Home Fortification with Micronutrient Powders to address Micronutrient Deficiencies among Children 6-23 months in Sierra Leone
UNICEF Sierra Leone (2013 – present)
The 2008 Sierra Leone Demographic Health Survey results show that 76 percent of children ages 6-59 months in Sierra Leone are anaemic, of which 28 percent are mildly anaemic, 44 percent are moderately anaemic, and 4 percent are severely anaemic. The prevalence of anaemia declines with age, from 87 percent among children aged 12-17 months to 68 percent among children aged 18-47 months. Anaemia is equally common in boys and girls in Sierra Leone. Children in rural areas (77%) are more likely than those in urban areas (73%) to be anaemic. Looking at the regional patterns, children in the Northern and Eastern Regions are the most likely to be anaemic (79% and 74% percent respectively), than in the Western Region (72%). Likewise, there are discrepancies in wealth quintiles where children from the middle (79%) and lowest (76%) quintiles are more anemic than their counterparts from the wealthier quintile (68.7%). The prevalence of anaemia is also high among children whose mothers have little or no education.1
The outcome of this program will enable the Ministry of Health and Sanitation (MoHS) and partners to effectively develop, introduce and implement an effective MNP intervention for control and prevention of anaemia and iron deficiency in the Sierra Leone context, in line with government Nutrition Policy. Home Fortification is not a stand-alone intervention, but is meant to be introduced as a component of improved Infant and Young Child Feeding (IYCF). Therefore the introduction of Home Fortification in Sierra Leone will create appropriate linkages with the IYCF counselling and promotion program, which aims to improve the feeding practices of children in terms of quality, quantity, and frequency of diets in its bid to impact on the overall physical and mental development of young children.
The purpose of the consultancy proposed by our team is to provide technical support to the Food and Nutrition Programme Ministry of Health and Sanitation (MoHS) and partners as well as to oversee the modeling of the implementation of Home Fortification protocol in one district of Sierra Leone as outlined in the concept note by the National Technical Committee.
The formative phase was to address the purpose through different methodologies including:
1) a feasibility study with focus groups and key informant interviews and;
2) a 30-day acceptability trial of home fortification with MNP among a sample of households in two districts.
The next step of the project is the 90-day pilot of home fortification with MNP in two districts.
The objectives of the pilot were to generate evidence and recommendations that help identify the most effective strategy for the pilot and scale-up with regard to procurement, distribution, storage, and delivery (communication, training, MNP product) and to develop a MNP monitoring and evaluation plan to integrate with existing systems for health reporting, as well as any corresponding recording and reporting tools.