Coverage of Nutrition Interventions Intended for Infants and Young Children Varies Greatly across Programs: Results from Coverage Surveys in 5 Countries

Abstract

Background: The efficacy of a number of interventions that include fortified complementary foods (FCFs) or other products to improve infant and young child feeding (IYCF) is well established. Programs that provide such products free or at a subsidized price are implemented in many countries around the world. Demonstrating the impact at scale of these programs has been challenging, and rigorous information on coverage and utilization is lacking.Objective: The objective of this article is to review key findings from 11 coverage surveys of IYCF programs distributing or selling FCFs or micronutrient powders in 5 countries.Methods: Programs were implemented in Ghana, Cote d’Ivoire, India, Bangladesh, and Vietnam. Surveys were implemented at different stages of program implementation between 2013 and 2015. The Fortification Assessment Coverage Toolkit (FACT) was developed to assess 3 levels of coverage (message: awareness of the product; contact: use of the product ≥1 time; and effective: regular use aligned with program-specific goals), as well as barriers and factors that facilitate coverage. Analyses included the coverage estimates, as well as an assessment of equity of coverage between the poor and nonpoor, and between those with poor and adequate child feeding practices.Results: Coverage varied greatly between countries and program models. Message coverage ranged from 29.0% to 99.7%, contact coverage from 22.6% to 94.4%, and effective coverage from 0.8% to 88.3%. Beyond creating awareness, programs that achieved high coverage were those with effective mechanisms in place to overcome barriers for both supply and demand.Conclusions: Variability in coverage was likely due to the program design, delivery model, quality of implementation, and product type. Measuring program coverage and understanding its determinants is essential for program improvement and to estimate the potential for impact of programs at scale. Use of the FACT can help overcome this evidence gap.

Farm-Level Agricultural Biodiversity in the Peruvian Andes Is Associated with Greater Odds of Women Achieving a Minimally Diverse and Micronutrient Adequate Diet

“…Therefore, while more diverse agricultural production was only moderately associated with more diverse and higher quality diets in absolute terms, it may have been important for achieving more adequate diets at the margin among women with less adequate diets. These findings are aligned with previous experimental research demonstrating that both direct dietary interventions as well as indirect, nutrition-sensitive interventions are more likely to yield dietary improvements among households and individuals with less adequate diets (33,34).…”

Advances in the measurement of coverage for RMNCH and nutrition: from contact to effective coverage

“…Finally, definitions of effective coverage vary across disciplines. For example, for food fortification programmes, effective coverage has been defined in some studies as the proportion of the population in need that uses the product with recommended frequency and quantity 10…”

Role of home visits by volunteer community health workers: to improve the coverage of micronutrient powders in rural Bangladesh

“…Based on literature about the coverage of MNP (6,7,(18)(19)(20)(21) , we identified two levels of covariates for this analysis: individual and household. Covariates at the individual level included age of the participant child in months, sex of the child (male or female), age of the caregiver in years and educational status of the father of participant child (years of education completed).…”