Objective: To determine the feasibility of distributing micronutrient powders (MNP) for home fortification during biannual Maternal, Neonatal and Child Health Week (MNCHW) events, as a strategy to improve young child nutrition. Design: We evaluated the coverage, delivery, use and adherence of MNP, and associated behaviour change communication (BCC) materials and social mobilization, through cross-sectional surveys of caregivers attending healthservice distribution events and health workers involved in MNP distribution, facility-based observations of MNP distribution activities and a repeated survey of caregivers in their homes who received MNP for their child. Setting: Four Local Government Areas in Benue State, Nigeria. Subjects: Caregivers of children 6-59 months of age attending health-service distribution events. Results: The 8 million MNP delivered in this pilot during three distribution events were estimated to reach about one-third of eligible children in the area at each event. Programme fidelity was limited by shortages of MNP, BCC materials and inadequate social mobilization, with some limitations in health worker training and engagement. MNP use was consistent with the recommended two or three sachets per week among 51-69 % of caregivers surveyed at home. Conclusions: MNP coverage was low, but consistent with that typically achieved with other services delivered through MNCHW in Benue. Among caregivers who received MNP, acceptance and use among targeted children was high. While some weaknesses in knowledge and delivery of MNP by health workers were observed, health system strengthening and more extensive social mobilization would be key to achieving higher coverage with MNP and other health services provided through MNCHW.

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Background: Renewed efforts by the Nigerian government to address malnutrition have led to nutrition actions by several sectors, including the agriculture sector. However, the success of these actions depends on the characteristics of the stakeholders involved, including their relationships and coordination. Objective: This article reports a 2015 study of nutrition-sensitive agricultural stakeholders in Nigeria that assessed what the stakeholders do, where they work and how they are organized to improve nutrition. The study provides a baseline for assessing progress and measuring stakeholder and coordination changes in the Nigerian nutrition-sensitive agriculture landscape. Methods: Semi-structured interviews (n = 17) and focus group discussions (n = 2) were held with federal, state, and local government level stakeholders; reviews of stakeholder program documents were also conducted. Results: The study identified 7 groups of nutrition-sensitive agriculture stakeholders and several coordination challenges. Political leadership, advocacy and provision of material and human resource support by nongovernmental organizations, and donor interest and funding have been vital for mobilizing nutrition-sensitive agriculture. Still, although stakeholders frequently highlighted that nutrition was an important consideration in their interventions, nutrition goals and activities and/or indicators to measure outcomes were not regularly communicated. Also, while coordination mechanisms existed, there appeared to be minimal actual cross-sectoral partnerships because of inadequate trust, competition, and conflicts over institutional turf and mandates. Conclusions: Needed enablers for improving nutrition-sensitive agriculture in Nigeria included improved stakeholder nutrition literacy, as well as enhanced stakeholder engagement facilitated by role definition, clarification, and consensus. Exploring different approaches to coordination may also be necessary.

Objectives:The aim of this study was to: 1) ascertain the levels of compliance with national fortification standards for vitamin A and iron; and 2) use the results as an advocacy tool to improve compliance and regulatory monitoring. Methods: The study was carried out in 2012 using quantitative devices (BioAnalyt iCheck Ex-Flouro, Ex-Chroma and Ex-Iron) for the measurement of vitamin A and iron in sugar, vegetable oil and flour. Laboratory analyses were also carried out using high performance liquid chromatography and atomic absorption spectroscopy for comparison. A total of 293 samples were collected from six geopolitical zones. Results: 16.7%, 11.6% and 2% of sugar, vegetable oil and flour respectively met the minimum levels of fortification standards for vitamin A. 28.6% of flour samples met minimum levels for iron. Based on the results, the National Agency for Food and Drug Administration and Control (NAFDAC) developed a monitoring tool for retail samples. Trained food and port inspectors have been put in place. Conclusions:The outcome of this study revealed that food fortification compliance in Nigeria is low. The study and its effective dissemination prompted remedial action from NAFDAC. Monitoring tools and capacity building activities were revised and are now being implemented. Compliance