Informing National Scale-up of Micronutrient Powders: Evidence from a 12-month Effectiveness Study in Rural Rwanda

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.