Home Fortification with a Small-quantity, Lipid-based Nutritional Supplement to Improve Complementary Feeding and Child Nutritional Status in Kasenga (DR Congo)

Abstract

Objectives: To address the high prevalence of anemia and chronic malnutrition (71% and 43% among children <5 respectively), UNICEF and CDC supported the Ministry of Public Health to develop an integrated IYCN pilot program in October 2012, which includes the distribution of a small-quantity, lipid-based nutrition supplement (SQ-LNS), through the routine health system. The program targets 16,500 children 0-12 months and their mothers. Methods: The program involves i) monthly individual and group IYCN counseling by trained health workers and volunteers, and ii) a monthly distribution of SQ-LNS (locally known as Kulabora) to children 6-12 months through the health system, for daily consumption. Formative research was conducted to generate culturally acceptable key counseling messages and product branding. Routine health system reporting and bi-annual Lot Quality Assurance Surveys (LQAS) are used for program monitoring. Results: After 10 months of intervention, LQAS data showed 65% of mothers received the Kulabora at the last monthly health center visit, 53% received IYCN counseling at this visit, and additionally 55% received counseling by volunteers at home. Routine monitoring data reports that 3,100 women have enrolled in the program and approximately 2,000 children receive Kulabora monthly. Results from two rounds of LQAS show improvements in several IYCN indicators. LQAS data has allowed for targeted corrective action and further formative work will be used for program strengthening. Conclusions: Formative research has been important for program success, and program implementation is possible even in difficult settings. The impact assessment in October 2014 will inform a possible scaling up of the program.