Browsing by Author "Suter, Mélanie"
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Item Building Operational Capacity for Successful Implementation of HOME Fortification: Academic Institutional Support for MNP Implementation.(2015) Suter, Mélanie; McLean, JudyObjectives: Many countries are expressing interest in implementing Home Fortification programmes using Micronutrient Powders (MNP) because of their proven effectiveness and low cost. A gap exists, however, between evidence based guidelines for practical implementation. Therefore our objective was to make technical support globally accessible and build operational capacity for successful implementation of MNP. Methods: As an academic institution and project group we have identified gaps, partners, research needs, and evaluated and streamlined existing guidelines for the implementation of MNP. We developed and field-tested tools for formative research to guide the design of MNP interventions integrated into IYCF and other programmes in Rwanda, Zambia, Cameroon, Laos, Sierra Leone, and Mali. Communication and training strategies and materials were developed, utilized, and continuously improved by our teams in multiple countries followed by comprehensive reporting and recommendations. Results: Broad contextual experience was built and made available to governments in implementing countries, organizational partners, and stakeholders through our team support. We facilitated knowledge exchange through national and global conference presentations and workshops. Research methods, communication and training materials, and monitoring & evaluation tools are constantly improved and adjusted and country specific implementation strategies for MNP are based on our findings. Conclusions: Creating an enabling environment for micronutrient interventions requires collaborative efforts from multiple stakeholders. Our university's multi-disciplinary team has enabled countries to move forward cost-effectively with Home Fortification programmes. Lessons learned are being integrated into practice-oriented technical guidelines and shared with other countries to operationalize and scale-up MNP programmes efficiently and effectively.Item High Levels of Iron Deficiency Anaemia (IDA) and Stunting by 6-11 Months of Age in Northern Zambia: Evidence of the Need for Early-Life Intervention Scale-Up.(2015) Daly, Zachary; Suter, Mélanie; Aongola Agnes, Dominique; Brunet, Dominique; Green, Tim; Mclean, JudyObjectives: Anaemia and stunting are widespread in Zambia with developmental implications from the individual to the national level. To address these conditions, an integrated Home Fortification with Micronutrient Powders (MNP) and Infant and Young Child Feeding (IYCF) programme has been introduced in Mbala district, Northern Province, Zambia. Here we present key findings from a baseline survey conducted to inform the project and investigate relationships among morbidity, biochemical and anthropometrics in children 6-11 months. Methods: A convenience sample of 631 child-caregiver pairs was recruited from health centres and outposts in Mbala District. We collected demographic, health, biochemical and anthropometric data. Children with severe anaemia or severe acute malnutrition were excluded and referred for treatment. Results: Stunting was 30% and 57% of the children were anaemic (haemoglobin <110 g/L), 42% were iron deficient (serum ferritin <30 μg/L) and 22% had IDA. Children with fever in the previous two weeks had higher rates of anaemia (65% versus 49%, p <0.001) and lower mean haemoglobin (104 g/L versus 107 g/L; p =0.005). 5% were Vitamin A deficient based on retinol binding protein <0.7 μmol/L. Furthermore, 74% of children had signs of inflammation (C-reactive protein >5mg/L and/or alpha-1-glycoprotein >1 g/L). Conclusions: The high rates of anaemia, stunting, and inflammation all indicate a high burden of disease and/or malnutrition among these young children. Children with recent fever were more likely to be anaemic which might have implications for physical and cognitive development. Interventions must target early life to prevent irreversible consequences.