with micronutrient powder (MNP) programme as part of the post-Ebola resilience plan for vulnerable children in Sierra Leone.
Formative research was conducted (2013-2014) to ensure successful introduction of MNP through package design, understanding of feeding practices, appropriate distribution channels and effective integration with community-based IYCF counselling. A micronutrient survey assessed iron and vitamin A status in young children.Programme design, training and communication materials were tailored for the post-Ebola context, high malaria prevalence and results from formative research. Home Fortification was integrated with improved complementary feeding practices and infection prevention to address multiple causes of deficiencies among young children.
High levels of anaemia (76.3%) and vitamin A deficiency (17.4%) were found among young children at baseline; iron deficiency anaemia was lower than anticipated (5.2%). IYCF and WASH practices among caregivers of young children were sub-optimal. Health workers, caregivers and community members responded positively to the messages and activities of the MNP programme. Gaps were identified in bednet usage and access to appropriate treatment for malaria; integrated monitoring with the MNP programme promoted proper implementation of community case management of malaria.
The Home Fortification with MNP programme was well receivedby health workers, caregivers and community members, and contributed to improved IYCF practices. The cause of anaemia among young children remains unclear although multiple micronutrient deficiencies are probable based on current sub-optimal IYCF practices. Implementation of Home Fortification with MNP in Sierra Leone will help address gaps in micronutrient intake as a component of improved complementary feeding.