title: A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening.
abstract: Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers' disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6-59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system.
authors.affiliation: Global Alliance for Improved Nutrition (GAIN), Geneva 1211, Switzerland. n.guyen_marie@yahoo.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Nguyen
authors.affiliation: Global Alliance for Improved Nutrition (GAIN), Geneva 1211, Switzerland. apoonawala@gainhealth.org.
authors.forename: Alia
authors.initials: A
authors.lastname: Poonawala
authors.affiliation: Global Alliance for Improved Nutrition (GAIN), Geneva 1211, Switzerland. magali.leyvraz@gmail.com.
authors.forename: Magali
authors.initials: M
authors.lastname: Leyvraz
authors.affiliation: Institute of Research for Development (IRD), UMR 204 Nutripass IRD-UM-SupAgro, Montpellier cedex 34394, France. jacques.berger@ird.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Berger
authors.affiliation: Global Alliance for Improved Nutrition (GAIN), Geneva 1211, Switzerland. dschofield@gainhealth.org.
authors.forename: Dominic
authors.initials: D
authors.lastname: Schofield
authors.affiliation: National Institute of Nutrition (NIN), Hanoi 100803, Vietnam. thuynga1997@gmail.com.
authors.forename: Tran Thuy
authors.initials: TT
authors.lastname: Nga
authors.affiliation: National Institute of Nutrition (NIN), Hanoi 100803, Vietnam. khanhvan206@yahoo.com.
authors.forename: Tran Khan
authors.initials: TK
authors.lastname: Van
authors.affiliation: National Institute of Nutrition (NIN), Hanoi 100803, Vietnam. dothibaohoa@gmail.com.
authors.forename: Do Thi Bao
authors.initials: do TB
authors.lastname: Hoa
authors.affiliation: Institute of Research for Development (IRD), UMR 204 Nutripass IRD-UM-SupAgro, Montpellier cedex 34394, France. franck.wieringa@ird.fr.
authors.forename: Frank Tammo
authors.initials: FT
authors.lastname: Wieringa
mesh_terms: D017028:Caregivers; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003296:Cooking; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000178:diet therapy; D004034:Diet Surveys; D019587:Dietary Supplements; D005191:Family Characteristics; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D018977:Micronutrients / Q000008:administration & dosage*; D010865:Pilot Projects; D011208:Powders; D011635:Public Health Administration; D014744:Vietnam
chemical_list: D018977:Micronutrients; D011208:Powders
keywords: IYCF; Vietnam; complementary feeding; delivery model; health system; micronutrient powders; sustainability