Executive summary for the Micronutrient Powders Consultation: Lessons Learned for Operational Guidance

Abstract

Iron deficiency anaemia is estimated to be the leading cause of years lived with disability among children. Young children's diets are often inadequate in iron and other micronutrients, and provision of essential vitamin and minerals has long been recommended. With the limited programmatic success of iron drop/syrup interventions, interest in micronutrient powders (MNP) has increased. MNP are a mixture of vitamins and minerals, enclosed in single-dose sachets, which are stirred into a child's portion of food immediately before consumption. MNP are an efficacious intervention for reducing iron deficiency anaemia and filling important nutrient gaps in children 6-23 months of age. As of 2014, 50 countries have implemented MNP programmes including 9 at a national level. This paper provides an overview of a 3-paper series, based on findings from the "Micronutrient Powders Consultation: Lessons Learned for Operational Guidance" held by the USAID-funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. The objectives of the Consultation were to identify and summarize the most recent MNP programme experiences and lessons learned for operationalizing MNP for young children and prioritize an implementation research agenda. The Consultation was composed of 3 working groups that used the following methods: deliberations among 49 MNP programme implementers and experts, a review of published and grey literature, questionnaires, and key informant interviews, described in this overview. The following articles summarize findings in 3 broad programme areas: planning, implementation, and continual programme improvement. The papers also outline priorities for implementation research to inform improved operationalization of MNP.

Keywords: complementary feeding; evidence-based practice; infant and child nutrition; iron deficiency anaemia; micronutrients; programming.

Figure 1

MNP Consultation working group components. The three working groups included (a) planning and supply; (b) delivery, social and behavioural change communication (SBCC), and training; and (c) monitoring, process evaluation, and supportive supervision for continuous programme improvement. The working groups were composed of country‐ and global‐level MNP implementers, and each working group summarized evidence and lessons learned in their respective programmatic area. MNP, micronutrient powders

Figure 2

Literature search flow chart. The literature search flow chart presents the process undertaken to conduct to systematic review of literature related to micronutrient powders (MNP) programmes. Articles were included using the following criteria: (a) MNP as an intervention to children 6–59 months of age; (b) relevant learning for MNP intervention implementation; and (c) full text available in English. Exclusion criteria included formulation or safety trials, registrations of clinical trials, press releases, commentaries, and editorials. A systematic search was conducted of the following databases from inception of the Consultation to December 2015: PubMed, Conference Proceedings Citation Index—Science (CPCI‐S), EMBASE, Web of Science, New York Academy of Medicine's Grey Literature Database, Proquest Dissertation, and Theses Fulltext. A search strategy that combined various terms for MNP was modified from the search strategy used in the Cochrane review on efficacy of MNP (De‐Regil et al., 2013).