Informing National Scale-up of Micronutrient Powders: Evidence from a 12-month Effectiveness Study in Rural Rwanda
Kristina Michaux *
University of British Columbia, Vancouver, BC, Canada.
Fidele Ngabo
Ministry of Health, Kigali, Kigali, Rwanda.
Abiud Omwega
United Nations Children's Fund, Kigali, Kigali, Rwanda.
Jennifer Foley
University of British Columbia, Vancouver, BC, Canada.
Tim Green
University of British Columbia, Vancouver, BC, Canada.
Judy McLean
University of British Columbia, Vancouver, BC, Canada.
*Author to whom correspondence should be addressed.
Abstract
Objectives: While the efficacy of Micronutrient Powders (MNP) at reducing anaemia is known, effectiveness within a Community-Based Nutrition Programme (CBNP) in Rwanda is needed to inform scale-up and policy.
1. Determine the acceptability and effectiveness of MNP on the reduction of anaemia in children aged 6-23 months in Nyaruguru and Musanze districts.
2. Investigate the feasibility of national scale-up of MNP within a CBNP.
Methods: A 12-month quasi-experimental control trial was conducted with 1049 mother/child pairs (intervention: n=569; control: n=480). Information on household demographics, IYCF knowledge, attitudes and practices, and morbidity, as well as children’s anthropometry and hemoglobin (Hb) were collected at baseline, 6 and 12 months. Caregivers were interviewed on the acceptability and perceived benefits of MNP at midline and endline.
Results: At endline, 98% of caregivers were willing to continue using MNP. A high percentage of mothers perceived benefits of MNP, including improved appetite (84%), increased activity levels (87%), and improved health (88%) of their child. Hb levels of children with moderate to severe anemia significantly improved in the intervention group compared to children in the control group (P<0.05).
Conclusions: Our results illustrate nearly universal acceptance of MNP among mothers. Together with the reduction in anemia, these findings demonstrate the feasibility of implementing national scale-up of MNP within Rwanda’s CBNP and will help achieve sustainable improvements in infant and young children’s health.