Home Fortification with Micronutrient Powders to address Micronutrient Deficiencies among Children 6-23 months in Uganda: Formative Research and Acceptability Trial
World Food Programme Uganda (2014 – present)
The 2011 Uganda Demographic and Health Survey (UDHS) indicates that poor nutritional status is widespread in Uganda. The diet lacks diversity as it is based on staple foods such as plantains (bananas), starchy roots, and grains. In general, the diet lacks the necessary energy and micronutrient density required for proper growth and development. Stunting (an indicator of chronic malnutrition) afflicts 33% of children aged 6-59 months and 49% of children in the same age group have some level of anaemia (22% mild anaemia, 26% moderate anaemia, and 2% severe anaemia). When anaemia prevalence exceeds 40%, the WHO considers it to be a public health issue, and it may be assumed that the broader population is suffering from some degree of iron deficiency.
The purpose of the formative research and acceptability trial is to gain vital information to inform a pilot programme for Home Fortification with Micronutrient Powders (MNP) for children 6-23 months of age in Uganda. Regions with particularly high levels of anaemia and/or stunting have been identified, with eight specific districts. This phase of the research is to assess the acceptability and utilization of MNP, and to inform a context driven Behaviour Change Communication (BCC) strategy.
While the efficacy and effectiveness of home fortification with MNP has been extensively evaluated, what needs to be determined are the different contextual elements that can lead to acceptability and adherence to the appropriate utilization of MNPs. Regional differences in knowledge, attitudes and practices around complementary feeding, food sources, understanding of anemia and iron deficiency, are commonly found and these differences are relevant to the design of behaviour change and communication materials, including packaging and messages for caregivers. It is therefore strongly recommended that Home Fortification projects undertake this essential step to ensure the development of a successful implementation strategy in Uganda.
The Micronutrient Project group designed and developed the study protocol, research tools, and communication strategy, including packaging and behavior change communication materials. Draft communication materials for use in the pilot districts are being field-tested during this phase of the work and modified accordingly to effectively guide programme implementation. The formative phase addresses the purpose through different methodologies including:
1) a feasibility study with focus groups and key informant interviews and;
2) a 20-day acceptability trial of Home Fortification with MNP among a sample of households in two districts.
The main objective of the pilot program was to inform a scale-up programme to introduce home fortification with Micronutrient Powders (MNP) for young children in Uganda.
1 Uganda Demographic and Health Survey, 2012